5 Natural Ways to Increase Uterine Lining Thickness and Prepare for an Embryo Transfer
During natural cycles, cycle monitoring, IUI, IVF & FET
Uterine (or endometrial) lining thickness is a useful predictor of embryo implantation and miscarriage prevention. It is measured via ultrasound during cycle monitoring, IUI, IVF, and frozen embryo transfers. A thin lining can halt the entire fertility process, and not seeing any growth in thickness, despite medical efforts, can be really frustrating.
The Lining “Norm”
Uterine lining thickness varies depending on the phase of your menstrual cycle and hormonal influence.
On your period: 2-4mm
Follicular phase (before ovulation): 5-7mm
Ovulatory phase: 7-11mm
Luteal phase (after ovulation): up to 16mm
A lining < 8mm is associated with implantation failure, poor receptivity, and low pregnancy rates. The numbers aren’t the only measurement that matters. The endometrial pattern is also relevant; the most receptive lining is called triple-line or tri-laminar (due to its 3 layer appearance).
Hormones
The most common pharmaceutical approach to a thin lining is supplementation with synthetic hormones; conjugated estrogen, progestin, or a combination of both like the oral contraceptive pill.
Adjunct Medications
There are also non-hormonal medications used to support uterine lining thickness: viagra, aspirin, and the injection fragmin can all be used to promote pelvic blood flow.
Extra Testing
EMMA - a biopsy to assess the uterine microbiome. A healthy uterine lining is made up of 99% lactobacillus species. How do you create this environment? With probiotics!
ALICE - a biopsy to assess for inflammation or infection in the uterus
ERA - a biopsy to determine the ideal length of time that progesterone should be used before an embryo transfer
If you have experienced an unsuccessful embryo transfer or miscarriage, there is more testing you should undergo as well.
1. Vitamin E
A 2017 study showed that 12 weeks of low-dose vitamin E supplementation in women with prior implantation failure increased endometrial thickness by 2mm and decreased inflammatory cytokines.
2. L-Arginine
A pilot study in 2010 used high-dose L-arginine to increase endometrial thickness and pelvic blood flow.
3. N-Acetyl-Cysteine
NAC is a super-fantastic-marvelous supplement. It has proven to improve endometrial thickness (pertinent here) as well as: induce ovulation, recruit mature follicles, reduce insulin sensitivity, and break down endometriomas! Woah!
4. Fruit: lemon, lime, orange, pomegranate, watermelon
What do all of these fruits have in common? They are nitric oxide producers. Nitric oxide dilates your blood vessels so more blood can be delivered to your uterus to build up that lining. Viagra works the same way, which means pomegranates are nature’s Viagra!
5. Acupuncture (including electro-acupuncture)
Fertility acupuncture is used to support embryo implantation and promote pelvic blood flow. It supports endometrial thickness by reducing stress on the uterine artery. Multiple studies have shown a statistically significant increase in pregnancy rates with acupuncture before embryo transfer and on the day of transfer.
When all else fails, remember that lifestyle makes a huge difference! Simple strategies like drinking at least 2L of water daily and moving your body with gravity can increase endometrial thickness.
