Dr. Aruna Ashok MBBS, MS OG, DNB OG
- Clinical Director
Aruna Ashok | 24 Oct 2022
Whether you are trying to conceive naturally or through assisted reproductive technology (ARTs), receptive endometrium, high-quality eggs and sperm, and the perfect hormonal balance play a significant role in achieving successful implantation.
In this blog, we are going to talk about endometrium. Reasons why the thickness is reduced, thin endometrium symptoms, thin endometrium treatment and more.
The receptive endometrium, in simple terms, is referred to as the state when the uterine lining (endometrium) is being prepared for implantation. It’s like preparing to welcome a new guest. However, this preparation mode will last only for a short period of time, typically lasting a few days. This usually happens after your ovulation period and fertilization.
When we talk about preparation, the thickness of the uterine lining is denoted. The thickness of the lining is a crucial factor in increasing the possibility of pregnancy. That is why, during ART treatments, endometrial assessment is routinely performed.
When a woman has an endometrial thickness of less than 7 mm, it is then referred to as the thin endometrium. Thin endometrium is generally considered an inappropriate state for embryo transfer or implantation to happen naturally. The thinness can have a negative impact on the pregnancy. Even if pregnancy is achieved with a thin endometrium, severe complications during pregnancy and childbirth may take place. The complications during pregnancy may include miscarriage, and issues with fetal growth and development. The complications during childbirth may include low birth weight, preterm birth, and intrauterine growth restriction.
The endometrium is indeed the inner layer of the uterus, which typically changes in its consistency throughout the menstrual cycle. During menstrual bleeding, the uterine lining tends to be thinner by about 2-4 mm. Whereas before ovulation, the lining tends to be thickened by about 5-7mm. And the days after the ovulation, the lining tends to be thickened even further by about 8-14 mm. This thickening is substantial for the healthy and successful implantation of a fertilized egg. When the implantation doesn’t take place, the shredding happens, leading to menstruation bleeding. The cycle continues until a woman reaches the menopause.
This is the natural process of the endometrium. However, when there is a disruption in the process, the issue arises. In this section, let’s see what are all the causes that lead to thin endometrium.
Reproductive hormones such as estrogen and progesterone play a crucial role in the overall reproductive health of the woman. Most importantly, when it comes to the thickening of the endometrium, these hormones are significant. The shifts in these hormones may lead to the thinning of the endometrial lining. Your healthcare provider may determine the cause by performing certain blood tests.
The sufficient amount of blood flow to the uterus is the crucial factor in controlling the health and growth of the endometrial lining. Studies found that an inadequate amount of blood flow to the uterus has contributed to the higher risk of negatively impacting the implantation.
The endometrium can certainly become thin because of numerous reasons including surgeries like dilation and curettage (D&C), adhesiolysis, hysteroplasty and polypectomy. In rare scenarios, adhesions in the intrauterine lining can happen because of caesarean surgeries. Moreover, the surgery to remove fibroids, particularly through the myomectomy procedure, can also cause the inner layer of the uterus to be thin.
The usage of certain oral contraceptives can efficiently thin down the endometrial lining for a shorter period. This happens as the pill contains the hormone progesterone. The medication can potentially amend the natural process of the uterine lining. Furthermore, spotting or light bleeding can also be experienced by some women as a side effect of the hormonal medication.
Clomiphene is a nonsteroidal oral medication, which is used to stimulate ovulation in women during fertility treatment. The medication works wonders when used as per your physician’s instructions. However, the excessive usage of the very same medication can indeed cause the inner layer of the uterus to be thin.
Infections and inflammations, in specific chronic endometriosis, can potentially cause the inner layer of the uterus to be thin. The condition is caused by certain infections such as gonorrhoea, tuberculosis, and chlamydia. Other conditions such as PCOS and fibroids can also contribute to endometrial inflammation and scar tissue.
Certain chronic medical conditions like thyroid disorders, diabetes, and autoimmune conditions can significantly impact endometrial health. Moreover, these conditions can also interfere with the uterine blood flow and hormonal imbalance, resulting in thin endometrium. Furthermore, the conditions can have a negative impact on fertility, menstrual cycle, and more.
Listed below are some of the significant symptoms of thin endometrium.
Infertility is one of the most common symptoms of thin endometrium. When the endometrial lining is thin, the ovulation is disrupted, obviously leading to infertility. The endometrium (uterine lining) plays a crucial role in supporting an embryo to be implanted into the uterus. A thin endometrium can make it difficult for the embryo to get implanted or attached to it. Even if implantation takes place, it increases the chances of miscarriage.
As we all know during the menstrual cycle, the uterine lining breaks down and shreds, leading to menstrual bleeding. The thicker the lining is, the more bleeding a woman experiences. On the other hand, a woman may experience abnormal menstrual bleeding, if the uterine lining is thin. This happens as there is no tissue to shred during her cycle.
Note that the amount of bleeding may also be dependent on the overall health of the uterus.
Hormonal imbalance is another symptom of thin endometrium. The symptoms of hormonal imbalance may include fatigue, mood shifts, changes in libido, and more. Women who have hormonal imbalances may also experience changes in the menstrual cycle.
Recurring miscarriages are a significant symptom of thin endometrium. The symptom takes place as a thin uterine lining (endometrium) is unable to support the implantation and growing fetus. This potentially causes repeated pregnancy loss.
A woman with a thin endometrium may experience discomfort or pain in the pelvic region. However, the symptom may also be caused by other factors such as low uterine blood flow, hormonal imbalance, chronic uterine conditions and more.
Even though the thin endometrium is not a serious condition, it can potentially cause recurring miscarriages and infertility. Experts use certain methods and procedures to overcome the issue. Some of them include:
Hysteroscopy is the procedure performed to have a look at the uterus and determine the causes of thin endometrium. In certain scenarios, the procedure is helpful for physicians to treat diagnosed conditions like endometriosis, fibroids, or polyps. Furthermore, a biopsy can also be performed to examine whether the tissues contain cancer cells or not.
It is essential to understand that the natural thickening of the endometrium (uterine lining) is dependent on the estrogen hormone. When this natural process weakens, the estrogen hormone medications may potentially be administered to stimulate endometrial growth. The medication can either be in the form of pills, shots, or patches.
Endometrial scratch is a procedure, which is performed to gently scratch the endometrium (uterine lining). Recent studies have identified that the procedure has significantly increased the thickness of the endometrium and pregnancy rate, especially when performed before the IVF treatment. The concept of the procedure is to enhance the endometrial receptivity to support embryo implantation by stimulating tissue growth.
Platelet-rich plasma (PRP) is the procedure performed by injecting the patient’s own concentrated platelets inside the uterus. The concentrated platelets are typically derived from their own blood. The concept of the procedure is to enhance the endometrial receptivity to support embryo implantation by stimulating tissue growth.
During IVF treatment, the procedure of embryo glue is performed to enhance the chances of successful pregnancy, specifically in couples experiencing thin endometrium disorder. Embryo glue is a medium with hyaluronan solution, which is used to attach the embryo to the uterine lining during embryo transfer. The process can significantly help couples to achieve a successful and healthy conception.
Granulocyte colony stimulating factor (GCSF) is a kind of growth factor that has glycoprotein present in it. During IVF treatment, the therapy is administered into the uterine cavity to enhance the endometrial receptivity and pregnancy rates. The process is specifically suggested for couples who experience recurring miscarriages.
1. What are the risks associated with thin endometrium?
A thin endometrium can significantly lead to numerous risks including irregular menstrual cycle, abnormal bleeding, recurring miscarriage, infertility and more.
2. Can I treat thin endometrium naturally?
The answer to the question is yes. You can treat the thin endometrium by consuming healthy food, regular workouts, and managing stress. You can also treat the condition by having certain vitamins and supplements like vitamin E and L-arginine. However, it is always suggested to have a consultation with your healthcare provider before trying any medications.
3. Which foods are good for endometrium?
To enhance the health of your endometrium, you can consider including omega-3 fatty acids, folate, and iron in your diet. Along with this, consuming leafy greens, berries, lean proteins, seeds and nuts significantly improves the health of your endometrium.
4. What are all the conditions that are associated with thin endometrium?
A thin endometrium or uterine lining can be associated with several conditions. The conditions may include uterine infections, hormonal imbalances, certain procedures, scarring from previous surgeries and more. Other than that, certain medical conditions like endometriosis, PCOS, polyps, etc., inadequate blood flow to the uterus, and more are all associated with causing thin endometrium.
5. Which hospital is best for treating thin endometrium in Chennai?
Several hospitals in Chennai provide the treatment for thin endometrium. However, the A4 Fertility Centre is well-known for its expertise and treatment in efficiently addressing thin uterine lining or endometrium conditions.
