When thinking of the components needed to conceive a child, “the endometrium” is not one that immediately comes to mind, but it is one of the most important. In fact, without even realizing it, you are reminded of your endometrium every month when you get your period and when it comes to getting pregnant, whether you have a thick or thin endometrium can be key in whether or not you have an easy time conceiving.
What is an Endometrium?
The endometrium is the lining of your uterus. Every month, this lining should thicken. It does this in anticipation of ovulation and the fertilization of the egg. This fertilized egg will become an embryo and then implant itself in this newly thickened endometrium lining. It’s almost as if your uterus is trying to make the embryo as comfortable as possible to ensure a pregnancy that will last a healthy nine months.
If the egg is not fertilized or if the embryo does not implant (or is unable to implant), the lining sheds itself which is when a woman gets her period. This happens every month.
How Would You Know If You Have a Thin Endometrium?
Some signs may be if you have light periods or missed periods, but most women only find out if they have a thin endometrium when they have a fertility work up at a doctor’s office. The rule of thumb is if you are younger than 35 years old and haven’t conceived within a year, or if you are 35 years old or older, and haven’t conceived within six months, you should make an appointment with a reproductive endocrinologist. A fertility workup would include a blood test to look at various hormones such as your Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Estradiol and your Anti-Müllerian Hormone (AMH). A hormone imbalance can affect your uterine lining as well as your ovarian reserve (meaning how many eggs you have) and your overall fertility. Then, a transvaginal sonogram is used to visualize your ovaries, as well as evaluate and measure your uterine lining to see if there are any concerns or abnormalities. While this may all sound intimidating, it can be incredibly insightful in helping you find out what may be preventing you from conceiving.
Conceiving with a Thin Endometrium
The good news is that sometimes there are issues that can be addressed which organically help thicken your endometrium to get it to where it needs to be. Whether it’s a hormonal balance, an inflammation you were not aware of that antibiotics can address or perhaps you had Asherman’s Syndrome and didn’t realize it. In that case, surgery can increase blood flow which can help thicken thin endometrium lining.
Still, if they can’t find a specific cause, fertility treatment like in vitro fertilization (IVF) can be beneficial for many reasons. If you choose IVF you will be monitored on a regular basis, so a doctor can not only check your hormone levels and adjust accordingly but they will be performing regular ultrasounds and measuring your uterine lining to see how thick or thin it is. They can then change their medication protocol and even change when they would transfer an embryo to your uterus to make sure they are doing so at an optimal time to increase chances of implantation. Also, it is important to let you know that even with a no responder thin endometrium your embryo could implant successfully if the embryo transfer is well planed in the best receptive endometrial timing, following the Endometrial Receptivity Analysis (ERA), it is especially valuable in situations where thin endometrium is a concern. You can also ask your doctor about Pre-implantation Genetic Diagnosis (PGD) and Pre-implantation Genetic Test for Aneuploidy (PGT-A) to help increase the chances of having a healthy baby and decrease your chances of a miscarriage.
Thin endometrium, while not always instantly thought of, can be so important, and does require the expertise of a medical team to visualize and assess. Speak with a doctor if you notice your periods seem light or irregular or if you’ve been trying to conceive for a while with no success. Your periods are a piece in the puzzle of your reproductive health. The more you know, the more empowered you become.