Failed FET thin lining

[Kernowlady]

Hello, Hope someone here can help:

I just did my first FET but it was cancelled due to my thin lining. They scanned on day 10 my lining was 4mm, they said they’d keep going with my medication (prognova patches and estrodiol pills plus buserelin injections) and 5 days later it was still 4mm! My fresh transfer was also cancelled for this FET as my lining was only 4.7mm

I’m devastated by how thin it is. They are going to do a Hysteroscopy but waiting times are long on the NHS route. I just don’t know if this will solve anything and the whole time / waiting game is hard. I may look to go private if this is the case

Has anyone had any experience with their lining being this thin?!

Hi @Kernowlady

I'm sorry about the cancelled cycle, I hope you're ok.

There's a few of us in the ERA EMMA ALICE thread that have had issues with lining. Do you have light periods? Have you ever had uterine surgery like a d&c? There is a condition called Ashermans syndrome where you get scarring and adhesions in the uterus that causes a thin lining.

Have you had a saline scan or HSG? They are the initial scans to look for the condition as the hysteroscopy not only diagnoses the condition but also is used for treatment and you'd need to be under a specialist that treats this often if you do have it or harm can be done during the treatment.

Thank you for replying. I will look at that thread you mentioned.

I have very light periods but have never had any uterine surgery - also no to a saline or HSG. I was on the pill for 17 years then came off two years ago, tried for 6 months - my partner found out he had very low sperm count - started ICSI and have now found out I have a thin lining which is posing more problems.

It’s a strange one as I don’t understand why it would be that thin(4mm) even after the oestrogen pills and patches (plus all the legs in the air, vitamin E, l’arginine, pomegranate)

Hey @Kernowlady I completely sympathise with what you're going through! I've been there.

This thread might be helpful and give you a few ideas:

Thin lining www.mumsnet.com/Talk/infertility/4142634-thin-lining

Good luck xx

@Kernowlady I also had my first fet cancelled due to thin lining, it didn't budge past 6mm. My last fet I got to 8mm and they decided to go ahead and transfer and it failed, as expected. It's so frustrating isn't it, I also was completely sidelined by this as I just didn't realise it could be an issue!

Just going into my third fet and they've put me on a really high dose of patches, tablets and vaginal tablets.
I also have really light periods, two days bleeding then completely stops. No history of surgery etc.
Sorry you're going through this you have my sympathies

Thank you all - that thread has some amazing information and I will probably start posting in it during my very un fun journey! It’s crazy that it is so difficult to pin point why this happens.

@Gardenlady543 on one of the threads you mentioned you had raynaulds. I have bad raynaulds and varicose veins - I think my circulation is poor (not diagnosed), I’ve asked both my nhs and private doctors if they think there is a correlation between poor circulation and thin lining but they don’t think so. As I’ve had no reason to have a thin lining (well so far) I’m thinking could it be a blood flow issue?!

@Kernowlady they should be able to see what the blood supply is like in the uterus from a US with Doppler, however there are tiny spiral arteries that supply the endometrium and it could be that people with poor circulation have vasoconstriction. The options for that are to add in viagra and pentoxifylline + vitamin E.

With a lining of 4mm I would be thinking is something structural going on though, if you can afford it pay for an initial consultation with either Mr Trew or Mr Lower, they will arrange an investigation and tell you if it's likely there are adhesions and scaring present. They can then arrange surgery if there is, but it will likely cost a few thousand. There is a surgeon called Dr Nugert in Hamburg who can offer treatment for cheaper if you do have this issue.

If that's all clear then I'd be thinking, why aren't you responding to estradiol, some people don't respond well and do better with stims, but even in your fresh cycle you had issues.

This paper talks about various options for a thin lining:

reader.elsevier.com/reader/sd/pii/S1110569016300589?token=96E9464FE69FC83B642C0BCD84C9B5C8D65EC52127B70033B0A530CB81FC59FCB2CF2011617E764B5B891822C77E9BF4&originRegion=eu-west-1&originCreation=20210908070454

I would start with some imaging though.

@Gardenlady543 thank you. I’ll see how the hysteroscopy goes and then take it from there

@whatagloriousthingtobe I’m so sorry your going through it too! What a nightmare hey and something it looks like there is no definite answer for. Sending you good vibes for this cycle. Let me know how the increased dosage goes

@whatagloriousthingtobe Ashermans syndrome can be caused by endometritis and IUDs as well, so you might want to consider imaging with a saline scan or HSG to investigate.

I have thin lining issues and 5 failed transfers. My clinic give me aspirin, viagra, 12 mg estrogen (8 oral, 4 vaginal) plus 200mg patches plus two neupogen infusions into my uterus in the lead up to transfer. Personally I don't think the viagra or aspirin do anything and I don't think the estrogen does much but I could be wrong, so take it all anyway. The neupogen does seem to work but I do sometimes wonder if that's just the doctor doing generous measuring on the day!

I've just this week had surgery after mr lower found a big adhesion in my uterus and I also had a c-section scar, so I'm hoping now they've been improved my lining will be better. 2 1/2 years ago I was incorrectly diagnosed with a midline septum (not a big problem) during a laparoscopy but the saline scan showed it was actually a big adhesion (big problem). The scan and surgery have cost a lot, but worth it in my case hopefully.

Thought I'd come back and update.
I had my first lining scan today (day 13) and my lining is only at 7.8mm. So that's on max dose estrogen, 16mg daily plus patches and down regulation. It doesn't take an expert by now to figure out my lining just does not respond how they want it too. I'm due back Thursday for another scan and I feel I'm Gona have a fight on my hands regarding transfer.

@whatagloriousthingtobe - see to me getting to 7.8mm should be fine for at least a go at transfer. It is still slightly on the thin side but where I am they said they’d transfer if I got to 6.5… I can’t even get past 5 at the moment!!
Really push for it and I hope it either increases more or they allow you a go. Fingers crossed for you, let me know if it happens