The key value in conceiving and carrying a child belongs to the inner lining of the uterus - the endometrium. In the body of a healthy woman, its thickness and state throughout the cycle change under the influence of sex hormones. Underdevelopment of this layer is a common cause of infertility, as well as early miscarriages. Modern medicine has different methods of diagnosis and treatment of this deviation. To successfully cope with it, it is important to know exactly why the endometrium is not growing. This information will help you find the most effective corrective measures.
Endometrial thickness for conception and pregnancy
At different periods of the menstrual cycle, the thickness of the functional layer of the endometrium is different. This part of the mucous membrane is represented by vessels, glandular and connective tissue. They are all very sensitive to the level of estrogen and progesterone. The following thickness values are considered normal:
- 5–9 mm - immediately after the completion of menstruation,
- 12-14 mm - at the time of ovulation.
After ovulation, the volume decreases slightly, the functional layer prepares for rejection.
Seven millimeters are considered the minimum thickness for embryo implantation. But meeting only this condition is not enough, the receptivity index (the ability to interact with the embryo) is important, as well as the preservation of the normal three-layer structure of the endometrium.
The close relationship between the characteristics of the functional layer (thickness, degree of maturity, receptivity) and fertility is simply explained. Even if the egg develops normally, ovulation and fertilization occur, for the further development and growth of the ovum it is necessary to gain a foothold in the uterus. This is possible only if the endometrium meets all the necessary requirements: it is sufficiently thick, loose and ready to “come into contact” with the embryo.
Otherwise, the fertilized egg is either removed from the female body, or a cervical pregnancy can occur - when the embryo is fixed and begins to develop in the cervix. It is a dangerous condition for a woman and hopeless for the fetus.
In medical practice, there are cases when the pregnancy began even with a smaller thickness of 0.4 mm, but it is rather difficult to preserve such a fetus. Insufficient nutrition and poor attachment of the embryo lead to the fact that the probability of miscarriage in the early stages is very high. Thin endometrium is considered to be one of the causes of intrauterine growth retardation, premature delivery, abnormal formation of the placenta, eclampsia.
Therefore, if the mucous membrane grows poorly, it is extremely unlikely to become pregnant naturally and carry the child. This condition is considered a contraindication for in vitro fertilization.
In the IVF program, thin endometrium prevents the embryo from sticking in the uterus, the probability of successful conception with such a diagnosis does not exceed 15%, and the favorable course of pregnancy is even lower.
If menstruation is scarce or absent altogether, pregnancy does not occur for a long time, or early miscarriages occur systematically, it can be assumed that the problem lies in insufficient development of the lining of the uterus. Below are the reasons for this phenomenon.
The relationship with the level of estrogen
Changes in the inner uterine layer are cyclical and are regulated by exposure to sex hormones. During menstruation, the detached endometrium is removed from the cavity of the genital organ, and in the first half of the cycle, under the influence of estrogens, it increases again. If the endocrine glands produce an insufficient amount of these hormones, then the mucous inner layer remains thin, it cannot ensure the embryo consolidation and the normal development of the fetus.
The causes leading to hypoestrogenism are varied:
- long-term use of psychotropic drugs, antidepressants,
- premature menopause,
- nutritional disorders - with prolonged adherence to strict diets, the production of estrogen decreases and the endometrium does not grow,
- previous operations on the ovaries,
- endocrine disorders: abnormalities in the pituitary, adrenal glands, ovaries, thyroid,
- ovarian exhaustion syndrome
- hormone therapy, introduction to artificial menopause (for example, with endometriosis),
- uncontrolled use of certain drugs (for example, Postinor).
To increase the functional layer of the mucous membrane with a reduced production of estrogen prescribe drugs containing this hormone.
If the thickness indicator does not rise, although hormones are normal, you need to look for another reason for the deviation. It may be that there is a lack of receptors for estrogen and progesterone in the cells of the mucous layer. There is a special analysis to identify this feature of the endometrium - immunohistochemistry.
Endometrial disorders in women
Estrogen deficiency is a frequent, but not the only possible reason why the endometrium is not growing. The problem may be due to the following factors:
- congenital malformations of the uterus (hypoplasia, aplasia),
- mechanical damage to the basal (germ) layer of the mucous membrane,
- chronic infections of the uterus,
- poor circulation in the pelvic organs,
- hormonal imbalance (hypoestrogenism).
The most difficult cases in terms of treatment are the first two options. Often they are equivalent to complete sterility.
Curettage of the uterus (curettage) - removal of the contents from the organ cavity using a special tool (curette). This is a metal spoon with sharp edges, which the doctor removes the embryo during abortion, polyps or the affected endometrium in some gynecological diseases. Another procedure is called cleaning. Since the specialist acts “blindly” during the operation, it is likely that the endometrial layer called the basal layer is damaged.
With repeated scraping each subsequent procedure increases the likelihood of damage to the germ layer. It is thanks to his stem cells that the functional layer builds up during the menstrual cycle. If the basal layer is removed or injured, the endometrium cannot grow, its cells have nothing to form.
Women wonder why the endometrium stopped growing after curettage and how to eliminate it, but the prognosis in this case is disappointing. In rare cases, it is possible to cure infertility by replanting stem cells in the uterus that can transform into a functional mucous layer. Then there is a chance to get pregnant and have a baby.
Insufficient blood supply to the uterus may be the reason why the endometrium does not grow. Lack of nutrients prevents the formation of a functional layer, and it remains too thin to conceive and carry. As a rule, this contributes to other pathologies:
- chronic iron deficiency
- increased blood clotting,
- cancers pinching blood vessels
- hypoxia in chronic inflammation and infections.
Prolonged infectious diseases of the uterus lead to stroma sclerosis - the connective tissue between the basal and functional layers of the endometrium. When this occurs, cellular hypoxia - an insufficient supply of oxygen, disturbed cell division mechanisms. As a result, the functional layer grows poorly even with a sufficient amount of sex hormones.
Thin endometrium contains insufficient nutrients to provide the embryo with them for the first time after conception, and the immature structure of the functional layer prevents the fertilized egg from fixing. To find the right treatment, it is necessary to accurately determine the reason why it does not grow.
Diagnosis and treatment
The problem of insufficient thickness of the endometrium is often detected when a woman visits the doctor with the following complaints:
- unsuccessful attempts to get pregnant,
- habitual miscarriages in the early period
- there are no monthly
- very scarce discharge during menstruation.
The causes of this condition can be many, therefore, requires a comprehensive survey. The following methods are used for diagnosis:
- Standard inspection on the chair. Allows you to identify abnormalities in the structure of internal organs, the presence of inflammation and defects of the mucous membrane of the vagina.
- Ultrasound examination (US), usually with a transvaginal probe. This method shows the thickness of the mucous membrane, its compliance with the phase of the cycle, as well as the presence of structural pathologies in the pelvic organs.
- Doplerometry of uterus vessels. Usually carried out in conjunction with ultrasound. The study determines the quality of the blood supply to the organ.
- A blood test for the content of sex hormones (estrogen, progesterone, if necessary - the hormones of the pituitary and thyroid gland).
- Blood test for antibodies to pathogens.
- A smear of vaginal secretions on the microflora, if necessary - bacposiv or PCR examination.
- Diagnostic hysteroscopy - according to indications. Examination of the uterus with a microcamera shows the presence of small myomatous nodes, polyps and other neoplasms. During the same procedure, they can be removed.
- Biopsy followed by immunohistochemical and histological examination of the material. Very informative diagnostics, allowing to determine the reasons why the endometrium is not growing.
All these methods are not used at a time. The doctor determines the necessary “set” of diagnostic measures on an individual basis, based on the clinical picture. The results obtained allow you to accurately determine the cause of the deviation and choose adequate methods of treatment.
If the endometrium is not growing due to the low level of estrogen, the doctor will prescribe the appropriate drugs. These can be products that either contain the necessary hormone or increase its secretion in the body (Proginova, Divigel, Gormel).
The thickness of the functional layer depends not only on estrogen, but also on the amount of progesterone. Therefore, to recreate the normal cycle in the second half of it, drugs based on this hormone (Utrogestan, Duphaston) are prescribed.
If the cause of the deviation is chronic endometritis (infection), antibacterial drugs will come to the aid, to which the pathogen is sensitive. Only after exclusion of the infectious agent can we start building up the functional layer and planning pregnancy.
With insufficient blood circulation in the pelvic organs, the doctor will prescribe medications for correction. This may be drugs that reduce blood viscosity, normalize vascular tone, or others, depending on the cause of poor blood supply. Drug treatment can only prescribe a doctor, self-treatment for thinned mucous membrane is ineffective and dangerous.
Congenital structural abnormalities of the uterus and injuries of the germ layer of the mucous membrane are almost not treatable. Successful are the procedures of "sitting" in the body of biomaterials containing stem cells. By adjusting to the surrounding tissues, they can be transformed into a functional layer of the endometrium that can “embrace” the embryo and ensure safe gestation.
A good result for the growth of the endometrium can give physiotherapy procedures. Their use is justified if infections are treated and hormones are normalized. The following types of physical therapy have proven themselves well:
- magnetic therapy
- electrophoresis on the lower abdomen (with preparations of copper, zinc, potassium iodide),
- pulsed current for the cervix - improves blood circulation, accelerates cell division,
- laser therapy is a little-studied, sometimes dangerous, but very effective method.
The choice of physiotherapy procedures should be entrusted to a specialist, since there may be serious contraindications to their use. With an abnormal structure of the uterus or a damaged basal layer of the mucous membrane, this type of exposure is ineffective.
Treatment of folk remedies
Traditional medicine also offers a large selection of tools and methods for increasing the endometrium. Their use is justified in combination with traditional medical therapy, strictly in consultation with the attending physician.
To accelerate the growth of the mucosal functional layer, traditional healers recommend drinking decoctions of sage, boron uterus or red brush, raspberry leaf tea or pumpkin juice. These plants contain phytosterols - substances whose composition and effects are close to the female sex hormones, which explains their positive effects in this pathology.
In addition to medicinal herbs, there are positive reviews about the use of hirudotherapy, massage and acupuncture to improve the reproductive system and the rapid growth of the endometrium.
In most cases, the problem of infertility due to insufficient endometrial thickness is solved. To do this, you need to take the task seriously - to find a qualified doctor, to undergo a thorough in-depth examination, to systematically and consistently perform all appointments. It is important not only to increase the endometrium, but also to eliminate the cause of its improper formation - chronic hormonal imbalance, infections and inflammation, and blood supply disorders. With this approach, you can count on a positive result and a safe pregnancy.
During each menstrual cycle, the thickness and structure of the mucous membrane of the uterus changes. It occurs under the influence of estrogen produced by the ovaries. In phase 1, when an egg cell matures in them, the thickness of the endometrium increases, and the network of blood vessels grows in it. Progesterone, which is secreted in the ovaries after ovulation, promotes loosening of the mucosa. Conditions are created so that the fertilized egg can be fixed in the wall of the uterus, the development of the embryo continues.
What causes the growth of the endometrium? The shell consists of 2 layers: a deeper, basal, and superficial, functional. During menstruation, the functional layer exfoliates and is expelled. At the same time, the mucosa becomes thinner to 0.3-0.5 cm. At the end of the menses, a new functional layer of the cells of the basal layer rises. The woman of reproductive age is normal, this process is constantly repeated. By the time of the full maturation of the egg, the endometrium should thicken to 0.9-1.4 cm. This is enough for a woman to become pregnant. The lower permissible limit is 0.8 cm. If it is smaller, you need to think about how to increase the endometrium.
Possible complications of underdevelopment of the uterine mucosa
For some reason, a failure occurs, as a result of which the endometrium does not recover after menstruation, remains too thin. Therefore, the woman is either infertile or her pregnancy fails. Another consequence of the thinning and disruption of the structure of the mucous membrane becomes ectopic fastening of the ovum, the occurrence of pathological pregnancy.
Even if it occurs when the thickness of the endometrium is less than the norm, there are various complications. Among them is an insufficient supply of nutrients and oxygen to the fetus (this is fraught with a serious violation of its development), improper presentation of the fetus, poor uterine contractility during labor.
Causes of endometrial malformation
The reason for the insufficient development of the endometrium and its thinning can be:
- Disruption of the hormonal background in the body of a woman as a result of diseases of the pituitary, ovaries, thyroid, adrenal glands. Contraceptive use, treatment with hormonal drugs can affect the state of the hormonal background.
- Scraping the uterus. During such an operation, there is always a risk of damage to the basal layer, from which a new layer of mucous membrane is growing.
- The presence of inflammatory processes in the uterus, after which there are adhesions and scars that prevent the restoration of the mucous membrane.
A frequent cause of thin endometrium is impaired blood circulation in the uterus.
Symptoms of pathology, diagnosis
Suppose that the woman's endometrium is too thin, it is possible for a number of signs. Among them, the increase in the duration of cycles, irregular onset of menstruation, hypomenorrhea (scanty menstruation), infertility. Perhaps the appearance of severe bleeding after a delay of menstruation (abortion occurs, which the woman does not realize).
If you suspect that the cause of infertility is underdevelopment of the uterine mucosa, a blood test is made for estrogens, progesterone and other hormones. To measure the thickness of the endometrium ultrasound of the uterus is performed. Blood supply impairment is determined using doppler sonography (ultrasound of blood vessels).
Endometrial extension methods
Существует несколько способов, с помощью которых можно нарастить эндометрий, повысить вероятность наступления и сохранения беременности.
Традиционное лечение производится следующими методами:
- лекарственная терапия,
- surgical removal of the defect
Traditional medicine also offers a variety of proven tools to help increase the mucous membrane of the uterus, to save a woman from infertility.
First of all, it turns out that the reason for the insufficient growth of the endometrium is the elimination of the underlying disease. For example, if the growth of the mucous membrane does not occur due to the presence of chronic endometritis, then antibiotics are prescribed, as well as drugs to strengthen the immune system (cycloferon, genferon, licopid). Enzyme preparations lidaza (promotes the resorption of scars in the uterus) and wobenzym (anti-inflammatory and immunostimulating action) are taken.
To eliminate the disorders of the menstrual cycle, the homeopathic remedy Goremel drops is actively used. It has an anti-inflammatory, analgesic effect, helps to restore mucous membranes, stimulating the production of estrogen in the ovaries.
In the case when the endometrium is too thin due to the lack of female sex hormones in the body, hormone therapy is carried out.
In phase 1 of the cycle, estradiol-based drugs are prescribed with the direct purpose of increasing the endometrium: divigel, proginova or femoston. Divigel is applied to the skin of the abdomen, quickly absorbed and penetrates the blood. Proginova is available as a dragee. Femoston is a combination drug that contains estradiol and progesterone.
In phase 2 of the cycle, progesterone drugs are taken (utrogestan or dufaston) so that the growing mucosa has a normal structure.
Note: In preparations containing estrogen in its pure form, there are unpleasant side effects, such as the development of heart disease, vascular thrombosis. The consequence of long-term estrogen treatment may be the occurrence of malignant tumors. Combined with progesterone is not so dangerous, as this hormone softens the harmful effects of estrogen on the body.
Improving blood flow in the uterus vessels
The cause of circulatory disorders in the uterus can be damage to the vessels during abortions, operations, as well as diseases of this organ. A sedentary lifestyle, taking vasoconstrictor drugs are additional factors for the deterioration of blood flow and nutrition of the cells from which the endometrium is formed.
To improve the blood supply to the uterine mucosa and accelerate its growth, the patient is prescribed such drugs as Clexane (prevents blood clots), chimes (vasodilator), pentoxifylline.
Sometimes in the uterus there are adhesions that prevent the growth of the mucous membrane, the normal flow of the menstrual cycle. In this case, only surgical treatment using hysteroscopy can help the woman to eliminate infertility. In this case, adhesions are dissected, scar removal is performed.
Operations are also performed if the endometrium cannot grow normally due to the presence of tumors in the uterus. In some situations, in order to achieve an increase in the normal endometrium, the mucous membrane is scraped together with polyps and cysts that violate its structure.
Some women fear treatment with hormonal drugs. Alternatively, traditional medicine offers recipes that use the healing properties of certain plants. It is possible to increase the endometrium using their phytoestrogenic effect and the ability to relieve inflammation, anesthetize, thin the blood.
Sources of phytoestrogens are sage, red clover, hops and many other herbs. From them prepare infusions and decoctions. For example, a pinch of dry sage is taken, poured with 1 cup of boiling water and infused for 15 minutes. Broth taken after the end of the month until about the middle of the cycle. Raspberry leaf tea also has a similar effect.
Effective treatment of infusions of red brush (drink in 1 half of the cycle) and boron uterus (taken from the middle of the cycle and up to menstruation). To prepare the infusion of red brushes pour 1 cup boiling water 1 tbsp. l herbs, after 4 hours, filter, use 3 times a day before meals and 1 tablespoon.
The infusion of the uterus of the uterus is prepared on alcohol. Take 1 tbsp. l dry herb for 1 cup of alcohol, infused for 2 weeks. The drug is taken three times a day and 1 teaspoon.
How to speed up the growth of the endometrium
In order to regenerate the mucous membrane faster, it is recommended to eat foods with a high content of vitamin E. This substance stimulates the production of female sex hormones, accelerates tissue repair. Vitamin E is found in spinach, nuts, seeds, carrots, pumpkin, avocado, meat.
It is useful to eat fruits with a high content of vitamin C (pineapples, citruses, black currants). Berries and fruits, as well as honey, contain blood-thinning substances (salicylates). The diet should be fatty fish - a source of polyunsaturated acids necessary for the formation and nutrition of new cells.
To improve blood circulation in the uterus, you need to move more, go to the dance, play sports. Women who are treated for infertility and dream to get rid of the defect of endometrial development, it is recommended to quit smoking.
If a problem such as “thin endometrium” occurs, it is advisable to avoid using vasoconstrictor agents (for example, from a cold or a cold or allergies).
Causes and signs of pathology
The thickness of the mucous layer may be different and depends on the day of the menstrual cycle. In the first days, it does not exceed 0.5–0.9 cm, and a few days before the beginning of menstruation, it reaches 1.3 cm. If the thickness is less than 0.5 cm, it is a question of hypoplasia (thinning) of the endometrium.
Why endometrium thinned?
Among the predisposing factors emit:
- hormonal imbalance,
- endocrine diseases
- congenital disorders in the blood supply to the uterus,
- chronic inflammatory processes in the genitals,
- polycystic ovary syndrome,
- underdevelopment of the uterus,
- frequent use of emergency contraception (Postinor).
It should be noted the negative impact of surgical procedures that were performed on the uterus. Especially dangerous are the effects of scraping on abortions. In some women with thin endometrium, an underdevelopment of the mammary glands, a narrow pelvis, short stature, and later menarche are noted.
There are no specific signs of the disease, so many women who are not planning a pregnancy may not be aware of the problem. Typically, hypoplasia is diagnosed in the process of determining the cause for which the pregnancy either does not occur or is interrupted in the early stages.
Thinning may indicate thin monthly periods, failures of the menstrual cycle. Painful periods, the presence of large blood clots, discharge in the middle of the menstrual cycle should also be alerted. Sometimes uterine bleeding can occur in the reproductive age. These symptoms should be the basis for a visit to the gynecologist.
The probability of pregnancy in this pathology
In most cases, thinning of the mucous layer of the uterus worries women who are planning to conceive or those who have a long-awaited pregnancy after previous failures. What if the endometrium is thin and how does it affect the development of the fetus?
First of all, in women, the possibility of becoming pregnant naturally decreases, since the thin mucous layer of the uterus prevents the egg from fastening.
Can I get pregnant with thin endometrium?
Medicine knows cases where conception occurred even at a thickness of 0.4 cm. But if pregnancy does occur, the risk of its termination at an early period, the appearance of toxicosis, bleeding, and further weakness of labor and other complications during childbirth increase.
After conception has come, the endometrium continues to grow. In the first trimester, its thickness reaches 2 cm or more. Often, it is his significant increase that allows the doctor to determine the pregnancy on an ultrasound, as the egg of the egg itself may still not be noticeable. In early pregnancy, thin endometrium requires increased attention from physicians and the appointment of immediate treatment, since miscarriage can occur at any time.
Separately, mention should be made of the IVF procedure in diagnosing thin endometrium. This procedure is extremely undesirable in this pathology, since the chances of the embryo to successfully implant in the uterus are extremely small. The probability of pregnancy with a thickness below 0.7 cm is no more than 15%. Therefore, the patient is advised to postpone the procedure and take appropriate measures.
The basis of successful treatment is proper nutrition. It must include foods rich in vitamins A and E, as well as products with high levels of salicylates. The diet should include fatty fish, vegetables (tomatoes, sweet peppers, spinach, cucumbers, beans, cabbage), fruits and berries (grapes, apples, currants, raspberries), dried fruits, honey, red wine.
A variety of spices are useful, such as paprika, thyme, cinnamon, curry. At the same time, a woman needs to limit the intake of fatty and sweet dishes, as well as fast food, strong coffee and tea.
To increase the endometrium plays an important role active lifestyle. It is useful to play sports and dance, visit the pool. It stimulates active blood circulation, which has a positive effect on his condition.
Endometrial thickness and estrogen levels
There is no universally accepted concept and such nosological form as a thin endometrium. In studies, experts suggest using various sizes of endometrial thickness as a prognostic criterion for embryo invasion failure. One of the reasons why implantation did not end in success is the thickness of the inner uterine layer of less than 8 mm. However, there are cases when the endometrium does not grow more than 7 mm, but the pregnancy successfully develops with such a value. This fact gives reason to believe that the negative result of attempts at conception is due to the influence of a complex of factors on the uterus.
In addition, the endometrium is growing or not, an important characteristic is its three-layer. One of the reasons why a successful pregnancy and childbirth occurs in thin (6-8 mm) endometria is considered to be divided into 3 layers, as it should be normal.
Endometrium contains several tissue structures that are located and function in close connection with the production of sex hormones. In a healthy woman, it grows up to the 14 mm mark, is rejected monthly and under the influence of estrogen increases again. Among the reasons why the normal growth of the inner uterine layer is disturbed is the suppression of the synthesis of estradiol.
The causes of hypoestrogenism consider:
- history of resection of the ovaries (removal of cysts, tumors),
- pathology of the pituitary gland, leading to the fact that the level of estrogen does not increase (pituitary nanism, tumors or any pathological processes in the anterior pituitary, cachexia),
- long-term use of antidepressants
- treatment with preparations for introduction into artificial menopause, as a result of which the endometrium does not grow,
- ovarian exhaustion syndrome
- early menopause,
- prolonged rigid diets, which are considered the reason why the amount of protein in the body required for the synthesis of estrogen is reduced, the endometrium does not grow in such cases,
- self-medication with various types of drugs,
- long smoking.
One of the prerequisites for why a healthy woman’s menstrual cycle is regular is sufficient estrogen production, which, in turn, is caused by the work of the thyroid gland, adrenal glands, and the full functioning of all organs and systems. If there are certain pathologies and causes that lead to suppression of ovarian function, the endometrium does not grow and scanty periods or lack thereof are observed. If the endometrium is growing, but not enough, due to the low level of estrogen, there is no proper production of progesterone, why the 3 layers required for the implantation window are not formed.
To eliminate the causes that lead to the fact that the inner uterine layer does not grow, take estrogen preparations.
The lack of estradiol leads to a monophasic cycle, and in the case of two-phase preservation, the quality of the endometrium changes significantly, which is why conception does not occur. If the causes of infertility lie only in hypoestrogenism, then artificially replenishing them causes the endometrium to grow.
For one of the most important reasons why the glandular layer does not grow, an insufficient number of sex hormone receptors in cells is considered. Receptors are an integral part of any cell and are necessary for biologically active substances to bind and act on the cell. In particular, estradiol - the female sex hormone - by binding to the cells of the inner uterine layer, ensures their division and maturation. Thus, the endometrium grows and provides implantation.
Progesterone, the level of which increases after ovulation has occurred, binds to cell receptors, which leads to the formation of the necessary qualities of the endometrium, including its trilayer. One of the reasons why the endometrial layer does not have the proper qualities is the lack of progesterone or its receptors.
The endometrium does not grow due to the small number of receptors for both hormones, which is revealed in the process of immunohistochemistry.
It has been established that the reason why endometrial receptivity is reduced is the desynchronization of the daily rhythm of gene activity. This leads to a lack of harmony between the ovarian and endometrial cycles.
The concept of receptivity also includes the ability of the functional glandular layer to produce a number of substances that contribute to the introduction of the blastocyst. One of the many reasons why implantation does not occur is the insufficient production by the glands of biologically active substances that attract the embryo and promote its invasion. A number of pathological factors, in particular, endometritis and hypoestrogenism, are considered as causes of reduced receptivity, along with the fact that the endometrium is not growing.
Thin endometrium or its hypoplasia may develop due to previously transferred infectious and inflammatory diseases. However, not all experts agree with the opinion that the endometrium does not grow due to chronic inflammation, since not always antibacterial therapy shows a positive result.
It has been established why the inner uterine layer does not grow in chronic infections and the main cause is considered to be persistent disruption of intercellular interactions due to stroma sclerosis (basis) of the most important layer of the uterine cavity. Connective tissue growths around the capillaries, as a result of prolonged inflammation, lead to ischemia - disruption of oxygen supply to cells. This explains why cells cannot fully divide.
The causes of chronic nature of endometritis, which leads to infertility, most often are:
- chlamydia infection
- miko and ureaplasmosis,
- mixed viral-bacterial associations (herpes simplex virus, cytomegalovirus, human papillomavirus, chlamydia, ureaplasma and mycoplasma),
- long bacterial vaginosis (gardnerellosis), dysbiosis.
The endometrium does not grow due to the long asymptomatic course of the above infections, which is why women do not seek medical help. Sluggish clinic of inflammation is not accompanied by high fever, severe pain or copious secretions. For several months and years, persistent chronic endometritis is formed, and this is the reason why the endometrium is not growing.
A distinctive feature of the inner layer of the uterus, which is affected by the infectious process, is the disruption of the normal response to the implantation of the embryo, which is why miscarriage occurs in the early stages. In addition, the placentation process changes, which becomes abnormal.
Synechiae in the uterus are considered one of the causes of female infertility. The prognosis for a successful pregnancy is determined by the degree of involvement in the process of uterus volume. The endometrium does not grow due to the fibrosis of the germ layer, but single adhesions after dissection and drug treatment do not adversely affect the implantation process.
The effects of scraping
Curettage of the uterine cavity can lead to traumatization of the germ layer, which is considered the cause of absolute infertility. The only method of treatment is the use of stem cells. When a biological material containing stem cells is transplanted into the uterus, their differentiation begins according to the microenvironment - they are transformed into endometrial cells and it grows. The woman has a chance to carry the child.
It was established that with each subsequent cleaning of the uterus, the risk of injury to the germ layer increases, which is why there is a recommendation from gynecologists to plan a pregnancy or interrupt it for up to 5 weeks using vacuum aspiration.But the endometrium does not grow even after cleansing of a diagnostic nature, why it is so important to diagnose reproductive tract pathologies in time and conduct non-invasive research methods.
If necessary, curettage of the uterus, treatment after the procedure should include antibiotics, enzyme preparations, vitamin therapy, courses of immunocorrection and hormonal drugs, physiotherapy. To exclude such causes of hypoplasia as adhesions after curettage, this treatment is considered necessary depending on the initial diagnosis.
Violation of uterine circulation
The causes of thin endometrium may be in its insufficient blood supply, which is caused by the following provoking factors:
- pathologies of the blood coagulation system (hereditary thrombophilia, coagulopathy, hemostasis mutations),
- varicose veins
- tumors that compress the vessels that feed the uterus,
- chronic anemia,
- hypoxia in infectious diseases.
The internal uterine lining does not grow due to thickening of the blood, initiated by a violation of the blood clotting process, which is why drugs that reduce the coagulation process are included in the treatment of hypoplasia. Low molecular weight heparins are most commonly used. In addition, diosmines are used to eliminate the causes of the disease. The drugs normalize blood flow, thin the blood, improve lymph flow and vascular wall tone. If the level of coagulability increases during pregnancy, anticoagulants are also prescribed for normal uterus nutrition.
After carrying out diagnostic procedures, complex treatment is prescribed, which allows to increase the inner uterine layer.
Why do we need endometrium, how should it be?
Endometrium is called mucous membrane inside the uterus. It is a system that consists of many components, in particular:
- Epithelium - integumentary and glandular,
- Blood vessels
- Stroma- supporting, connective tissue, which during menstruation develops into mature cells that produce collagen and a number of other substances.
Creating favorable conditions for attachment and development of the embryo in the uterus is the main function of the endometrium. If conception occurs, the number of blood vessels and glands begins to increase in the endometrium, in order to:
- Endometrial vessels became part of the placenta,
- Oxygen was delivered to the developing fetus,
- Ensuring nutrient delivery by the embryo.
Effective ways to build up the endometrium: medications
For rapid growth of the endometrium, as a rule, use medications. It should be noted that thin endometrium is difficult to treat.
Since the capacity of the endometrium is directly dependent on estrogen, respectively, appointed:
- Hormonal treatment: as a rule, these are estradiol injections, divigel.
- Drops "Gormel" - a homeopathic drug that is used to regulate the hormonal states of a woman. Its action is aimed at enhancing the production of estrogen. The impact of the drug is quite mild and effective.
It is believed that drugs such as "Duphaston" and "Utrozhestan"increase the endometrium. This is not true. These drugs help the endometrium to form, ripen. These drugs contain progesterone: “Duphaston” consists of synthesized progesterone and has no side effects, “Utrogestan” - from natural.
In this case, it is not surprising that the endometrium does not grow. What to do - to plant a biomaterial with stem cells in the uterus. As a result, they will be differentiated according to the surrounding tissues. Then a transformation will gradually occur and the endometrium will begin to grow. The chances of carrying a child are greatly increased.
Each cleaning of the uterus increases the risk of injury to the germ layer. That is why gynecologists call either to protect themselves, if the pregnancy is undesirable, or to interrupt it in the early period of gestation - up to 5 weeks. The most gentle will be a vacuum aspiration method.
It is worth noting that cleaning the uterus is not only an abortion. There is also a diagnostic curettage. In this case, why the endometrium does not grow, the reasons will be the same - injuries of the basal layer. That is why it is very important to undergo an annual survey, when non-invasive examination methods are still possible.
If it was not possible to avoid curettage, then supportive therapy is necessary after the procedure. It includes: antibacterial drugs, enzymes, vitamins, hormones, physical therapy, as well as various ways to restore the immune system.
To avoid synechiae after curettage, the gynecologist also recommends taking action and initiating preventive therapy in time.
With insufficient blood supply, the endometrium does not grow either. What to do? Familiarize yourself with the factors causing such a state of the pelvic organs:
- bleeding disorder,
- a neoplasm that exerts pressure on the uterus vessels,
- lower hemoglobin levels
- infectious diseases.
The inner layer will not be able to grow if the blood thickens and the coagulability is broken.
Therefore, in the treatment of hypoplasia, anticoagulants are required. Low-molecular-weight heparins are usually prescribed. Causes of pathology removed with the help of Diosmin. This group of medicines allows you to restore blood flow, improve lymph flow, increase vascular tone, and thin the blood.
During pregnancy, if blood clotting disorders are detected, anticoagulants are also needed to provide the uterus and the embryo with a normal diet.
Determine the blood flow in the uterus is possible only by ultrasound with Doppler.
In the article we examined why the endometrium does not grow. The reasons are quite different. As it turned out, the situation can be taken under control, if you consult a doctor in time. This is especially true for women who want to become pregnant.
Underdevelopment of the uterus
This is not a very common reason why the endometrium is not growing. But in this case it is most difficult to treat the condition. In this case, the mucous is thinned because it is a congenital condition. The general underdevelopment of the reproductive organs leads to the fact that the endometrium is poorly developed or not developed at all. In this case, this is diagnosed, usually, in the absence of menstruation, and not after curettage.
Significantly inhibit the speed of recovery of the mucous can be infectious and inflammatory processes. The destructive effect of bacteria and viruses leads to the fact that all resources are spent on fighting them. As a result, the mucosa itself is not restored. In particular, the infection can get into the uterus just during curettage.
Taking a number of contraceptives leads to the fact that the endometrium ceases to be renewed and thinner over time. In fact, the effect of such birth control pills is that they create a condition close to a false pregnancy. As a result, estrogen is produced insignificantly, whereas there is a lot of progesterone, the endometrium does not grow in these conditions. Therefore, the reason may be the reception of obsolete single-component contraceptive, consisting of progesterone.
In addition, the reasons may be:
- Uterine hypoplasia,
- Total avitaminosis,
- Serious lack of weight
Some pathological processes can also lead to a lack of endometrial growth.
How to ramp up?
There are many ways in which the endometrium can grow. Usually, doctors prefer drug therapy with hormones. In other cases, it is necessary to treat the inflammatory process or normalize the microcirculation of blood in the mucous membranes. More information about what to do with such a diagnosis is described in the article "How to increase the endometrium."
The reasons for the lack of growth of the endometrium
The minimum allowable thickness of the functional layer of the uterus is 7 mm. This is important for the possibility of embryo implantation. At the same time, the endometrium itself must retain its own three-layer structure and be distinguished by a sufficient measure of receptivity (the properties to interact with the attached embryo).
The inability to get pregnant or fully bear the child often provokes too thin endometrium of the uterus. The causes of this pathology (lack of sufficient growth of the thickness of the mucous membrane layer) can be as follows:
- hormonal imbalance in the form of reduced estrogen production,
- pathology of the circulatory system in the pelvic and uterus,
- development of varicose diseases
- the presence of inflammatory and infectious diseases in the genital area,
- reduction of receptivity properties (readiness for attachment and invasion of the formed embryo),
- previous scraping.
Pathology is a serious obstacle to conception, both naturally and extracorporeally. If the pregnancy has already occurred, then there is always the risk of spontaneous abortion for a period of 12 weeks.
In the process of earlier scraping, the germ layer of the uterus can be damaged, from which the basal layer is formed.
Sufficient production of the hormone estrogen ensures the process of building up a new functional layer of the uterine mucosa after rejection of the previous one (the last monthly discharge). Its synthesis occurs in the follicular apparatus of the ovaries, and the violation of the process itself causes the formation of the endometrium in the uterus of insufficient thickness (hypoestrogenism).
Disruption of the hormonal balance in the female body can be caused by:
- previous ovarian surgery (for example, removal of cystic formations), as a result of which part of the organ itself was removed,
- changes in the pituitary gland causing insufficient estrogen production,
- long-term use of antidepressants or drugs intended for the formation of artificial menopause,
- the presence of early manifestation of menopause and premature depletion of the functional activity of the ovaries,
- adherence to diet, in which the body enters too limited amount of protein,
- long and excessive smoking craze,
- active use of various hormonal drugs without prior consultation with a doctor.
As a result, it turns out that the regularity of the cycle and the retention of the usual abundance of the secretions themselves is determined by the sufficient production of estrogens. The synthesis of the hormone itself is directly dependent on the well-functioning of the thyroid gland and the adrenal glands. The individual health of the patient, for example, the presence of inflammatory or infectious lesions in the area of the pelvic organs, has a separate effect on the hormonal balance.
The first serious symptom may be the observation of extremely scarce menstrual discharge for no apparent reason.
A detailed study of the causes and determine the thickness of the endometrium at a specific stage of the menstrual cycle can be a doctor after an ultrasound.
The formation of the endometrium of insufficient thickness can also be caused by impairments in the process of blood supply to the cells and tissues in the pelvic area. The causes of this pathology can be:
- the presence of varicose veins,
- blood clotting disorders,
- abnormal decrease in hemoglobin level in the blood,
- the presence of infectious diseases
- the formation of various types of tumors that exert pressure on the uterus vessels.
The effectiveness of treatment in such cases directly depends on the correctness of determining the cause of the violation itself. If the pathology is associated with bleeding disorders, the doctor may recommend taking anticoagulants. Diagnosis of pathology in such cases is carried out by ultrasound with Doppler.
Determining the true cause of the disruption of the reproductive system of the female body determines the effectiveness of the treatment chosen and the possibility of a full pregnancy in the near future.
- If the problem itself is a hormonal imbalance, then the patient may be recommended special drugs that provoke the production of estrogen.
- The presence of inflammatory and infectious diseases provide for treatment with special antibacterial drugs.
Any medicinal products prepared at home can be used only after consulting a doctor, with obligatory observance of permissible daily doses and the duration of the treatment course itself.