We said in the previous popular science that the thickness of the intima before ovulation, or the thickness of the inner membrane on the day of the ovulation induction cycle, if it is less than 7mm, is a thin intima, and the chance of conception is relatively small.
Today, let's talk about the treatment of thin lining!
First, there is inflammation and tuberculosis that requires symptomatic treatment first.
Secondly, if the treatment is not effective for a period of time, the doctor may consider performing hysteroscopy first, first, to isolate the lining adhesions (if any) and to take a little intima for examination to rule out other lesions.
So, how can the endometrium be long when hysteroscopic and endometrial biopsy pathology has been clearly defined without abnormalities?
There are currently four ways to help you, because of their own characteristics and pros and cons, remember: do not use medicine under the guidance of a doctor!!!
1. Hormonal drugs
This is the most classic medicine, good at "fertilization", so that the inner membrane is fully nourished, becoming a fertile "black soil":
1. Estrogen
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The most authoritative method! High doses of estrogen can act on estrogen receptors on the endometrium, causing endometrial cells to proliferate. Because 95% of oral drugs are metabolized by the liver, vaginal administration and percutaneous patches have more advantages in recent years, and can achieve similar effects through smaller doses and stable blood concentrations. However, studies have also found that this method may be more suitable for "mild" patients with intimal thickness slightly below the threshold. However, the value of estrogen therapy is limited in some patients with defects in the estrogen receptor and downstream signaling pathways, as these people are unable to respond appropriately to estrogen.
2. Other hormones
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Growth hormone and GnRH-a (gonadotropin-releasing hormone analogues) and the like in some studies can increase the thickness of the endometrium, significantly shorten the endometrial preparation time, and then obtain a more ideal clinical pregnancy rate and embryo implantation rate, but the clear molecular mechanism needs to be further confirmed by the trial, and it must be used under the guidance of a doctor.
2. Blood-activating drugs
The proliferation of the inner membrane needs "nutrition", and to be transported through the blood, people who do not have a smooth blood flow will suffer!
Thin intima is characterized by high resistance to arterial blood flow, especially uterine arteries, poor blood flow perfusion of the intima, and slow growth rate of glandular epithelium, which affects the thickness of the intima. Therefore, on the basis of estrogen use, drugs to improve the blood supply of the endometrium came into being, including aspirin, "Viagra" (sildenafil) and so on. Right! There is indeed "Viagra", as for the principle, you know! In addition to this, there is pelvic floor muscle massage/neuromuscular electrical stimulation.
However, these efficacy effects need to be further studied, and the medication needs to be individualized, and do not buy the medicine blindly!
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Third, "regeneration" technology
One of the most scientific and technological methods is not to "cultivate soil", but to directly "make soil", is it not cool? In recent years, with the deepening of stem cell therapy research, emerging evidence supports the existence of endometrial stem cells in the human body, which plays a role in the regeneration of the endometrium, and even non-endometrial stem cells seem to play a role in endometrial regeneration; in addition, hematopoietic and non-hematopoietic bone marrow-derived stem cells, which will be aggregated into the endometrium through damage stimulation, can play an important role in epithelial regeneration. For patients with thin uterine lining and repeated embryo implantation failures, there are a small number of cases of successful pregnancy after treatment with stem cells extracted from bone marrow and menstrual blood, but due to the difficulty of the technique and the lack of large-sample research, there has not been a large-scale application in clinical practice. However, scientists are still working hard, and stem cell technology is still worth looking forward to.
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4. Traditional Chinese medicine
Pay attention to natural and holistic treatment, mostly for the combination of traditional Chinese medicine + acupuncture.
1. Acupuncture
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Studies by scholars at home and abroad have shown that low-frequency percutaneous electrical stimulation can effectively improve the endometrial blood flow resistance index, improve endometrial tolerance, increase the thickness of the endometrium in patients with thin endometrial infertility, and improve the clinical pregnancy rate. A study of 145 frozen embryo transplantation cycles in 96 people of Nanjing Medical University found that after a transplant cycle of electrical stimulation of acupuncture points "Zhongji", "Guan Yuan", "Uterus", "Foot Sanli", "Sanyin Jiao", "TaiChong" and "Kidney Yu", the intima increased from an average of 3.9 mm to 6.3 mm in patients with an intima before treatment, and the intima increased significantly from an average of 5.4 mm to 7.8 mm in patients before treatment. However, the study also found that there was no change before and after treatment for those with an intimal 3 mm or less, and other therapies may be considered.
2. Traditional Chinese medicine
Traditional Chinese medicine starts from the whole, adjusts the balance of the body, and the study finds that it not only improves the local blood supply, but also acts on the endometrium in multiple ways and multiple targets, increases the thickness of the endometrium, improves the endometrial tolerance, and has the advantages of small side effects and low cost. At the same time, the combined use of traditional Chinese medicine on the basis of existing Western medicine treatment plans can optimize the efficacy and reduce the adverse reactions of pure Western medicine. A study recruiting 76 people found that the thin intima was treated with Qilin Pill (Warm Kidney Yang Proprietary Chinese Medicine) plus estradiol tablets Estradiol Didrogestone Tablets (Western medicine natural estrogen) to treat thin intima, and the increase in intima (2.7 mm) after 3 months of treatment was about twice (1.4 mm) of Western medicine alone.
It should be noted that Chinese medicine is an individualized treatment, not everyone eats the same medicine to have an effect, do not buy it yourself! The same is the thin inner membrane, and the treatment regimen may be different for different people.
Although there is no specific study on whether lifestyle affects the thickness of the endometrium, from a physiological point of view, proper exercise, adequate sleep, a balanced diet and a stable mood are good for the endometrium! (Actually, it's good for all diseases and sub-health...) ）
bibliography
1. Xu Yining, Sun Xiaoxi. Progress in the treatment of thin endometrium. Shanghai Medical Science, 2019, 42(2): 107-112
2. Tian Li. Pay attention to the influence of thin endometrium on fertility. Chinese Clinical Journal of Obstetrics and Gynecology 2018,19(4):289-290.
3. Ding Zhaofei, Tian Li. Research advances in thin endometrium. Chinese Clinical Journal of Obstetrics and Gynecology 2017,18(6): 568-571
4、Siristatidis CS, Basios G, Pergialiotis V, Vogiatzi P. Aspirin for in vitro fertilisation. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD004832.
5、Bodombossou-Djobo, M.M., Zheng, C., Chen, S. et al. Neuromuscular electrical stimulation and biofeedback therapy may improve endometrial growth for patients with thin endometrium during frozen-thawed embryo transfer: A preliminary report. Reprod Biol Endocrinol 9, 122 (2011).
6. Chang Xiaoxia, Gao Yan, Ge Huan, etc. A preliminary study on the therapeutic effect of acupuncture point electrical stimulation on thin endometrium. Journal of Reproductive Medicine 2017,26(3): 228-231
7. Zhang Bin, Jiao Jiao, Lin Xiaoxia, etc. Effects of pelvic floor muscle massage on pregnancy outcomes in thin endometrial patients undergoing freeze-thaw embryo transfer cycles. Chinese Journal of Sex Science 2018, 27(12): 58-60
8. Huang Xuekun, Feng Yuezhi, He Ling, etc. Effects of Kirin Pill combined with Fenmethorn on thin endometrial thickness, blood flow and pregnancy rate. Reproduction and Contraception 2016, 36(2): 95-99
9. Sun Rui, Zhang Meng, Zhao Yansong. A review of the current status of traditional Chinese and Western medicine interventions in the treatment of thin endometrium. Journal of Traditional Chinese Medicine Information 2020, 37(2): 76-85
Editor: Li Miaoran