Poor endometrial lining development during ovulation induction (OI) cycles can become a valid concern for some patients. Endometrial lining increases its thickness with increasing estrogen levels in the body that comes from developing follicles. A thick, receptive, nourishing endometrial lining is the best possible environment for the embryo to implant. It is measured when you come in for your ovulation induction ultrasounds. Ideally, we want to see a lining close to 8mm in thickness with a noted tri-laminar (3-striped) pattern when the follicle is ready for a trigger shot. We note when the lining is thinner than desired and try to adjust the treatment protocol, if possible.
Some patients may have thinner lining with Clomid therapy, as they may be more susceptible to the estrogen blocking effects of Clomid. We may try to remedy the current cycle with additional oral estrogen supplementation, if appropriate. We may also recommend switching to a different oral or injectable ovulation induction medication with your next cycle if pregnancy is not achieved during the Clomid cycle. Letrozole (or Femara) is another oral medication used to induce ovulation, which does not block estrogen receptors of the endometrial lining and may also be particularly effective in patients with polycystic ovarian syndrome (PCOS). Injectable gonadotropins, such as Follistim, Gonal-F or Menopur are another alternative but may not be covered by insurance or available for coverage only after specific treatment requirements are met by the patient. If we note poor lining development after trying these alternative medications, you may need to meet with your provider to discuss alternative treatments.
Our experienced physicians, Dr. Frattarelli, Dr. Karmon, and Dr. Goulet will find the best solution and develop a treatment approach that is right for you! To schedule a consultation, please contact Fertility Institute of Hawaii at 808-545-2800 and/or check out our web page https://www.ivfcenterhawaii.com/.