Zhimei's girlfriend Xiao Chen, in recent years, has been relatively small menstruation, and it is clean every time it can't come for two days.
What's even more depressing is that she has been pregnant for 1 and a half years and has not succeeded.
After going to the hospital for a check-up, the doctor said it might be because the endometrium was too thin.
The doctor made an analogy that the uterine lining is thin like the "soil" is not fertile enough, and the fertilized egg cannot make a home.
So the question is, why does the inner membrane become thinner, and how thick is enough?
The endometrium is not constant, it is like a leek, each menstrual cycle will grow a stubble, during the menstrual period is "cut off", into menstrual blood, excreted from the body.
(Relatives who like to eat leeks can ignore this metaphor.) ）
(Source: treated.com)
Normally, after menstruation, the thickness of the intimal film generally ≤5 mm.
After menstruation, the endometrium begins to grow again under the action of "fertilizer" (estrogen) and enters the hyperplasia period.
Seeing this, the attentive reader may ask, where does "fertilizer" come from?
After menstruation, the follicles in the ovaries begin to develop, and as they continue to grow, the follicles continue to secrete estrogen, estradiol.
Therefore, the thickening of the endometrium is accompanied by the development of follicles.
In general, when the diameter of the dominant follicle (follicle that can release eggs) reaches or exceeds 15 mm, the thickness of the endometrium should be 7-8 mm or more.
If it can reach 9 mm, this thickness of the endometrium is more comfortable, which is very suitable for the fertilized egg (a combination of egg and sperm) to implant.
Studies have also confirmed that when the endometrium ≥ 8 mm, the chances of pregnancy increase, and when the < 5 mm, the fertilized egg is basically unable to complete implantation [1].
The thinner the endometrium, the lower the pregnancy rate and the higher the rate of spontaneous abortion.
So the question is, why can't some people's endometrium grow?
The endometrium is divided into two layers: the functional layer and the basal layer, like leek leaves and leek roots.
(Relatives who like to eat leeks can't stand it again)
The functional layer is thicker, regulated by estrogen and progesterone, and periodical changes occur, and it is the functional layer that falls off each menstrual period.
The basal layer is thin and does not fall off, providing blood transport to the functional layer.
If the basal blood vessels are destroyed and the functional layer lacks blood supply, the endometrium does not grow.
The main reasons for the thinning of the endometrium in women are as follows:
Endocrine factors
Endocrine disorders caused by intrinsic factors, such as insufficient estrogen and progesterone, and growth hormone deficiency. This is generally not enough fertilizer, the leaves are not long.
age
Studies have shown that as women age, the endometrium thins with it [2,3].
Repeated operation of the uterine cavity
Repeated evacuation of the uterus can destroy the basal layer of the uterus by abortion or due to embryonic suspension, mole mole, incomplete abortion, etc. Simply put, it hurts the roots.
inflammation
Mycoplasma infection, chlamydia infection, pelvic tuberculosis, etc. can cause damage to the basal layer of the uterus, affect the blood supply of the lining and the proliferation of intimal cells, resulting in thinning of the lining [4], and in severe cases, the root can also be injured.
The most immediate effect is low menstrual flow, and the most headache is that it is not easy to get pregnant or easy to miscarry.
Scratch the point!
Therefore, if your menstrual volume is too small (the number of menstrual days is shorter than 2 days, the amount of menstrual blood does not exceed 20 ml at a time), and you have a pregnancy plan, it is recommended that you go to the hospital for a comprehensive examination to determine whether it is caused by endocrine or the uterus itself.
If the inner membrane is thin due to hormone deficiency, hormone adjustment therapy can be performed under the guidance of a doctor.
If the endometrium is thin due to endometrial adhesions, it is treated with minimally invasive surgery [5].
For some stubborn thin endometrium, drugs that improve blood supply, such as aspirin and sildenafil, can also be applied [6,7].
It should be noted that if the basal layer of the endometrium is severely damaged, it is difficult to repair. Current methods of treating the basal layer of the endometrium are limited and the effect is uncertain.
So, the most important thing is prevention!
Regarding prevention, Zhimei would like to emphasize again:
Minimize damage to the endometrium, timely treatment of inflammation;
Do a good job of contraception and reduce unnecessary uterine cavity manipulation;
If it is impossible to avoid uterine cavity manipulation, try to go to a regular hospital to do it.
Reviewer
Liu Juan | Deputy Director of the Department of Gynecology, the Third Affiliated Hospital of Guangzhou Medical University
bibliography
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[6] Weckstein LN，Jacobson A，Galen D，et al. Low -dose aspirin for oocyte donation recipients with a thin endometrium: prospective, randomized study[J]. Fertil Steril，1997，68（5）：927 -930.
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