Infertility Endometrial Lining

Infertility evaluations often include an evaluation of the endometrial lining.  The endometrial lining is responsible for supporting the implantation of a fertilized egg for a developing pregnancy.  Infertility from poor endometrial lining is actually a bit more common than you might imagine.

First, the endometrial lining must be fairly normal in order to conceive and maintain a pregnancy.  The lining begins development almost immediately after the menstrual period ends.  The lining is built up in response to hormones and to prepare the body for another potential pregnancy.  If no pregnancy happens, the body recognizes the event and the endometrial lining is once again shed at the end of the menstrual cycle.

Fertility evaluations should be individualized to each couple based on their history and physical examinations.  However, there are some baseline evaluations that should be investigated.  Infertility is medically defined as a condition where by a couple has been having unprotected sex for six months without conception.

There are several generalized studies and protocols.  Your physician may find that a different route is more efficient while evaluating your particular problem.  Infertile endometrial linings are responsible for poor conception rates.  Those rates increase as a woman’s age increases.

An infertile endometrial lining that leads to infertility can be caused by many factors.  Endometritis is inflammation of the uterine lining, which can happen after a septic baby delivery, an abortion or even a miscarriage.  Endometritis causes the uterine lining to inflame and become an unsupportive environment for a pregnancy.

Adenomyosis is an invasion of the uterine wall by endometrial tissue.  This infertile environmental issue will cause the uterus to lay down poor endometrial support for a pregnancy.  Multiple fibroid tumors can invade the uterine wall and take up the area an egg may implant.  Prenatal exposure to DES will permanently alter the uterine environment and cause infertile endometrial lining development.

Women who receive Clomid to increase their chance of conception are asked to take a break from the medication after three months because the medication causes changes to the endometrial lining which doesn’t allow conception.  The good news about these changes is that they are reversible.

An endometrial biopsy may be performed in order to reveal the response of the uterus to the hormonal signals that happen during the cycle.  Pathologists evaluate the biopsy of a small piece of the uterine lining just before the end of the menstrual cycle to date the lining and to test for the uterine wall response to hormones.  If the uterine lining (endometrial lining) is out of sync with the hormones then this causes a major problem with infertility if left undetected or untreated.

Research during IVF (invitro fertilization) shows that the pre-ovulatory endometrial thickness is predictive of whether there will be a successful pregnancy.  In a small study reported in Human Reproduction April 2000 researchers found that use of a compounded Viagra vaginal suppositories used at specific intervals increased the endometrial development by increasing the blood flow. (1)

In another small study in Fertility and Sterility, October 2002, researchers again found a high rate of pregnancy following IVF in women who used the Viagra vaginal suppositories to improve endometrial lining. (2)

Infertility endometrial lining problems can cause emotional and psychological pain to the couple who are attempting to become pregnant.  But, with a correct diagnosis and treatment many women go on to carry a full term pregnancy.

(1) New Scientist: Not Just for Men

(2) Fertility and Sterility: Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage

(3) Fertility and Sterility: Effect of vaginal sildenafil on the outcome of invitro fertilization after multiple IVF failures attributed to poor endometrial development