What is thin Endometrium?

A women’s uterus usually comprises of 3 layers-outermost, middle and innermost layers. The endometrium is the innermost lining of the uterus where implantation of the fertilized eggs takes place. The endometrium has a unique role in pregnancy. Before pregnancy, our body undergoes preparation to house the fetus. Just before ovulation or release of eggs from fallopian tube takes place, estrogen hormone levels will spike resulting in thickening of endometrium and growth of blood vessels. This helps in implantation of the embryo and creating an optimal environment. During pregnancy, the blood vessels will grow further which helps in providing oxygen and nutrition to the fetus through formation of the placenta. If however, implantation of the embryo does not take place, this built-up lining is shed in form of menstrual blood. This cycle whole cycle lasts 28 days. A thin endometrium may not be able to support pregnancy resulting in infertility. Generally, an endometrium less than 7mm in thickness will be unsuccessful in supporting pregnancies.

What causes a thin endometrium?

There are several causes of thin endometrium. Inadequate levels of estrogen are the major cause. It is also caused by long term use of birth control pills, inadequate blood supply, presence of fibroids, adhesions or conditions such as pelvic inflammatory disease. It could also result from a previous uterine surgery that leads to scar formation. Menopause will stop the cycle of thinning and thickening leading to a thin endometrium.

What are the symptoms of thin endometrium?

Women with thin endometrium have irregular periods, educed menstrual bleeding or very painful menses. This can also affect women who are trying to conceive as thin endometrium does not support pregnancy. Many women remain asymptomatic and are detected only with an ultrasound.

Is pregnancy possible for thin endometrium?

Although there have been cases of pregnancies in women with thin endometrium, it is usually rare. The endometrium must ideally be 7-8mm thick for successful implantation of the embryo. A simple blood test can indicate the estrogen levels and thus determine if the pregnancy will be successful. An ultrasound is performed for confirmation.

Are there any treatments?

Current treatments focus on estrogen injections or administration of drugs to improve thickness of the endometrial lining. Depending on the condition, surgery may be required. The clinical outcomes of these existing treatments are very poor. Stem cell therapy is a new treatment measure for restoring the thickness of the endometrium. Successful pregnancies have been reported after administration of stem cells. Stem cells are the naïve cells of the body that can give rise to different cells and tissues. They have immense potential for repair and regeneration. Stem cells can help in implantation of the embryo by angiogenesis- a process of generation of new blood vessels and capillaries. This will create a better environment for the fetus to develop.  Stem cell transplantation will help in better tissue reconstruction and thus improved rates of successful pregnancies.


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