Thin Uterine Wall: Causes of Difficulty Getting Pregnant and How to Nourish It – Can You Still Have a Baby?

A thin uterine lining, or thin endometrial lining, is one of the most common causes of infertility. It makes it difficult for a fertilized egg to implant in the uterus, significantly reducing the chances of natural conception.

The endometrium is the inner lining of the uterus responsible for embryo implantation. Its thickness varies throughout the menstrual cycle.

Endometrial Thickness Changes During the Menstrual Cycle

• During menstruation, the endometrial lining is at its thinnest as it sheds.

• It gradually thickens in response to hormonal changes and reaches its peak thickness during ovulation.

• After ovulation, the thickness may slightly increase or decrease while preparing for embryo implantation.

• If fertilization does not occur, the lining sheds again during menstruation.

Ideal Endometrial Conditions for Pregnancy

Thickness between 8-14 mm
Should not be thinner than 5 mm
Clear and healthy, without retained old menstrual blood
Displays a triple-line pattern (Triple Lines)
Warm uterus with proper blood circulation

A healthy endometrial lining is essential for successful implantation and pregnancy.

A thin endometrial lining, or thin uterine lining, refers to an endometrial thickness of less than 5 mm, which can significantly reduce the chances of pregnancy. When the uterine lining is too thin, it becomes difficult for the embryo to implant, leading to infertility issues.

Currently, the exact cause of thin endometrial lining remains unclear. However, it is suspected that factors such as a history of uterine curettage (D&C) or long-term use of birth control pills may contribute to this condition.

• Dilation & Curettage (D&C) Procedures
  A common cause of thin endometrial lining is previous uterine curettage (D&C), often performed after miscarriages or other uterine procedures. This can lead to inflammation, scarring, or adhesions, affecting the uterine lining’s ability to thicken.

• Hormonal Imbalance (Low Estrogen Levels)
  A decline in estrogen levels, often due to premature ovarian failure or ovarian dysfunction, can hinder endometrial thickening, making it difficult for embryo implantation.

• Uterine Infections or Pelvic Inflammatory Disease (PID)
  The uterus is rich in blood vessels that supply oxygen and nutrients. Poor blood circulation caused by infections or chronic inflammation can result in uterine coldness, leading to scarring and a thin uterine lining.

• Reduced Blood Flow to the Uterus
  Conditions like fibroids or uterine tumors may obstruct blood circulation, limiting hormone delivery to the endometrial lining and preventing proper growth.

• Prolonged Use of Ovulation-Stimulating Drugs
  Medications like Clomiphene (Clomid, Serophene), used to stimulate ovulation, can act as an anti-estrogen, reducing the ability of estrogen to thicken the uterine lining. Long-term use can lead to a persistent thin endometrium.

• Long-term Use of Progestin-Only Contraceptives
  Methods like progestin-only birth control pills, injections, and implants suppress estrogen production, leading to thinning of the uterine lining over time.

• Uterine Fibroids or Polyps
  Some types of fibroids or endometrial polyps can interfere with endometrial tissue growth, preventing the lining from thickening properly.

• Unexplained Causes
  In some cases, the cause of a thin uterine lining remains unknown. Severe endometrial scarring (Asherman’s syndrome) or irreversible damage after surgery may render the uterus incapable of sustaining pregnancy.

The uterine lining that is prepared for pregnancy should not be less than 8mm in thickness. If it becomes thinner than 5mm, the chances of conception decrease significantly, increasing the risk of infertility. This is because a thin uterine lining makes it more difficult for the embryo to implant.

Therefore, the ideal endometrial thickness for pregnancy is between 8-14mm.

Diagnosis of Thin Endometrial Lining

The diagnostic process for a thin endometrial lining includes the following steps:

1. Medical History Assessment

   • The doctor will ask about the patient’s medical history, including whether they have undergone a D&C (dilation and curettage) procedure before.

2. Transvaginal Ultrasound

   • An ultrasound examination through the vagina is performed to measure the thickness of the endometrial lining.

   • This also helps identify any other abnormalities that may be affecting the uterus.

3. Hormonal Treatment (if necessary)

   • If the uterine lining is found to be too thin or too thick, the doctor may prescribe hormonal medications to help regulate and stimulate endometrial growth.

4. Follow-up Examination

   • The doctor will schedule a follow-up scan to assess whether the endometrial lining has reached an optimal thickness for embryo implantation.

If the endometrial lining is too thin during pregnancy, it can lead to several complications, including:

1. Increased Risk of Placenta Previa (Low-Lying Placenta)

   • The placenta may implant too low in the uterus, covering the cervix, which can lead to bleeding and delivery complications.

2. Risk of Uterine Rupture

   • If a woman has previously undergone uterine surgery (such as a C-section or fibroid removal), a thin uterine lining increases the risk of scar tissue formation.

   • During pregnancy, the placenta may attach to the scar tissue, causing abnormal implantation.

3. Abnormal Placental Attachment

   • Improper implantation of the placenta can lead to placental abruption (placenta detaching too early), which may cause severe bleeding (hemorrhage).

4. Preterm Birth

   • Due to insufficient support from the uterine lining, the pregnancy may not reach full term, leading to preterm labor and delivery.

5. Severe Bleeding or Hemorrhage

   • If the placenta does not implant correctly, it can cause heavy bleeding during pregnancy, increasing the risk of miscarriage or emergency delivery.

To minimize these risks, early medical intervention and close monitoring by a doctor are highly recommended.

1. Enhance Nutrition with Protein Consumption

Protein is an essential nutrient for the development and repair of cells in the body. If you are planning to conceive, increasing protein intake is crucial for nourishing healthy egg cells and supporting endometrial thickening. Reduce refined carbohydrates and opt for complex carbohydrates like whole grains, black sesame, barley, flaxseeds, and pumpkin seeds.

For more information on foods that support uterine health before pregnancy, read: "14 Uterus-Nourishing Foods Before Pregnancy to Boost Egg Health."

2. Hormonal Balance Regulation

The "Luteal Phase" is the period after ovulation when the body increases progesterone levels. Progesterone plays a key role in thickening the endometrial lining, preparing it for embryo implantation.

However, if there is a deficiency in this phase, it means that the body has low progesterone levels, leading to an insufficiently thickened endometrial lining and reduced chances of embryo implantation.

3. Improve Blood Circulation

To enhance blood circulation, consuming warm-natured foods is essential, as good blood flow helps stimulate endometrial growth. It is recommended to eat red-colored fruits and vegetables such as tomatoes, carrots, beets, and pomegranates. These foods help nourish the blood, dilate blood vessels, and improve circulation, promoting a healthy uterine environment.

Currently, there is no definitive way to prevent a thin endometrial lining. However, proper nourishment can help strengthen the uterine lining. Here are some recommended ways to support endometrial health:

1. Nutrition – Eat three balanced meals per day and include a variety of nutrient-rich foods, such as:

   • Magnesium (Mineral)

   • Vitamin B6

   • Zinc

   • Omega-3

   • Vitamin E

   • Vitamin C

2. Avoid Harmful Chemicals – If you are preparing for pregnancy, avoid exposure to harmful substances, including:

   • Processed foods

   • Pesticide-treated fruits and vegetables

   • Growth hormone-injected meats

   • Cosmetics containing Phthalates

3. Reduce Stress – Chronic stress can disrupt hormone balance, lowering the chances of successful conception. High stress levels during pregnancy may also increase the risk of miscarriage. Practicing relaxation techniques, such as meditation and yoga, can help maintain hormonal balance and support a healthy pregnancy.

A thin uterine lining refers to an endometrial thickness of less than 5 millimeters, which makes it difficult for an embryo to implant. The causes may include uterine curettage, abnormal estrogen levels, uterine inflammation, poor blood circulation in the uterus, or uterine fibroids. While a thin endometrial lining does not pose a life-threatening risk, it can lead to infertility.

For diagnosis, doctors perform a transvaginal ultrasound to measure endometrial thickness and check for any abnormalities. Currently, there is no way to prevent this condition, but certain measures can help improve uterine health. These include increasing protein intake, consuming essential nutrients like magnesium, vitamin B6, zinc, omega-3, vitamin E, and vitamin C, avoiding processed foods and chemically treated fruits and vegetables, and managing stress.

For those planning to conceive, it is recommended to undergo a health check-up beforehand. If any abnormalities are detected, doctors can provide appropriate guidance and treatment. If you have any questions, feel free to contact us via Line: @beyondivf