Several approaches have been used to overcome the problem of implantation failure. Scratching of the endometrium prior to embryo transfer is one method of enhancing the likelihood of implantation. Usually, preceding cycle of the transfer, the endometrium is “scratched” with a small catheter known as the Pipelle®. The catheter is pushed forward through the cervix to the fundus, and then retracted in circular movements in order to stimulate the endometrium. Scratching can be performed on an outpatient basis without anaesthesia and no pain for the majority of patients.