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Will thin endometrium affect the success of IVF?

Updated: 2020-07-23


Endometrium is the mucous membrane lining the uterus, which thickens during the menstrual cycle in preparation for possible implantation of an embryo. Thin endometrium generally refers to a thickness of the endometrium of less than seven millimeters during ovulation or the mid luteal phase. The condition does have a significant impact on the success rate of in vitro fertilization, or IVF. At the same time, there is a lack of corresponding treatment at present, which is still a worldwide problem.

The followings are common causes of thin endometrium:

1. Inflammatory diseases

Endometritis caused by various reasons may cause damage to the endometrial basal layer, which serves as the source of endometrial growth. If irreversible damage is encountered, it will lead to the failure of the endometrium to grow to the desired thickness.

2. Direct injury caused by surgery

Artificial abortion, hysteroscopic separation of intrauterine adhesions, myomectomy, polypectomy and uterine deformity corrections will directly damage the endometrium. If the damage is too large, it will cause different degrees of damage to the endometrial basal layer, resulting in the endometrium no longer restoring to the previous thickness.

3. Deficiency of endometrial blood supply

Many medical factors may cause damage to the subendometrial blood vessels, causing endometrial necrosis and adhesion, thus reducing the nutrients for endometrial growth -- so making it difficult for the endometrial thickness and environment to recover.

4. Unknown causes

Very few patients do not have the above conditions, but there are still inexplicable reasons in the occurrence of endometrial thinning. These conditions may be related to the patient's endocrine status, age, endometrial gland dysplasia, estrogen and progesterone receptor deficiency and other factors.

Current common symptomatic treatment methods:

1. Hormone sequential treatment

2. Surgical treatment

3. Careful selection of drugs to improve vascular activity and increase endometrial blood perfusion, according to the doctor's advice

4. Intrauterine injection of granulocyte colony-stimulating factors, for treatment

5. Pelvic floor muscle exercise and bioelectric stimulation therapy

6. Traditional Chinese medical acupuncture physiotherapy and traditional Chinese medicine therapy

7. Intrauterine stem cell transplantation

It seems that there are many treatments for thin endometrium, but due to the large individual differences, the overall treatment effect is still not good. Therefore, for those with thin endometrium, doctors need to consider their condition comprehensively and formulate the most suitable individualized treatment plan for each patient. Never think that all methods can be used to ensure maximum effectiveness, which often causes unnecessary risks and waste.

Even after a variety of treatments, it may still prove impossible to achieve the desired endometrial thickness. But there is no need to panic because endometrial thickness, although one of the important factors affecting the success rate of IVF, is not a major determinant of the outcome.

Pregnancy can still be achieved if the patient has only thin endometrium, but the endometrium has a strong adhesion to the embryo and implantation. Clinically, it is often seen that many patients can still get pregnant and have children when the endometrium thickness is only four to five mm.

To sum up, try not to pay too much attention to this indicator of endometrial thickness. If it cannot really improve, it is better to go down different paths. If, after a comprehensive assessment of the patient's condition, the doctor believes that IVF is worth trying -- even if the endometrial thickness is not ideal but other determinants are in place -- pregnancy can still be achieved.