To address thin endometrium, it’s important to first understand its causes. Thin endometrium may result from damage due to uterine surgeries, infections leading to intrauterine adhesions, or, in some cases, unknown reasons.

Thin endometrium is a significant factor in infertility, recurrent miscarriage, and repeated implantation failure. Therefore, its treatment is a key challenge in reproductive medicine. Strategies for improving pregnancy outcomes with thin endometrium include:

1. Surgical Treatment

The primary cause of thin endometrium is often basal endometrial damage and intrauterine adhesions due to uterine procedures.

  • Hysteroscopic Evaluation and Treatment:
    Patients with ultrasound findings of disrupted endometrial echoes typically show varying degrees of intrauterine adhesions.

    • Endometrial Scratching or Minimal Trauma:
      Also known as “uterine cavity preparation,” this procedure is suitable for patients with repeated implantation failure but no significant endometrial abnormalities on ultrasound. It helps exclude intrauterine abnormalities or inflammation while improving endometrial receptivity and pregnancy rates.
    • Adhesion Separation:
      For mild adhesions, one surgery is often sufficient. Severe cases may require multiple procedures.

2. Medical Therapy

Medications can promote endometrial proliferation and improve uterine receptivity. Commonly used drugs include:

  • Estrogens:
    Natural estrogens are the most widely used:

    • Progynova (oral medication)
    • Femoston (oral or vaginal use)
    • Estradiol Gel (topical application)
  • Drugs to Improve Endometrial Blood Flow:
    • Aspirin
    • Low-Molecular-Weight Heparin
    • Tadalafil
  • Growth Hormones:
    These are sometimes used to stimulate endometrial proliferation in more resistant cases.

3. Intrauterine Infusion

Intrauterine infusion is a newer treatment specifically targeting thin endometrium, especially for patients with repeated implantation failure. This method significantly improves embryo implantation rates. Substances used include:

  • Granulocyte-Colony Stimulating Factor (G-CSF)
  • Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF)
  • Platelet-Rich Plasma (PRP)
  • Stem Cell-Based Therapies

These agents regulate local immunity in the uterine cavity and promote basal endometrial cell proliferation, improving endometrial thickness and receptivity.

I have been performing intrauterine infusions for over a decade, successfully helping many patients with thin endometrium achieve pregnancy and childbirth. I have also shared my experience at academic conferences to advance this treatment among peers.

By combining these strategies—surgical intervention, targeted medical therapies, and advanced intrauterine techniques—many patients with thin endometrium have successfully achieved healthy pregnancies.