Role of Endometrium in Fertility Treatment
Role of Endometrium in Fertility Treatment
Endometrial Thickness:-
One of the most important parameters in infertility treatment is endometrial thickness. The thickness of the endometrial lining is important for embryo implantation.
In the natural cycle as well as in the stimulated cycle, when the egg reaches around 18 mm the endometrium grows under the effect of oestrogen and usually reaches the magic measurement of around 10.3+- 0.3 mm or more and becomes triple layered. If endometrium remains thin in spite of good egg size then that needs an evaluation.
Causes of Thin Endometrium:-
Some important causes of the thin endometrium include chronic pelvic infection, genital tuberculosis, previous history of dilatation and curettage or asherman's syndrome.
It has been seen that when we use clomiphene citrate for ovulation induction, it is associated with a thinner endometrium.
Compared with clomiphene citrate, letrozole has been associated with a thicker endometrium. Gonadotropins represents the most aggressive ovarian stimulation strategy and are associated with highest _estradiol levels which are believed to result in more pronounced endometrial thickening. In summary, the studies have found live birth rates are associated with increased endometrial thickness and triple layered pattern of endometrium.
Role of ultrasound in the assessment of the Endometrium:-
Ultrasound and that too trans vaginal ultrasound is the best way to measure endometrial thickness. According to various studies the endometrium is at its thinnest during menstruation, when it usually measures between 2-4 mm in thickness and increases to.10-12mm before ovulation In the first half of the cycle that is proliferative phase, three echogenic lines are seen.A trilaminar endometrium on the day of trigger of ovulation is associated with higher pregnancy rate. Once ovulation has occurred, this triple layered pattern disappears and the endometrium becomes more homogenous with poorly defined outer wall.We can also assess the endometrial blood flow on ultrasound.
Endometrial Pathology associated with thin endometrium:-
If any endometrial pathology, like polyp, submucous fibroid, any fluid or blood collection is there that can easily be picked by ultrasound.
These pathologies make the endometrium unfit for implantation.
Endometrial polyp, submucous myoma are easily removed by operative hysteroscopy so these procedures should be offered in a patient of infertility if needed.
For additional information you can contact Chawla nursing home and maternity hospital Jalandhar Punjab at +91 7307103001, 9023703001.
