Infertility and Endometrium / Lining Issues

[funkymonk]

Please join here if you are experiencing infertility as a likely result of lining issues... Support and chat needed...

New thread started here Bananafish

Me, 34. DH, 34. TTC since Oct 2012. MC June 2013 (5 weeks), MMC Dec 2013 (8 weeks), MC June 2014 (chemical). Fresh IVF Jan 2015, 20 eggs, 11 fertilised, 4 blasts. Unresponsive, thin endometrium (never made it past 5.4mm). Quality improved with l'arginine, vitamin e and low dose aspirin. Prof Quenby and Brosens awesome back to back endo scratches managed to achieve what others hadn't (lining 6.5mm). Finally made it to FET. Currently 6dp5dt (and getting bfn, but not out just yet I hope).

Yes! Me! Totally unproven and clinic perfectly happy with my lining but I want 8mm as per everything I read everywhere! The best I've had was 6.9mm compacted to around 6mm by transfer day.

Have had 2 failed FETs now, no fresh transfers. Due to start cycling again soon, last bcp will be taken on Thursday.

I know bananafish from another thread. Waves

Hi Sammy! Nice to have another member. Hopefully banana will be along shortly.
I was holding out for the 8mm lining too, but it's taken 18 months to get from 5.4mm to 6.5mm (the day before transfer) so I just went with it. I'm 7dp5dt today and bfn so I think I'm out .

Hoping that we can get a group together here to discuss tips and treatment plans. What have you tried so far?

I also have a thin lining. 38, TTC for 1 year. Previous missed miscarriage and light periods since. ERPC done in Nov 2013. Used cerezette for approx 5 years. Recent Hysteroscopy showed thin lining, but no scarring.

On scanning my lining has been;

4mm on day 4
6.2mm on day 11
4.2mm on day 27

I'm taking Vit E, baby aspirin, red clover, raspberry leaf tea, Zita west pregnancy vitamins , omega 3 and coenzyme q10.

We are awaiting IVF, but I hold little hope of it working of lining doesn't thicken up.

My clinic didn't seem particularly concerned when my lining was 6.2 and said they happily do transfer at this thickness- I'm not so sure!

Hi both.

So last FET my lining was the thickest it's ever been (6.9mm at last scan). Although it had dropped to 6mm after starting progesterone.

Things I did to thicken it were hot water bottles, warming foods, gentle exercise, pomegranate juice and selenium. I also had estrogen patches alongside the tablets.

This time round I am having Accupuncture too. Xx

Spiny - when in your car clue do you take the aspirin?

Glad to meet some more people who's clinics will transfer at less than 8mm. I thought it was only mine, and everyone I speak to on here seems so shocked, and convinced that's why my previous cycles have failed of course they may well be right...

Car clue?! Cycle obviously!

Hey fellow thin-lining-ers - thank you so much funkymonk for starting this thread. Know I’ve wanged on at length on various threads about thin lining, so apols sammy and funky if you’re subjected to the same waffle from me!

I’m sorry you ladies share the same problem, but it’s lovely to have a thread to share tips and support, as it often seems that lining just isn’t an issue for anyone else.

Will follow up with an epic ramble about my own sad history of thin lining - have appt with consultant this evening for the latest installment of “WTF is my toxic uterus doing now’, so will do a proper introduction after that

Just wanted to chip in on the minimum thickness for transfer. My consultant said his absolute minimum was 7mm, preferably 8mm, ideally 9mm. He said he’d had pregnancies with less than 7mm in ovulation induction cycles, but generally wouldn’t risk transferring a good embryo into a suboptimal uterine environment

In anticipation of an upcoming FET, I basically combed the internet for research about thin lining

I think I read most of pubmed, but these are three articles which basically summarise the key findings of all the existing research on thin lining, including minimum thickness for transfer

If you’re a geek like me, you might these interesting / useful!

The endometrium in assisted reproductive technology: How thin is thin?
www.jhrsonline.org/article.asp?issn=0974-1208;year=2016;volume=9;issue=1;spage=3;epage=8;aulast=Mahajan

Strategies to manage refractory endometrium: state of the art in 2016
www.rbmojournal.com/article/S1472-6483(16)00051-1/fulltext

Current Strategies to Manage a Thin Endometrium
scientonline.org/fulltext/current-strategies-to-manage-a-thin-endometrium/21255

Banana - good luck for your appointment, I'll be looking out for your update.

Goodness those articles are in depth! Xx

Hello all! We are growing in numbers! Hurrah!

How did the appt go banana? Hope you got some answers? Do you mind me asking what clinic you are under? They sound very thorough and efficient. Thanks for the links. I will be sure to have a good read.
You've mentioned the 'it starts with the egg' book a few times. Do you recommend getting that?

sammy my clinic transfer once you get to 6mm. IMO I think that they do this because it helps their clinical pregnancy rate statistics. I've read a few papers that state 8mm as optimal, with lower rates of pregnancy between 6-8mm and a higher miscarriage rate in thie category also. Good luck with the acupuncture. Everyone I know raves about acupuncture, apart from me! I tried it for a long time but found it made me quite anxious and I saw no benefits with the lining change. There is evidence that it can boost blood flow to the uterus and therefore increase lining. Have you had your blood flow checked?

spiny, you've got a good collection of vits going on there. I would also add some l'arginine in there too. I will try and find the link to the research and post it here for you. sammy you should defo try the l'arginine and vitamin E combo too. Spiny may actually be surprised when you have IVF as the multiple follicles you produce will be pumping out oestrogen that should boost your lining. This didn't happen in my case because my lining is totally unresponsive to oestrogen (I think due to longterm use of oral contraceptives). From what I remember banana had a thin lining for her first IVF, but then a super amazing one recently (11mm). The body does strange things it seems.

I'm 8pt5dt today and bfn, so I think I'm certainly out. Feeling pretty .

www.ncbi.nlm.nih.gov/pmc/articles/PMC2633338/

That was the link to the article on l'arginine and vitamin e. I mentioned this on another thread, but will add it here too.... my experience of taking these 2 supplements is that my ovulation day changed within a couple of cycles from day 17 to day 14 and my luteal phase increased from around 8-10 days to 10-13 days. The quality of my lining has clearly improved on the dildocams too.

Funky thanks for the link. Will definitely add it in. I am also doing weekly acupuncture!

Hi all!

I am a low AMH-er who had successful IVF in 2012 and have a two year old. No lining issues then, nice juicy lining, was 9.9 at action scan and no idea what it was beyond that!

Second IVF in March 2016, lining was only 4mm at action scan, finally got up to 8.9 at ET but they kept me on stimms longer to try and get the lining to thicken so many of my eggs were overmature. Tried lots of things such as hot water bottles, pom juice, gentle exercise etc to try and thicken. Bled 5 days after ET. :-(

Amazed how much things can change with the lining in 3-4 years!

Getting ready to start 3rd round of IVF later this month.

Funky - what dose of l'arginine should I take? I'm not sure I understand what you mean about clinics transferring at thinning linings to help their stats? I'm sorry you think you're out. I'm not going to bother with 'there's still a chance' etc, because I'm sure like me, u know your own body.

Glummy - that's a huge increase from your scan to EC! Wow. I'm sorry things didn't work out. We could be cycling together then, I'm taking my last bcp tomorrow throw them baseline scan on 21st.

I forgot to mention - I try to keep my feet warm, eat warming foods (curries, spices etc) and take liquid iron too! 2 AFs ago (when I was really good at taking/doing everything) I had the heaviest bleed I have had in about 12 years!

My consultant has mentioned adding estrogen after SC if lining is still looking thin... Although I'm not sure about the implications hormone wise. I may have misunderstood. I was crying at the time.

sammy I take 500mg of l'arginine, but for a while I did take 1000mg. I think the 500mg is sufficient. Do you mean oestrogen after egg collection?

With my comment about the clinical pregnancy statistics, I meant that I think that clinics that transfer at less than 8mm know that there's a reasonable chance of pregnancy even though the miscarriage rates are higher in this group of women (according to research). So if 4 women have a transfer with a lining of 6mm, 3 of these might get a bfp so will then be included in the clinics 'clinical pregnancy' stats. All 3 of these may then go onto miscarry. This is the same at all clnics but when they know that women with linings of 6-8mm are more likely to miscarry then I think it's poor of them to continue. In my case where it seems that 6.5mm is the best it will ever get, then yes I understand. Not sure if I have worded this properly?! I know what I mean but can't explain it properly!

It's so difficult to take information in properly at consultations isn't it. I always try and write questions down before I go in, but then I rarely remember anything when I come out. It's very overwhelming.

Oops, after EC yes! Lol.

That's, I'm going to order the l'arginine now

Yes that makes sense. I was thinking of the IVF failing due to insufficient lining and thinking that would make their stats worse!

Hi ladies

Realised I never came back and did the proper intro with the incredibly dull fascinating saga of my crap lining

Anyway here's the update from my appt on Tues with the case of the missing period and the 'will she or won't she have a proper bleed and clear out all the crap old dead lining' fun and frolics

So I'd done a stims cycle (freeze all for PGS) and amazingly grown 11mm of lining (whaaaaat?!) all by myself, so we thought I would finally have a proper period - assuming that the crappy non -bleeds I'd been having were because I'd never grown any lining to shed.

19 days post EC and I haven't had a bleed so after emailing in a panic, consultant gets me in for bloods and a scan

Basically it's all a bit of a mess down there

Hormones were all normal, progesterone was low so basically the 2 days of black clots was my period. Scan showed there didn't seem to be any thickened lining, but there is a visible 8mm old clot, so he's equally frustrated as my uterus just doesn't seem to want to give stuff up.

He thinks the lining I grew this cycle was probably not good quality, as he's concerned about the blood flow if I've only had a clotty bleed. So we're back to needing a good clear out first before we can start a FET

Plan A is a week of Provera to try and induce a bleed (currently taking now)

If that doesn't work I'm booked in for a HyCoSy in 2 weeks time to have a clearer look at the uterine cavity, with plan B being a month of cyclo-progynova (ie an HRT cycle),where we build fresh lining up with oestrogen and then try to have a withdrawal bleed off that.

Plan C is another hysteroscopy, but he's keen to avoid another op.

Said was fine for me to take a daily aspirin, and the 600mg vitamin E, plus the 6g l-arginine I'd added in post EC (may be detrimental to egg quality so didn't take during stims) in the mean time to help with blood flow, said they couldn't hurt. He's just as frustrated as I am, just really hope plan A works.

It's just really sad. The uterine artery blood flow was terrific. The thrombophilia tests showed no evidence of any underlying clotting disorders. But we don't know why I'm just clotting and not having bleeds. He said it might some kind of issue with the vascularisation of the endometrium which maybe compromised the blood flow to the foetus and that's why it died. Basically did my uterus choke the baby to death?  We just don't know.

L-arginine wise I take 6g a day as that's what the studies said - which is 6 x 500mg horse pills daily. They're bloody massive!!

BTW if you ladies haven't read the book 'It starts with the egg' I would definitely recommend it, as it has lots of advice about supplements. Primarily about egg quality (clue is in the title!!) but it had some tips for lining - and for example it advised about studies indicating that whilst L-arginine could have a very positive impact on the endometrium, it could also have a negative effect on egg quality - ie best used only in a FET

It’s also really interesting that ALL of us have had years on the pill before TTC: long term use of oral contraceptives was specifically mentioned as one cause of thin lining in one of those articles I linked to:

”We have recently determined that a persisting thin endometrium, which does not seem to respond normally to E, is associated significantly more frequently with long-term use of birth control pills (i.e., >10 years) (unpublished data). This apparent adverse effect on the endometrium of long-term use of combined oral contraceptive pills is infrequent but when present seems to persist for years after cessation of the contraceptives”

Another of those articles explains how/why in a bit more detail - which reassuringly was pretty much exactly what my Dr said he thought had happened in my case. My Dr said he thought years of exposure to the progestin in the pill had essentially switched off the oestrogen receptors in my endometrium (‘antennae’, he called them) - so the sleepy antennae in my lining weren’t responding properly to rising levels of oestrogen.

They never bloody tell you this when you take the pill!!! They tell you it doesn’t have any effect on your long term fertility!

Sammy just to say that my Jan cycle (where I got pregnant, but miscarried, and we think my lining was the likely case) my lining only thickened up once I started taking oestrogen after EC. I have no proof, but given the lining changes quality under the influence of progesterone (switches from growing mode to compacting mode), I have often wondered if my lining was buggered right from the start. Yes, it thickened up from 5.5mm to 8.5mm, but whilst it may have been thick, was the quality actually any good ? All the studies say it's the thickness at trigger that matters. And mine was crap at trigger! As I say, it's just something I've been pondering, and not something I've discussed yet with my Dr. But perhaps worth asking your Dr about the effect of oestrogen after EC?

Thanks Banana, I'm not sure they're actually going to be too forth comb with the estrogen anyway, but if it looks like we're heading down that route then I'll definitely mention that! In the mean time I'm going to do everything I can to get the best possible lining naturally. Including the damn femoral artery massage! Xx

Hi ladies

Had my first post stimms scan today and my lining is 7.4mm! Not sure if it's the Accupuncture, the liquid iron supplement or sheer luck but fx it grows a bit more over the next couple of days. EC pencilled in for Friday!

Was at my review appointment before first IVF cycle. Was gutted when they told me they were too busy to start me before mid August....I want it done now!

Anyway on day 14 my endometrial lining was 8.2mm - I nearly wept with joy! I'm convinced the acupuncture has made a difference. Also my most recent AMH was 17.2 ( it was 15 just 2 months ago).

Anyway regardless of all this, we still have not conceived and even though it's only been 14 months, it's time to get the IVF ball rolling x

Amazing news spiny that's brilliant!!

sammy congrats on being PUPO

First scan of my dummy FET was on Thu and lining of COURSE hasn't responded. Week of oestrogen tablets and it's only 5.8mm 😓

We've switched over from pills to patches, and going back on Fri for another scan and we'll see how it looks.

If that does the trick, then we'll start the FET for real with patches as soon as AF arrives

If that doesn't work then will have to have a bash at stimming me next cycle - consultant says he's had quite a few women whose lining doesn't respond to artificial oestrogen, but does when it's added in on top of their natural oestrogen.

So low dose stims to get some follies growing & producing oestrogen, potentially adding in patches on top to try and get that lining growing. If it does, we'll trigger & put a frosticle back.

If it doesn't then...don't want to think ahead that far.

We know my lining can thicken up when stimmed - 2nd cycle we got to 8.5mm with some progynova added in (when I got pregnant), 3rd cycle it got to 11mm all by itself. So desperately hoping that having some natural oestrogen in the mix will make a difference (if we don't get anywhere with the patches) & that my lining has done it before, hopefully it can do it again

6 perfect embryos but we can't even get off the starting block. Urgh.

Hi all

Have done 8 cycles of stm cycles. 1 miscarriage @7.5wks
Lining has been thin ever since my D&C 5
5 - 7mm
The only time i hit 9mm was the positive cycle

Anyone found any treatment or tried alternatives which has effectively improve your lining?