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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Endometrial Thickness Reduction Despite Progynova Intake For IVF Indicate?

hi doctor , i am shery i am 35 years old . i am undergoing ivf my embryos have been forzen but as i dont have appropriate endometrial thickness it is being postponed . i have thickness of 5 .2 on the 12th day of my cycle.but after taking progynova tab,2vaginaly &1 orally 3times a day from 12th day ,on the 16th day of my cycle my endometrial thickness was incresed to 7.5 but thou i continued the same tablet my emdometrial thickness droped to 5.9 .why is it so ?what can i do know what is correct thickness of endomertrium for FET.pls answer me soon sir.
Fri, 29 Apr 2016
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Infertility Specialist,  's  Response
Hello shery, thanks for writing in. I understand your anxiety. Let me explain you a few things.
1. Endometrium acts like soil where embryo gets implanted. The desired endometrial thickness for embryo transfer is at least 8 to 9 mm. Having said that, I would like to add that the blood supply to the endometrium is much more important than thickness alone. This can be found out by using Doppler technique by your sonologist. If your blood supply is fine, and your endometrium is giving a triple line appearance, a thickness at least 6 to 7 mm is acceptable. There are a FEW reports where pregnancy has happened with even 5 mm endometrium.

2. Its quite unlikely that endometrium has shrunken unless progesterone has been started after good endometrial growth with estrogen. The thickness is subjected to inter observer and intra observer variability which means there will be a difference of 2 or 3 mm when same person measures at different times or different people measure.

3. You may try estrogen gel three times to see if it works better for you after discussing with your doctor. It bypasses liver and makes maximum estrogen available to the endometrium to support its growth.

Hope you find this useful. Good luck.
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What Could Endometrial Thickness Reduction Despite Progynova Intake For IVF Indicate?

Hello shery, thanks for writing in. I understand your anxiety. Let me explain you a few things. 1. Endometrium acts like soil where embryo gets implanted. The desired endometrial thickness for embryo transfer is at least 8 to 9 mm. Having said that, I would like to add that the blood supply to the endometrium is much more important than thickness alone. This can be found out by using Doppler technique by your sonologist. If your blood supply is fine, and your endometrium is giving a triple line appearance, a thickness at least 6 to 7 mm is acceptable. There are a FEW reports where pregnancy has happened with even 5 mm endometrium. 2. Its quite unlikely that endometrium has shrunken unless progesterone has been started after good endometrial growth with estrogen. The thickness is subjected to inter observer and intra observer variability which means there will be a difference of 2 or 3 mm when same person measures at different times or different people measure. 3. You may try estrogen gel three times to see if it works better for you after discussing with your doctor. It bypasses liver and makes maximum estrogen available to the endometrium to support its growth. Hope you find this useful. Good luck.