Support for Lining Thickness
Posted by Christina Pistotnik
I have been seeing a number of patients in the clinic recently that have had issues in the past with their Frozen Embryo Transfer (FET) because their uterine (endometrial) lining has not been thick enough for embryo implantation. The optimal uterine lining is at least 8 mm in thickness and has a three-layer (trilaminar) appearance.
To help support the growth of your endometrial lining, I tend to advise on supplements, diet, acupuncture treatments, and of course following the advice of your Reproductive Endocrinologist (RE). Your RE follows a protocol that they deem will yield the highest success and therefore it is important to trust and follow their advice.
Supplements and Medication
When it comes to medications and supplements to help support the growth of the endometrium, I tend to site a pilot study that was published in the Journal of Fertility and Sterility (1). This study compares Vitamin E, L-Arginine, and Sildenafil Citrate (Viagra) in 61 women with thin endometrial lining (less than 8mm) and a high radial artery-resistance index (RA-RI) . Radial artery-resistance is associated with lower pregnancy outcomes.
The study found that vitamin E improved endometrial thickness in 52% and RA-RI in 72% of participants. L-arginine improved endometrial thickness in 67% and RA-RI in 89% of participants. Sildenafil citrate (Viagra) improved thickness and RA-RI in 92% of participants. The control group (no medication) improved in both parameters in 10% of participants.
It is important to speak to a practitioner about dosages of Vitamin E and L-arginine. If Sildenafil citrate is something that you wanted to explore you would have to talk to your RE about this, because they would need to write a prescription.
I know it might seem like a no-brainer to eat a healthy and balanced diet to help with good blood flow and overall health, but did you know that Traditional Chinese Medicine (TCM) also places importance on eating warm foods?
This includes eating foods that are cooked and not raw. The thought behind this is that a warming diet builds the body’s energy and blood to have the strength to conceive and carry a pregnancy full term. It also helps focus energy and blood circulation on the lower abdomen where reproductive organs reside.
With this in mind, I suggest making a big batch of bone broth and drinking 1 cup of this warm liquid every day for 2-4 weeks leading up to your transfer. Bone broth is high in nutrients, minerals, and collagen that can support the body on a blood level.
Another suggestion that is completely anecdotal but also yummy is drinking 1 cup of pure pomegranate juice per day for 2-4 weeks.
Acupuncture has the potential to support the uterine lining because it increases blood flow to the reproductive organs, and it can help to reduce central sympathetic tone and this may lower uterine contractions at the time of embryo transfer. When the uterus is calmer at the time of embryo transfer this has the possibility of a better embryo placement.
A small study done on central sympathetic tone showed that electroacupuncture did reduce the pulsatility index of those who had greater than 3 (2). Having a pulsatility index of 3 or higher at the time of transfer tends to have a less likely chance of a live birth (3).
Another small pilot study published in Fertility and Sterility evaluating combining electro acupuncture and Sildenafil on the endometrial lining thickness showed positive results (4). This study provided evidence that combining these two treatments resulted in endometrial lining thickness of greater than 9 mm in all participants who could not reach greater than 8 mm in previous cycles and these positive results included one patient whose lining did not exceed 5 mm previously.
Contact us to find out more about how we can support you with acupuncture and lifestyle support for uterine lining assistance and/or to book an appointment with our wonderful practitioners!
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