Endometrial thickness: How thin is too thin?

Jacobs, Emily A.; Voorhis, Brad Van; Kawwass, Jennifer F.; Kondapalli, Laxmi A.; Liu, Kimberly; Dokras, Anuja

doi:10.1016/j.fertnstert.2022.05.033

Cited by 18 publications

(17 citation statements)

References 101 publications

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“…Asherman syndrome has been suggested to be involved in this pathological condition with a lack of an endometrial basal layer 127 ; nonetheless, the reason remains unclear in several cases. Currently, an increase in the administration dose of 17β‐estradiol is commonly employed for patients with thin endometrium, 122 although some cases are refractory to this strategy.…”

Section: Resultsmentioning

confidence: 99%

“…Some patients undergoing ART show thin endometria during the period of WOI, and an endometrial thickness of <7 mm has been observed to occur in 0.7%-2.5% of fresh IVF cycles. 122 While several studies have shown the association between thin endometria and a decreased chance of pregnancy, [123][124][125][126] a definite cutoff value has not yet been established. 122 A thin endometrium, which is regarded as one of the most intractable problems in ART, does not have any specific treatment.…”

Section: Thin Endometriamentioning

confidence: 99%

“…122 While several studies have shown the association between thin endometria and a decreased chance of pregnancy, [123][124][125][126] a definite cutoff value has not yet been established. 122 A thin endometrium, which is regarded as one of the most intractable problems in ART, does not have any specific treatment. Asherman syndrome has been suggested to be involved in this pathological condition with a lack of an endometrial basal layer 127 ; nonetheless, the reason remains unclear in several cases.…”

Section: Thin Endometriamentioning

confidence: 99%

See 2 more Smart Citations

Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment

Hiraoka,

Osuga,

Hirota

2023

J of Obstet and Gynaecol

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Recurrent implantation failure (RIF) remains a challenging problem in assisted reproductive technology (ART). Further insights into uterine abnormalities that can disturb embryo implantation should be obtained. This review provides an overview of the effects of organic and non‐organic uterine disorders on endometrial receptivity. The results suggest that various uterine pathologies can lead to defective embryo implantation via multiple mechanisms. In particular, uterine adenomyosis dysregulates molecular and cellular interactions that are vital for successful embryo implantation with a background of chronic inflammation, which may be alleviated by pretreatment with a gonadotropin‐releasing hormone agonist. Uterine myomas can cause endometrial deformation and adverse alterations in uterine contractility. Nonetheless, the effectiveness of myomectomy remains debated, and endometrial polyp removal may be considered, particularly in patients with RIF. Chronic endometritis abrogates the appropriate uterine immunological environment critical for embryo implantation. Abnormal endometrial microbiota have been suggested to influence endometrial receptivity; however, supporting evidence is currently scarce. Platelet‐rich plasma therapy may be a potential treatment for thin endometria; nevertheless, further validation is required. Endometrial receptivity analysis can detect dysregulation of the window of implantation, and new non‐invasive methods for predicting endometrial receptivity have recently been proposed. However, numerous issues still need to be fully clarified. Further clinical and basic studies are necessary to investigate the pathophysiology of defective endometrial receptivity and identify optimal treatments for patients undergoing ART, especially those with RIF.

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Section: Resultsmentioning

confidence: 99%

Section: Thin Endometriamentioning

confidence: 99%

Section: Thin Endometriamentioning

confidence: 99%

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Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment

Hiraoka,

Osuga,

Hirota

2023

J of Obstet and Gynaecol

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“…In the studies of Check JH (2003) and Sundstroem P (1998), cases of pregnancy with the birth of healthy children were demonstrated in both natural and stimulated cycles with a ET of 4 mm [50,51]. However, since ET often determines the outcome of implantation and pregnancy, it is now recognized as an important surrogate marker of endometrial receptivity [52].…”

Section: "Thin" Endometriummentioning

confidence: 99%

The Therapeutic Potential of Multipotent Mesenchymal Stromal Cell—Derived Extracellular Vesicles in Endometrial Regeneration

Tabeeva

Silachev

Vishnyakova

et al. 2023

IJMS

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Disruption of endometrial regeneration, fibrosis formation, and intrauterine adhesions underlie the development of “thin” endometrium and/or Asherman’s syndrome (AS) and are a common cause of infertility and a high risk for adverse obstetric outcomes. The methods used (surgical adhesiolysis, anti-adhesive agents, and hormonal therapy) do not allow restoration of the regenerative properties of the endometrium. The experience gained today with cell therapy using multipotent mesenchymal stromal cells (MMSCs) proves their high regenerative and proliferative properties in tissue damage. Their contribution to regenerative processes is still poorly understood. One of these mechanisms is based on the paracrine effects of MMSCs associated with the stimulation of cells of the microenvironment by secreting extracellular vesicles (EVs) into the extracellular space. EVs, whose source is MMSCs, are able to stimulate progenitor cells and stem cells in damaged tissues and exert cytoprotective, antiapoptotic, and angiogenic effects. This review described the regulatory mechanisms of endometrial regeneration, pathological conditions associated with a decrease in endometrial regeneration, and it presented the available data from studies on the effect of MMSCs and their EVs on endometrial repair processes, and the involvement of EVs in human reproductive processes at the level of implantation and embryogenesis.

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“…Among the ultrasonographic parameters that are used to assess whether the endometrium is adequately prepared for implantation, endometrial thickness is the one that has been studied most extensively. Most clinicians consider cancellation of embryo transfer due to endometrial hypoproliferation or 'thin endometrium' below a certain threshold [3].…”

Section: Introductionmentioning

confidence: 99%

Treatment options for endometrial hypoproliferation

Çakıroğlu

Tıraş

Franasiak

et al. 2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewEndometrial hypoproliferation refers to the failure of the endometrium to reach optimal thickness during fresh or frozen embryo transfer cycles in women undergoing infertility treatment with in-vitro fertilization (IVF). This review discusses the treatment options for endometrial hypoproliferation. Recent findingsApart from factors related to the embryo quality, ultrasonographic findings associated with the endometrium, such as endometrial thickness, endometrial pattern and subendometrial blood flow, are considered key factors associated with the outcome of assisted reproductive treatment. To date, a consensus has not been reached regarding the definition of thin endometrium, while thresholds of 6, 7 or 8 mm have been used in the literature. Strategies to increase endometrial thickness can be reviewed in three groups: endocrine approaches, vitamins & supplements, and new experimental therapeutic interventions. Some of the recently introduced experimental therapeutic interventions such as platelet-rich plasma injection, stem cell treatment and tissue bioengineering are exciting potential therapies that need to be further studied. SummaryDespite a large number of publications on the topic, diagnosing and treating endometrial hypoproliferation remains a challenge. Well designed studies are needed to establish a widely accepted endometrial thickness cut-off value below which endometrial hypoproliferation is diagnosed and to generate meaningful data that would allow an evidence-based discussion of available therapeutic options with patients.

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Endometrial thickness: How thin is too thin?

Cited by 18 publications

References 101 publications

Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment

Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment

The Therapeutic Potential of Multipotent Mesenchymal Stromal Cell—Derived Extracellular Vesicles in Endometrial Regeneration

Treatment options for endometrial hypoproliferation

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