Thin Endometrium

Thin endometrium is the tissue that lines the inner layer of the uterus and is essential for reproduction because embryo implantation takes place here. For a successful pregnancy, the embryo must attach itself to the endometrial lining. There are two hormones (Oestrogen and Progesterone) which help in preparing and thickening the endometrial lining for implantation. As the pregnancy progresses, all the nourishment that is required for the growth of a baby is supplied by the glands present in the uterine lining. And in the absence of a proper thick endometrial lining, it would be difficult to hold a pregnancy.
Thin Endometrium
Thin Endometrium

What is thin endometrium or thin lining of womb?

The uterus is lined with three layers. The outer lining is called serosa, the middle layer myometrium and the innermost lining of the uterus is called the endometrium. The endometrium lining keeps changing throughout the menstrual cycle. For an Embryo to go and implant in the endometrium, it should be in an optimal condition that is, and it should be thick and trilaminar with good blood supply.

When a woman is undergoing an IVF cycle, her endometrial lining is routinely measured through transvaginal ultrasound. Because an endometrium thickness of 8 mm or above is considered normal for successful embryo implantation, a thickness of less than 7 mm is considered as Thin Endometrium and having a thin uterine lining symptoms, may decrease the chances of a successful pregnancy. And if the endometrium lining is less than 5 mm, then there is no chance of pregnancy.

What are the thin endometrium symptoms?

Females who have thin uterine lining can have some issues, as the thin endometrium symptoms or the symptoms of thin uterine lining, pertaining to:

  • Infertility – Women who have thin uterine lining may have fertility issues, as a healthy endometrium with proper thickness is needed for implantation and growth of the foetus.
  • Abnormal Menstrual Cycle – They may also have an abnormal menstrual cycle which may include:
    • Painful periods –Periods may be accompanied by pain and is one of the common symptoms of thin endometrium.
    • Irregular timings of periods – The timings of the menstrual cycle are irregular and pose to be the possible signs of thin uterine lining.
    • Reduced menstrual bleeding – This is also one of the symptoms of thin uterine lining. Menstrual bleeding lasts for lesser time than usual because the endometrial lining that is needed to be shed off is very thin and has fewer tissues that need to be flushed out during the time of menstruation.
  • Asymptomatic – Many times, they can be no symptoms of thin endometrium and detected on ultrasound.

What are the causes of thin endometrium?

  • Low Oestrogen –Oestrogen hormone is necessary for the thickening of the endometrium and a woman who has thin endometrial lining may have a low oestrogen level. In this case, medication with oestradiol is prescribed, and its response monitored. If endometrial lining doesn’t thicken, then it may indicate that the blood supply is inadequate or there has been some damage to the tissues of the uterine wall.
  • Inadequate Blood Flow – There are a lot of reasons for inadequate blood flow to the uterus. A woman who leads a sedentary lifestyle may have reduced blood flow, causing the endometrial lining to shrink. If a woman has a tilted uterus then also it will receive less blood supply. Presence of fibroids, polyps also constricts the blood vessels, thus reducing blood flow to the endometrial lining.
  • Poor Health of Endometrial Tissue – Any kind of bacterial infection like endometrial TB, sexually transmitted diseases and pelvic inflammatory diseases can cause inflammation which can scar the endometrial lining.
  • D & C or any Surgeries – Many a time during dilation and curettage the functional basal layer of endometrium called basalis is removed, in this case, the new endometrial lining cannot grow, and the endometrium stays thin, this is called Asherman Syndrome and is difficult to treat.
  • Birth Control Pills – Women who take birth control pills for a long time, can have a non-functional and thin endometrial lining. Oral contraceptive pills are a combination of oestrogen and progesterone and whose overuse or withdrawal can result in changes in oestrogen level and the endometrial lining.
  • Clomid – These drugs are administered to stimulate ovulation. Excessive use of Clomid can cut off oestrogen supply, because of which the endometrium lining cannot grow in thickness.

Is pregnancy possible with thin endometrium?

A thin endometrium has been associated with implantation failures or can lead to early miscarriages due to lack of blood supply. If a woman has been facing fertility issues or having recurrent thin uterine lining miscarriage, a doctor might ask to get her oestrogen level, and endometrial thickness checked. For successful implantation of an embryo or successful pregnancy with thin uterine lining, the uterine lining should be more than 8mm. An endometrial thickness < 7 mm is associated with a lower probability of pregnancy. So, for a successful pregnancy with thin uterine lining, it is seen that hormone replacement therapy (HRT) and frozen embryo transfer (FET) has given better outcomes due to improved endometrial receptivity. The endometrial receptivity of endometrium can be checked through a molecular diagnostic test which helps to locate the implantation window, so a personalized embryo transfer can be done to reduce the chances of implantation failure.

What are the treatment options for thin endometrium?

For a successful pregnancy, a thin endometrial lining should be properly evaluated and treated accordingly to make it thick and nourishing so that it can accept an embryo. A doctor would treat a patient based on the diagnosis of the problem. It can be managed both medically and naturally. Some of the thin uterine lining treatment methods are discussed below.

  • Oestrogen Therapy – As already discussed a decrease in the oestrogen level may cause the endometrial lining to thin. In this case, oestrogen can be given orally or as a suppository gel, as it stimulates the division of cells in the endometrial lining so that it becomes thick and the fertilised egg can go and implant easily.
  • Indirect Oestrogen Therapy – Women who are trying to conceive can be given human Menopausal Gonadotropin (hMG) so that it stimulates the pituitary gland to release the gonadotropin hormone. This will trigger the reproductive organs to release the oestrogen hormone, which will help the uterine lining to become thick.
  • Granulocyte Colony Stimulating Factor (G-CSF) – Newer techniques like an Intrauterine infusion of this (G-CSF) growth hormone has been seen to increase the thickness of the endometrial lining.
  • Hysteroscopy – If any intrauterine adhesions are responsible for the uterus lining thin, then through hysteroscopy, the scar tissues or adhesions can be removed which can eventually cause the endometrial lining to grow to its appropriate thickness.
  • Frozen Embryo Transfer (FET)– If during an IVF cycle it is found that a patient has a poor endometrium, then the best way would be to freeze all her embryos in that cycle, and transfer once the endometrium has thickened and ready to accept the embryos.

Natural Treatment – Some natural supplements and herbs, vitamins like Vit E and L-arginine, regular exercise, acupuncture and fertility massage have shown to improve the thickness of the endometrium, by improving blood flow to the uterus.

Successful Pregnancy with Thin Endometrium Lining - Patient Testimonial

I am thankful to Medicover Fertility and the team for such a wonderful gift, even when I had been suffering from thin uterine lining miscarriage, multiple times. The doctor suggested me for frozen embryo transfer and it really worked. Today I am blessed with a beautiful baby girl.

How can medicover fertility help women deal with thin endometrium?

Medicover Fertility is a renowned European brand with more than 24 years of experience in the field of Infertility. We have a team of highly skilled and experienced doctors who help couples to deal with fertility issues.

We have successfully treated many women who had recurrent miscarriages and many failed IVF cycles due to thin endometrium. The thin uterine lining is the biggest challenge faced in the IVF industry, but with advanced techniques and careful evaluation and treatment, these women have been able to conceive successfully. And in women who have a severely damaged endometrial lining, surrogacy can be an option.

To know more about  the treatment, you can call us on +917862800700. Our counsellor will guide you accordingly.

 

FAQs

Q1) How does a thin endometrium affect pregnancy?

A) With a thin endometrium, it is not possible to hold a pregnancy, and it will either cause implantation failure or recurrent miscarriages.

Q2) Is thin endometrium normal?

A) A thin, endometrium lining is not normal as studies say that a thin layer can lead to an abnormally high concentration of oxygen in the epithelial cells, which can cause a rise in free radicals, and can prove toxic to the cells and the implanting embryo, so resulting in implantation failure.

Q3) Can thin uterus lining cause miscarriage?

A) Yes, a thin uterus lining can cause recurrent miscarriages as the implanted embryo would not receive adequate blood flow and nutrients to survive.

Q4) How to thicken the endometrium?

A) To thicken the endometrium, there should be an adequate level of oestrogen present in the blood, which can be provided exogenously as an oral supplement or as a suppository.

Q – What is the cause of thin endometrium?

A – If the level of estrogen hormone (female sex hormone) is normal, then a thin uterine lining can be due to any damage to the uterine lining.

Q – Is it possible to get pregnant with thin endometrium?

A – Yes! It is possible to conceive with thin endometrium, but the doctor might recommend treatments to thicken the uterine lining before trying for pregnancy or before embryo transfer, to avoid any pregnancy complications.

Q – What is thin and intact endometrium?

A – Thin Endometrium is a condition of the damaged uterine lining, due to some hormonal changes, inadequate blood flow, etc. whereas intact endometrium means the endometrium in good condition.

References

1) https://www.sciencedirect.com/science/article/pii/S0015028211001774
2) https://www.sciencedirect.com/science/article/pii/S0015028208047833
3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817285/
4) https://www.ncbi.nlm.nih.gov/pubmed/21324451