Endometrial Thickness: What Affects It and Why It Matters for Conception

What is Endometrial Thickness?

The endometrium is the inner tissue lining of your uterus. Its thickness is regulated by hormones like estrogen and progesterone and naturally changes throughout the menstrual cycle.

The normal endometrial thickness for pregnancy is 8–15 mm. The lining grows to provide a healthy environment for the fertilised egg (embryo) to attach itself and for the baby (fetus) to grow.

Did you know?

The endometrial thickness:

• During menstruation: 1–5 mm
• Follicular phase (till ovulation): 10–15 mm
• Luteal phase: 15–18 mm

How to Measure Endometrial Thickness?

In some cases, doctors may use hysteroscopy, where a thin tube with a camera is inserted into the uterus for a closer look at the lining. Further, in cases where inserting the tube is difficult due to medical conditions, the doctor may suggest sonohysterography. During this, a saline solution is injected during the sonogram to observe the uterine lining. These imaging techniques are also widely used in endometrial thickness radiology, allowing doctors to assess the lining with precision.

Endometrial thickness is usually measured through a simple transvaginal ultrasound, which is the most common method used in endometrial thickness ultrasound assessments. A small probe is inserted gently into the vagina to capture clear images of the uterus. You may feel slight discomfort, but the process is rather quick and non-invasive.

Why is Endometrial Thickness Important for Conception?

The endometrium is essential for providing a nourishing environment for a fertilised egg during implantation.

Thin Endometrium (< 7–8mm)

• May not offer sufficient blood flow, nutrients and hormones.
• Raises the risk of infertility, miscarriage or early pregnancy loss.
• May be linked to low estrogen and the formation of fibroids.

Thick Endometrium (> 15–20mm)

• Often linked to hormonal imbalance (high estrogen).
• Can reduce oxygen supply and affect implantation.
• May be associated with conditions like PCOS.

Understanding the normal endometrial thickness for IVF is especially important during the treatment, where the lining plays a key role in implantation success.

What are the Signs of Thin Endometrium?

Signs of thin endometrium include:

• Irregular or light periods
• Short menstrual cycles
• Difficulty conceiving
• Recurrent miscarriages
• Early pregnancy loss
• Pelvic pain

What are the Signs of Thick Endometrium?

Signs of thick endometrium include:

• Heavy or prolonged bleeding
• Bleeding between periods
• Irregular menstrual cycles
• Severe menstrual pain
• Postmenopausal bleeding
• Difficulty conceiving
• Anaemia from blood loss
• Pelvic or abdominal pain

How To Improve Endometrial Thickness?

Doctors recommend the following tips to improve endometrial thickness:

• Eat a Healthy Diet: Focus on whole foods like fruits (berries) and vegetables (leafy greens), whole grains (brown rice) and lean proteins (fish).
• Stay Hydrated: Make sure you drink enough water throughout the day to support your overall health.
• Exercise Regularly: Try to include about 30 minutes of moderate physical activity in your day in the form of walking, jogging or swimming.
• Manage Stress: Try relaxation techniques like breathing exercises, yoga or meditation.
• Get Enough Sleep: Try to maintain a routine that allows for 7–8 hours of sleep per night.
• Avoid Processed Foods: Limit foods that are high in sugar, salt and unhealthy fats.
• Consider Supplements: Consult your doctor about including certain vitamins and minerals in your routine:
  • Vitamin E for hormone support
  • Omega-3 fatty acids for reducing inflammation
  • Iron for healthy blood flow

How Can Doctors Help?

Fertility doctors play a big role in helping with endometrial thickness. Here is what experts usually offer:

• Check Hormone Levels: Doctors can test hormone levels and identify imbalances.
• Conduct Scans: Ultrasound scans can help doctors assess the thickness of the lining.
• Prescribe Medications: Doctors can prescribe medications to regulate the hormones and improve endometrial thickness.
• Suggest Lifestyle Changes: Doctors can recommend lifestyle changes, such as eating a healthy diet and exercising regularly.

Doctors may also suggest:

• Hormone therapy to balance estrogen and progesterone levels.
• Fertility medicines to regulate ovulation and improve fertility.
• Drugs like Sildenafil are used to enhance uterine blood flow.
• Advanced treatments such as IVF, endometrial biopsy and platelet-rich plasma therapy.

Conclusion

Endometrial thickness plays an important role in conception and maintaining a healthy pregnancy. The ideal range is 8–15 mm, as this helps create a nourishing space for the fetus to attach and grow. A lining that is too thin or too thick can hinder implantation and affect your chances of pregnancy.

Adopting healthy lifestyle habits like a balanced diet, regular exercise and managing stress can help you improve endometrial health and increase your chances of conceiving. By working closely with fertility specialists, you can take effective steps to create the best possible environment for a successful pregnancy.