Thin uterus lining - FET

[Always28]

I’ve just been for a scan on day 14 of cycle - 13th day of meds. My endometrial lining is still thin - less than 7mm.

I have severe endometriosis and have had an emergency laparotomy in the past. So it could be there’s some scar tissue there.

This is our second FET. I had the same issues with lining the first time around although it got up to the lower side of what they would deem acceptable after about three weeks of meds. We then did an ERA cycle and found I need more hours of progesterone this time around.

I’m feeling really down about it and starting to lose hope. We have three euploid embryos left - and we can’t afford another egg collection. So really needing some luck on our side for this to happen.

If anyone else has experienced thin lining - or even had success with a thinner lining - it would be great to hear from you.

May I ask what is the acceptable thickness for your clinic? I think clinics vary widely in this regard. I never had very thick lining, I think the highest I ever got was 7.6mm at Day12, it's usually 6.5-6.7 around Day 11/12 and none of my transfers got cancelled because of the lining. But I haven't been successful yet either.

You may try drinking pomegranate juice, apparently it's good for lining.

Hi @Always28 have you tried stimulation (like a full cycle but without the egg collection at the end) instead of estrogen only? It’s the only thing that worked for me to get my lining over 7mm.

I have always had a lining that gets to 6.7-7.7mm max when on 8 Fematab a day. Tried all sorts- acupuncture, reflexology, vit e, drinking beetroot juice, eating pomegranate seeds, avoiding cold drinks and foods, eating warm nourishing foods, keeping my feet warm at all times (fluffy socks). Also had 4 endometrial scratches. The best thing was walking 20mins every day and I do think acupuncture improved things slightly. My clinic is happy to transfer it over 6mm as some women will suffer with “chronically thin “ (their words) lining. I did some research before and ask my clinic about neupogen wash, slidnifil, viagra etc etc but they didn’t want to use any of those. We did add 100mcg oestradot this time (oestrogen patch) to 8 femtab a day and while I don’t think this made a difference to my lining thickness, this is my first FET of four where I have gotten a positive test and beta. Have my first pregnancy scan this week so really hoping for the best 🙏🏻🙏🏻🙏🏻 My clinic never cancelled any transfers even when mine was 6.7mm. Just fyi my clinic also used embryo glue this time and I have been on 75mg aspirin every day since 3dpt. Hard to pinpoint exactly what has made the difference. Also my transfer cycle was done back to back with the ERA cycle which technically acts as an endometrial scratch so could be beneficial for you to transfer on this cycle. Best of luck :)

Thank you for the replies.

i had another scan today - day 18 of my cycle - and the lining is still at 6.5mm. I did have a look back at my first FET, and they kept going with estrogen until day 22, and the lining got up to 7.7mm. I’m going back for another scan on Thursday.

@Serendipity24 They prefer the lining to be over 7mm to transfer - but in my ERA cycle, it only got to 6.5 and they booked in the transfer anyway. It was thicker by the day of the transfer. I bought some pomegranate juice and have started drinking it - thank you!

@GracePKI thats really interesting - thank you. I wonder what thickness my lining was on my two egg collections (I did a freeze all each time as we were testing the embryos). If this cycle doesn’t work, I’ll definitely look into the stimulation possibility.

@Hopefulsummer35 Congratulations! That’s amazing news. Had you had your embryos PGT-A tested? Did they make any adjustments to your progesterone after the ERA cycle? Thank you so much for sharing your experience - it’s really reassuring to know that you’ve had a positive result with a lining that’s not super thick. Good luck with the scan.

@Always28 yes ours were PGTA and PGTM tested due to a known genetic condition on my husband’s side so I was suffering from recurrent implantation failure with no known issues on my side. Had karotyping, thrombophilia etc checked and nothing out of the ordinary. My ERA showed that I was receptive so no changes to my progesterone. Something else we have done is add antibiotics for 4 days before transfer (in case of endometritis) and also started prednisilone with the aspirin as I have sometimes had a reaction to the progesterone injections. This was our last of 5 tested embryos so hoping that by throwing the kitchen sink at my protocol that we are in with a good shot 🙏🏻🙏🏻🙏🏻

I'm joining this thread too as I also really struggle with thin lining.

I am in the middle of a medicated FET with my first scan scheduled for next Wednesday.

This cycle I am having pomegranate juice every day, a daily 20minute walk and trying to eat high protein. Also added bit E. For eostrogen I am on 3 oral progynova and 2 vaginal progynova every day and 2 everol patches every 48 hours.

@Hopefulsummer35 I hope your pregnancy scan has gone well? 🤞🏼

@Always28 how did your lining scan go?

Another thin lining here. Just increased my estradiol to include vaginal twice a day after 10 days of oral three times a day only got me to 6mm. Just wondering whether you ladies found the transdermal patches more effective?

Had my first acupuncture session today.. no idea if it will help the lining or not! She did some abdominal massage too.

Morning

@lemons44 is your scan this coming Wednesday? Hope it goes well. That’s great you did acupuncture. I have a reflexology session tomorrow. If nothing else, at least it will be relaxing and help me feel like I’m doing something to help!

@Sunshinebytheseaside what dose of estradiol are you on? I’m on a combination of estradiol and the patches. It doesn’t seem to make much difference for me to add in both, but I’m sure it does for lots of people!

my lining was still only about 6.5 at my last scan but they have decided to go ahead with transfer anyway. In my ERA transfer it was about the same at this stage but then thickened up a bit after the progesterone.

It is making me so much less hopeful than I would be if it was even just a mm thicker.

Transfer is booked for Thursday - and I have bloods and a scan on Wednesday. I’m having one more day of progesterone to my previous cycle, but at a slightly lower dose.

Morning @Always28 yes my scan is this coming Wednesday. That's great they have given you the green light to go ahead. I totally get about you worrying but I honestly don't think the clinic would go ahead if they didn't think your lining was thick enough.

@Sunshinebytheseaside last time I only added in the patches in the last 3 days before starting progesterone. This time I've been on the patches (as well as progynova tablets) from the start so I will report back on Wednesday if this has made a difference. Wednesday will be day 12 of eostrogen for me.

@Always28 how many days were you on eostrogen? Are you finding in this hot weather is making the patches harder to stick? mine keep peeling off and it's driving me mad! xx

Thanks for your response @Always28 I was on 12mg orally per day, now added 4mg vaginally per day as well. Good luck for your scan, hopefully it will have thickened up a bit more and everything crossed for your transfer on Thursday. And good luck to you @lemons44, the patches don’t sound much fun but hopefully they do the job!

Thanks @Sunshinebytheseaside when is your next scan?
Are your tablets the progynova ones? xx

@lemons44 I had another scan today and that’s me out for this cycle. Lining hadn’t improved much so going to abandon and try again with a higher dose from the start. I was on elleste solo which I believe is the same as progynova (oestradiol valerate). Good luck with your scan tomorrow.

I'm so sorry @Sunshinebytheseaside I once had a cycle cancelled due to a cyst and it is devastating. I hope you're doing ok ☹️
I've just bumped an old thread actually which I found useful on lining so you may see that on the infertility board now. I was curious how the current ladies got on in the end as the thread is 2 years old. Are you going to take a break or go straight into another cycle? Sending hugs xx

Thanks @lemons44 but I’m ok - we’ve been at this a long time and had far worse disappointments! This is probably our last shot so I want everything to be as optimised as possible so I actually feel relieved we’re not wasting a good embryo on a dodgy lining. I’ve got a follow up consultation next week and will decide what to do next and when to do it. I can see that other thread so will give it a read, thanks for the bump. Hope you got on ok today.

Thanks makes sense @Sunshinebytheseaside I hope the consultation goes well.

I also found this Reddit thread which has lots of positive stories for those with thinner linings:

https://www.reddit.com/r/InfertilityBabies/comments/jg0otv/fetsuccessswithlininggslightly_7mm/

I was pleasantly surprised at my scan, my lining was measuring between 6.7 and 7.3 (does anybody else get multiple readings? I know they go with the biggest one but it still confuses me). So I am happy with that!. I was expecting them to give me the green light to start progesterone however the doctor wants to see if we can get it up to 7.5 so has requested I stay on eostrogen and have another scan on Sunday. I just hope it stays the same or gets thicker as I know sometimes the lining can actually shrink and that happened to me before. xx

Just to add, my last FET my lining was between 6.8 and 7mm on day 15. I am on day 12 today. So I think perhaps the patches have helped things for me (either that or the vitamin E or acupuncture, which I didn't do last cycle).

Hi, a late update from me. I had a scan and bloods on Wednesday and the lining was 8.2mm and looking good so they went ahead with the transfer yesterday.

The transfer took quite a long time as they were having trouble getting the catheter in the right place. Hopefully the extra care they’ve taken will turn out to be a good sign.

Feeling very nervous now. We have two more euploid embryos still in storage. This is our last day 5 one though. The other two are day 6 blasts. All high quality.

Good luck for your scan on Sunday. It’s great that it’s already those measurements though!

I’m really sorry to hear this. Do you know when your next go will start?

Hi @Always28 8.2 is really great - well done! Fingers crossed for the TWW and a sticky embryo ❤️

Omg @Always28 that's incredible! Any tips or do you think it's just the progesterone that gave it a push? Best of luck for this transfer 🤞🏼

Thanks I feel nervous about my next scan. Sorry for the TMI but I was getting loads of EWCM and it's all disappeared now... so I just hope my body is still responding to the eostrogen.

@lemons44 I think it was at least partly the progesterone. I’ve also just been making sure I take a 20-30 minute walk most days, drinking beetroot juice and pomegranate juice. I also had a reflexology appointment earlier in the week. I have no idea if these things made any difference, but they can’t have hurt!

Try not to worry. I think the CM all gets a bit confused anyway with the different hormones and suppressants. I’m sure your lining will be at least as thick as it was and hopefully even a bit thicker.

Great news @Always28 got everything crossed for you xx

Thanks @Always28 do you mind me asking what reflexology is/does?

I've had 3 acupuncture sessions this cycle - not sure if it is helping. The first one I just lay there a bit unsure but by yesterdays sessions I really relaxed into it and enjoyed it. I figured if nothing else at least relaxing is good for IVF!

Just waiting for the train to go to my scan now. So nervous x