Just Research

I just want to copy and paste some things I found on Google about a thin lining.

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A normal endometrium requires adequate blood flow ; and high estrogen levels. Thus , if the lining is thin there are 3 possibilities: the estrogen levels may be low; the blood flow is poor; or the endometrium is damaged. We need to systematically examine all these 3 possibilities , so that we can pinpoint what the problem is in the individual patient , and then try to correct it.

However if the lining remains thin in spite of high doses of estrogen, this means the problem is either one of poor blood supply ; or a damaged endometrium. Some doctors have used color Doppler ultrasound to measure uterine blood flow, but the results with this have been mixed. Others have tried using vaginal viagra to try to improve endometrial blood flow. Since there is no reliable method to assess uterine blood flow , the next step is to determine whether the endometrium has been damaged or not. There are two possible causes of end-organ damage when the endometrium is nonresponsive. One is that the endometrium has been anatomically distorted because of intrauterine adhesions ( a common cause for this in India is uterine tuberculosis. This condition is called Ashermann syndrome; and this can be diagnosed either with a hysterosalpingogram , which shows filling defects within the uterine cavity ; or with hysteroscopy , during which procedure the scars can be surgically removed. However in some patients , even though the uterine cavity is anatomically completely normal ; the uterine blood flow is normal; and the estrogen levels are high, the endometrium remains persistently and frustratingly thin. We then hypothesize that the endometrium has suffered end-organ damage as a result of which it does not respond to estrogens. This condition has never been adequately studied; and it does not even have a name ! Most doctors just call it - " Thin endometrium" . The Latin equivalent for this would be leptometrium ( lepto = thin) . Maybe we should coin a name to describe this condition , so that we can study it properly. Today, this can be an unsatisfying diagnosis to make, because we cannot prove this diagnosis ; and neither can we correct this problem.

During my clomid cycles and fresh cycle I had no lining issues. In prepping for my FET cycle(s) my lining never got thicker than 5-6 mm. We did oral estrogen, vaginal estrogen, patches, and IM, and nothing worked! At one point my serum estradiol was up to 2500 and still my lining was only 5-6 mm. I did baby aspirin, cut out caffeine, high dose vitamin E, nothing worked. I was convinced my body didn't like exogenous estrogen. So we did an ovulation induction cycle (have PCOS and wasn't ovulating) with follistim. My lining got to 7.4 mm on the day before I triggered, so it was probably even a little thicker at the actual time of ovulation. It worked, and now I am pregnant! Also, during the follistim cycle I stuck with the baby aspirin and vitamin E, but went back to drinking my cup of coffee a day

Basically we used follistim to do an ovulation induction cycle, mimicking a natural cycle. We did low dose and got one follicle, which my husband and I took advantage of. I triggered with hcg, and started progesterone supplementation even though I had a CL, and 5 days later we transferred 2 frozen blasts. We also did use Ganirelex to prevent me from ovulating, and let the follicle grow a bit and the lining thicken up before triggering. We did add a big of vaginal estrogen 3 days before triggering--not sure if that made a difference or not.

I had this same problem with a FET in October and ended up having it canceled. We tried again this past month and my dr had my use a low dose of Gonal-F. My lining was between 9-10 when we had our transfer last week. Just a thought you may want to ask about. Good luck!!

The "natural cycle" I did was basically done like an ER without the actual procedure. I did 2 shots of stims..don't remember what med it was. That was just done to increase my estrogen levels because I have long cycles and we didn't want to wait for ovulation to happen. I was monitored every other day until levels were where they needed to be then did a trigger shot. Then transferred 3 days later.

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So I think I have some ideas if NEFI ever gets back to me. I just emailed my contact there, the PA, who had been out of the office. I asked if there was a game plan. Now I have the above examples to ask them about. And also why they did not increase the estradiol more? Maybe my body needs a higher level of it for some odd reason? I would really like to have a natural cycle monitored and see what happens then. Or attempt a natural FET cycle. Maybe we could schedule the flights etc for 5 days after I have a surge indicating ovulation. I know there is hope and options out there. Hopefully S&S do not give up on me yet. I have not heard from them since thursday. Neither has the agency.