Damn thin linings

I previously posted about endometrial lining thickness and its importance for a successful transfer (http://3yearwait.blogspot.com/2015/02/lets-talk-about-something-we-havent.html). 

I’ve always had light periods, which is nice from a lifestyle perspective, but not great when it comes to trying to get pregnant.  My lining has between 8mm (the absolute minimum to have a cycle) to 11mm.  My two successful pregnancies I was at 8mm (my son) and 11mm (anencephaly).  

Cycle 1 (fresh) – 8B – kid! [“thin” lining didn’t matter!]

Cycle 2 (fresh) – 8B – blighted ovum [“thin” lining didn’t matter; blighted ovum is not related to lining?]

Cycle 3 (frozen) – 11B – not pregnant [good lining]

Cycle 4 (frozen) – 10B – early miscarriage [good lining]

Cycle 5 (fresh) – 11B – anencephaly [good lining; anencephaly not related to lining]

Cycle 6 (frozen) – 8B – chemical (HCG less than 5) [“thin” lining an issue?]

My last cycle I was at 8mm with a genetically normal embryo, which implanted and then immediately failed.  (My HCG was a 2.)  I was worried that was related to my thin lining, but my RE did not seem concerned.  He said anything 8mm and above is fine.  But from what I’ve read I’d love to get that number higher.

The previous articles I discussed (full text for one here: http://www.fertstert.org/article/S0015-0282(06)03158-X/fulltext) suggest a thicker lining is better.

Another article I found says the same thing—less than 8mm is bad—but, happily, suggests that 8-10mm is best, at least when considering frozen cycles:

http://www.rbej.com/content/11/1/35

·        “The mean ECT for all FET cycles was 9.2 ± 2.7 mm.”

·        “Several studies suggest that pregnancy is less likely when the endometrium is < 8 mm.”

·        “They also found that pregnancy rates were highest with an endometrial thickness between 8-10 mm.”

This one suggests a lining of 9.4mm or more is (weakly) best:

http://www.rbej.com/content/7/1/33

·        “By receiver operating characteristic analysis, endometrial stripe ≥ 9.4 mm demonstrated a sensitivity of 83% for predicting clinical pregnancy following BET [blastocyst embryo transfer].”

·        BUT “the cutoff [was] a poor overall indicator of successful CP (specificity of 47%).”

·        “Patients achieving CP had a thicker ES on day of hCG prior to oocyte retrieval (11.2 ± 3.1 vs. 10.1 ± 2.6 mm, p = 0.022)”

·        Noting mixed results on whether, and how much, thickness matters: “Prior data relating the significance of ES thickness to pregnancy success after IVF are mixed. Some authors report positive correlations of ES thickness to pregnancy, [14-16], whereas others did not find such associations [17-20].”

It also cites a lot of other articles on the issue.

Anyway, based on my history I think my thin-ish lining has not impacted any of my cycles except maybe my last one.  Acupuncture is theoretically helpful in increasing blood flow and thickening up the endometrium, which I skipped for my last cycle.  L  But I’m doing that now too.