Successful pregnancy requires the joint presence and coordination of conditions from both the mother and the embryo. The thin endometrium is an important factor leading to infertility. With the development of Assisted Reproductive Technology (ART), a thin endometrium poses a significant challenge for IVF doctors.
Currently, the medical community has generally reached a consensus that an endometrial thickness of ≥8mm and <16mm is most suitable for embryo implantation. Endometrial thickness ≤7mm is considered thin, accounting for about 2.4% of IVF cycles. A very thin endometrium can affect endometrial receptivity, significantly reducing clinical pregnancy rates. The minimum endometrial thickness for successful pregnancy remains inconclusive. Some studies suggest that a thickness of less than 6mm results in a significant decrease in success rates. The causes of a thin endometrium mainly include uterine cavity operations and inflammation, with other causes and mechanisms still unclear. While various methods are applied for treatment, there is no universally applicable and effective method for thin endometrium, making its treatment a significant challenge. Although there are no "magic drugs" or "miracle methods" in clinical practice, in cases of thin endometrium before transplantation, several common methods can be used for endometrial conditioning: 1. Hysteroscopy: Hysteroscopy can confirm the presence of uterine adhesions, separate them, and restore the uterine cavity to a normal shape. However, for a simple thin endometrium, hysteroscopy is not an effective treatment method. 2. Estrogen Therapy: High-dose estrogen therapy post adhesion separation, or sequential therapy with estrogen and progesterone can aid in endometrial repair for adhesions. For thin endometrium without adhesions, estrogen therapy can be used orally or vaginally during ART to prepare the endometrium. 3. Anti-inflammatory Treatment: For suspected endometrial tuberculosis, proper diagnosis and treatment are essential to prevent worsening infection. 4. Stimulating Endometrial Regeneration: Stimulating endometrial regeneration through procedures like hysteroscopic growth hormone injections may improve endometrial receptivity. 5. Enhancing Endometrial Blood Supply: Drugs like aspirin or L-arginine can theoretically promote better blood flow to the endometrium. 6. Pelvic Floor Neuromuscular Electrical Stimulation: This technique aims to improve blood flow and endometrial receptivity indirectly. 7. Traditional Chinese Medicine: Acupuncture, physical therapy, and herbal medicine may improve endometrial health and blood flow. 8. Stem Cell Transplantation: Stem cells may enhance endometrial growth and thickness through the secretion of growth factors. Despite advancements in medical technology, thin endometrium remains a critical factor affecting clinical pregnancy rates. While modern medicine explores various methods to address thin endometrium, individual differences and lack of solid evidence for many treatment options remain a challenge. It is believed that while endometrium plays a role in pregnancy, embryo quality also influences the chances of implantation and growth. Combining treatment strategies with assisted conception can help optimize the chances of successful pregnancy.
