ways to improve uterine lining for IVF

How To Improve Uterine Lining For IVF

When it comes to IVF, a thin uterine lining can pose a serious threat as it can lead to unsuccessful implantation or abnormalities in the lining that can potentially lead to early pregnancy loss. You see, the endometrium or the e lining of a woman’s uterus, wherein a developing embryo typically implants during the initial days of pregnancy, plays quite a vital role for those undergoing IVF. The lining has to be preferably thick for implantation to happen. 

Factors such as estrogen deficiency, inadequate blood circulation to the uterus, the presence of uterine fibroids, adhesions or scar tissue in the uterus resulting from trauma or infection, hydrosalpinx, and chronic endometritis (an infection affecting endometrial cells) can contribute to a woman experiencing a thin uterine lining.

Typically, fertility doctors will measure the thickness of the uterine lining of their patients before the embryo transfer so as to make sure that implantation can occur. It is possible to achieve pregnancy with a uterine lining that is less than 7 to 8mm thick. However, for optimal results, specialists and doctors may encourage patients to enhance and thicken the uterine lining before the embryo transfer procedure.

What Defines an Optimal Uterine Lining?

The growth of the uterine lining relies on maintaining a healthy balance of both estrogen and progesterone hormones. During the starting phase of the menstrual cycle, as estrogen levels increase, the uterine lining undergoes growth. Following the release of an egg from the ovary, the production of estrogen decreases, while progesterone levels rise. This hormonal shift halts further growth of the uterine lining, prompts its maturation, and readies it for potential embryo implantation. In cases where a thin uterine lining is diagnosed without underlying conditions, supplementary treatments such as estrogen, hCG, and Sildenafil citrate may be prescribed.

Read more: hCG Levels After IVF Embryo Transfer

Serious Uterine Lining Issues and IVF

Certain uterine lining conditions can pose challenges in achieving and maintaining a successful pregnancy, even with the assistance of in vitro fertilization (IVF). Conditions such as Endometriosis, Adenomyosis, Asherman syndrome, and luteal phase defect may impact fertility outcomes. It’s worth noting that having one of these conditions does not universally affect fertility, and individuals may be unaware of their presence until attempting to conceive. However, for some individuals, these conditions can lead to infertility, which can cause them to consider fertility treatments to achieve pregnancy.

Reasons Why A Woman May Suffer From A Thin Lining. 

Several factors contribute to the development of a thin endometrium.

  • Hormonal imbalances stemming from various causes, such as stress, an unbalanced diet, and certain medications, can lead to a deficiency in estrogen.
  • Polycystic Ovary Syndrome (PCOS), affecting approximately 10% of women in their reproductive years, is a primary contributor.
  • Age is also a significant factor, as the production of estrogen decreases in older women, resulting in a thin endometrium.
  • Inadequate blood flow to the uterus, influenced by factors like smoking, obesity, high blood pressure, diabetes, as well as the use of birth control pills, can contribute to thinning.
  • Damage to the endometrial lining from previous uterine infections may lead to scar tissue formation.
  • Uterine fibroids, whether too small to be visible or large enough to cause uterine bulges, can impact pregnancy chances, potentially requiring surgical removal.
  • Chronic endometritis, characterized by infection or inflammation of the uterine lining, hinders embryo implantation. In the case of endometritis, a course of antibiotics can help.
  • Irregular menstrual cycles, often associated with hormonal disturbances and impaired ovulation, can also further cause a thin endometrial lining.

Symptoms Associated With Having A Thin Uterine Lining

For those uncertain about the condition of their uterine lining, several common symptoms may indicate the presence of a thin uterine lining. These symptoms include experiencing painful periods, scanty menstrual flow, the presence of clots in menstrual blood, ultrasound measurements revealing a thin lining, challenges with the implantation of embryos, recurrent pregnancy loss, and complications during pregnancy.

How To Improve Uterine Lining For IVF

Granted, experiencing a thin uterine lining may be despairing for those undergoing IVF. Good news is that there are several ways, both medical and lifestyle-related, to enhance and thicken the uterine lining:

1. Hormonal Support

There are exogenous estrogen, administered through patches, suppositories, or oral pills, to address a thin uterine lining. In some cases, treatments like Gonal-F may be suggested by doctors to stimulate the body’s own estrogen production (endogenous estrogen).

2. Blood Flow Optimization:

There are three ways that can be used to optimize blood flow:

  • Regular Exercise: Increased body weight can enhance blood flow to the pelvic region, as fat cells contribute to additional estrogen production. The objective is to maintain a BMI within the normal range of 18.5 to 24.9. Engage in moderate, regular exercise to improve blood flow to the pelvic region. Activities like brisk walks, gentle yoga, or moderate elliptical workouts can enhance circulation without causing undue stress. 
  • Lifestyle Adjustments: Reduce or eliminate substances like caffeine and nicotine, as they can impede blood flow. It’s imperative to consult a doctor about avoiding specific over-the-counter remedies that may restrict blood vessels.
  • Acupuncture: Acupuncture is a helpful method for improving the growth of follicles, boosting blood flow to the uterus and ovaries, and supporting the development of the uterine lining, egg maturation, and embryo implantation. Many studies have found that getting acupuncture before embryo transfer and on the transfer day increases the chances of pregnancy. 

3. Nutritional Supplements

  • Vitamin E: A 2017 study showed that women with low implantation rates experienced a 2mm increase in endometrial thickness and a decrease in inflammatory cytokines after 12 weeks of taking low-dose vitamin E supplements. Although there are certain foods to thicken uterine lining for IVF like avocados, nuts, and seeds are naturally high in Vitamin E, women with thin endometrial linings tend to benefit the most from a daily supplementation of 500-700 mg.
  • L-arginine: In a 2010 pilot study, a high dose of L-arginine was used to boost both endometrial thickness and pelvic blood flow. Foods rich in L-arginine, such as red meats, fish, soy, whole grains, beans, and dairy, were the primary sources considered in the study.

4. Frozen Embryo Transfer (FET)

Some fertility experts propose that women facing challenges with endometrial thickness may improve their chances of successful implantation by freezing embryos from their IVF cycle and delaying the transfer by a month or two. This delay allows the body to recuperate from fertility medications. Frozen embryo transfer (FET) demonstrates a success rate comparable to fresh embryo transfer. In certain situations, taking a break enables the reproductive system to “reset,” allowing the body to focus its energy on developing a thicker endometrial lining.

5. Dietary Choices

  • Whole Grains: Increase the intake of whole grains like dark bread, brown rice, and quinoa, as they are rich in nutrients that may support implantation.
  • Oily Fish: Opt for oily fish in your diet, as it has omega-3 fatty acids that contribute to improved blood flow.
  • Fruits Rich in Nitric Oxide: Consume fruits like lemon, lime, orange, pomegranate, and watermelon, which produce nitric oxide, widening blood vessels to enhance blood flow.

Read more: Do’s and Don’ts after your Embryo Transfer

FAQs on Improving Uterine Lining For IVF

What Is a Good Endometrial Thickness for IVF?

Higher clinical pregnancy and live birth rates are often observed in individuals with an endometrial thickness exceeding 9 to 10 mm. It’s important to note that implantation can still happen in some cases, even when the endometrium is thin.

Can endometrial thickness be improved with natural remedies?

Yes, engaging in regular physical activity, maintaining a diverse diet, and adopting a healthy lifestyle can lead to endometrial thickness.

Can you use vaginal viagra as a treatment to increase uterine lining?

Based on a study, using vaginal sildenafil (25 mg, 4 times a day) increased endometrial thickness (≥9 mm) in 70% of the patients. 

Does the endometrium continue to grow after Ovitrelle administration?

Yes, after taking Ovitrelle and during ovulation or after egg retrieval, the endometrium keeps growing because of estrogen.

Is it advisable to do the embryo transfer with an endometrial thickness of 6 mm?

Based on a study, embryo transfer with an endometrial thickness of 6 mm could still result in a successful pregnancy. However, it’s essential to consider individual patient factors and consult with experts in this field to make informed decisions about the embryo transfer.

What does it mean when the lining of the uterus is too thick?

When the lining of the uterus is too thick, it is referred to as endometrial hyperplasia. This condition is considered precancerous, indicating that there is an abnormal and irregular thickening of the uterine lining. Women with endometrial hyperplasia may experience uncomfortable symptoms, such as heavy menstrual periods, postmenopausal bleeding, and anemia due to excessive bleeding.

Can aspirin thicken uterine lining?

According to a study, aspirin seemed to have a positive impact on fertility outcomes and the visual appearance of the endometrium, but it did not cause a substantial increase in endometrial thickness.

How quickly can the uterine lining thicken?

The uterine lining can typically thicken within one-and-a-half to three weeks with the use of estrogen medications in fertility treatment. If the desired thickness is not achieved within this timeframe, further decisions about treatment options will be made in consultation with the doctor.

What foods thicken uterine lining for IVF?

Whole grains, oily fish rich in omega-3 fatty acids, and fruits high in nitric oxide, such as lemon, lime, orange, pomegranate, and watermelon, are dietary choices that may help thicken the uterine lining for IVF by providing essential nutrients and supporting blood flow.

What supplements are good for uterine lining during IVF?

It’s important to note that the use of supplements for thickening the uterine lining has not been conclusively proven, but vitamin E, L-arginine, and vitamin D can potentially help improve endometrial thickness during IVF. 


Contributor, SCRC. “How to Improve Your Uterine Lining to Prepare for IVF.” Blog.scrcivf.com, blog.scrcivf.com/thicken-endometrium-uterine-lining-ivf. Accessed 17 May 2024.

Thin Endometrial Lining | 3 Tips To Improve Your Uterus For IVF: University Reproductive Associates: Reproductive Endocrinologists. (n.d.). Www.uranj.com. https://www.uranj.com/blog/thin-endometrial-lining-3-tips-to-improve-your-uterus-for-ivf

‌Taylor, Michael, et al. “Endometritis.” PubMed, StatPearls Publishing, 2023, www.ncbi.nlm.nih.gov/books/NBK553124/#:~:text=Chronic%20endometritis%20is%20typically%20treated.

“Endometrial Hyperplasia.” Yale Medicine, www.yalemedicine.org/conditions/endometrial-hyperplasia#:~:text=Overview.

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