A prepared uterine lining (Endometrium) is critical for successful implantation after embryo transfer. A commonly used guideline for assessing the endometrium is to measure its thickness. Endometrial thickness is often abbreviated as EMT.
During the stimulation phase of IVF, EMT usually increases in response to estrogen released by the ovaries. It is generally accepted that it is a “thick” lining that will be receptive for the embryo(s) after transfer. The most commonly used cut off for defining a thin endometrium is less than or equal to 7 mm.Some studies have suggested that a thin lining is associated with low IVF pregnancy rates whereas others were not able to confirm this thesis. Despite this, EMT is now routinely measured using transvaginal ultrasound during in vitro fertilization (IVF).
Poor endometrial lining most commonly occurs in women with a history of unexplained recurrent IVF failures or early recurrent miscarriages and is usually attributable to the following factors:
Endometritis: Chronic infection of the endometrial cells.
Fibroids of the uterine wall (non-cancerous muscle tumors of the uterus).
Scar tissue of the endometrium (called Asherman’s syndrome), caused by prior D&Cs or other uterine manipulations
Endometrial thickness cannot predict the outcome of an IVF cycle. The impact of endometrial patterns on IVF pregnancy rates has been investigated with conflicting results.
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