FET cancelled due to thin lining

[GinevraWeasley]

Hi ladies,

my FET was cancelled this week as my lining wouldn't thicken. It's never been hugely thick and during previous FET it has been around 7ish. As I had a D&C following TFMR last summer they are now referring me for a hysteroscopy.

However I was told that my lining during stims was 7.9mm suggesting that it can thicken and I just wasn't responding to the drugs. I asked about changing the medication but they said that is the only medication they use and just up the dosage.

Feel at a bit of a loss because if the hysteroscopy identifies problems that's not good but if it doesn't and I don't respond to the medication that's not good either.

Just wondered if anyone else had lining issues or didn't respond well to the medication and were given different options to thicken the lining?

I haven't personally but i know friends who have and they are usually given estrogen injections/tablets to take

My clinic won't FET less than 8mm and like it more like 10mm

I'm not sure what the hysteroscopy is going to tell them in terms of lining thickness - all that does is look at the shape of the uterus - I would have thought measuring your hormone levels would be better?

Thanks for replying. Is your friend in the UK? I read somewhere that estrogen injections weren't available in the UK.

I think they want to check there are no issues from the D&C in terms of scarring/damage to endometrium. But it seems quite an invasive next step considering my lining thickened up during stims and I did have a FET cycle after my D&C where they were happy enough with the lining to put an embryo in, it just didn't survive the thaw.

I was just hoping to get some info from anyone on here about approaches they took for lining so I know the right questions to ask. They are useless at communicating unless you ask the questions.

As we've been doing this for a few years now we are getting to the end of our tether and it's really getting to me now as I just can't see a happy ending for us.

@GinevraWeasley I was on tablets which didn't work well for me, they then added patches which did the trick xx

Thanks for your reply Wesstywoo. How many patches did you have? I had 1 patch from the start this time as they added a patch during my previous FET cycle half way through. But it didn't do much this time. Did you put it on your thigh?

I had 2 patches at a time, changed every 3 days plus continued on the tablets. I think the patches were the 100 dose each. I had them on my thighs and had to move where I put the next one each time due to skin irritation!

That's so frustrating, @GinevraWeasley. I had much better lining thickness with Progynova than I did with Estrimax (the two types of oestrogen tablet that I've taken over my four cycles) but I don't know if it's coincidence or down to the meds. They could be exactly the same just with different brand names for all I know.

Which brand of oestrogen have you tried?

Also, are they doing a biopsy during your hysteroscopy? And have you asked them to do an endometrial scratch while they're at it?

Hi RedPanda, thanks for your reply.

I was on Progynova and evorel patches. The first two cycles were tablets only the last two have included patches at various stages. This cycle was the thinnest by far and I started the patches at the same time as the tablets.

They haven't said they are doing a biopsy. All I was told was that they wanted to check nothing looked wrong considering my history (D&C following TFMR).

Never heard of an endometrial scratch, what does that involve?

I'm NHS funded as we're having PGD so they don't seem to deviate from the approach taken during previous FET which I think is why we have jumped straight to hysteroscopy rather than attempting any other medication first.

Sometimes they take a sample of the womb lining to see if there's anything wrong with it, and they'll remove any polyps or fibroids that they find - as opposed to just a diagnostic hysteroscopy where they'll just have a look around.

The endometrial scratch is one of the very few add-on procedures that have been proven to increase chances of success of IVF - they make some scratches in the lining of the womb, and then apparently the healing process makes the lining come back richer and better.

Those are my clumsy explanations of my understanding of the procedures I've had 😄

It's really good that they're doing a hysteroscopy - I was private and it cost over £2k to have it done privately in the UK, so I went abroad where it was cheaper.

That's interesting thanks, I will mention the scratch to the gynaecologist.

Did you manage to get your lining issues resolved?

Yes - for the first two cycles I was on Estrimax, then the second two cycles I was on Progynova and got a much better lining.

I'm currently 18 weeks pregnant from that 4th cycle, but we threw everything at it this time - I was on Prednisolone (a steroid), low dose aspirin, daily inhixa injections (an anticoagulant) as well as the oestrogen and then the progesterone. I'll probably never know if it's coincidence or all the drugs helped. I do know I have high levels of NK cells which the steroid would have helped with.