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Birla Fertility & IVF

What is thin Endometrium, Symptoms, Causes & Treatment

  • Published on July 07, 2022
What is thin Endometrium, Symptoms, Causes & Treatment

According to NCBI, thin endometrium is not common. However, a woman with a thin endometrium layer can experience issues with embryo implantation and pregnancy. In their research, they have also stated, “Though pregnancies have been reported at 4 and 5 mm, it is apparent that an endometrial thickness <6 mm is associated with a trend toward a lower probability of pregnancy. Hormone replacement therapy—frozen embryo transfer (FET) cycles appear to give better results due to an improvement in endometrial receptivity (ER).” Read the full article to understand what is thin endometrium, its causes, symptoms and its impact on pregnancy and fertility treatment

What is Thin Endometrium?

The tissue layer in the inner lining of the uterus is called the endometrium. The thickness of the endometrial layer keeps on changing during the menstrual cycle. The uterus is lined with 3 layers:

  • The outer layer is called serosa
  • The middle layer is called the myometrium 
  • The third and innermost layer is called the endometrium. 

When the endometrium layer gets abnormally thin, it can impact embryo implantation, causing difficulty in conception. The thickness of the endometrium layer in the uterus is essential for successful embryo implantation and to achieve a healthy pregnancy. This layer also protects the baby and nourishes it for further development. 

The endometrial lining keeps changing throughout the menstrual cycle. For a successful pregnancy, the embryo should be implanted well in the endometrial lining, which is also in optimal condition. Oestrogen and progesterone are two sets of hormones that help prepare the thickness of the endometrial lining for pregnancy. If the endometrial lining is thinner than the standard and required thickness, it would be difficult for the woman to reach conception or hold the pregnancy for a full term. In addition, experts suggest that a thin endometrium often leads to complications like miscarriage.

Measurements of Endometrium layer

According to the experts, the endometrium layer is classified into different phases based on their measurements. Refer to the below table for reference and a better understanding of the thickness of the layer:

Phase in Menstrual Cycle Thickness of Endometrium Layer
Menstrual Phase 2 – 4 mm (Thin Endometrium)
Follicular Phase 5 – 7 mm (Intermediate)
Luteal Phase 11 mm (Thick Endometrium)
Ischemic Phase 7 – 16 mm

Symptoms of Thin Endometrium

Below are some common symptoms of thin endometrium 

  • Abnormal or irregular menstrual cycle
  • Issues of infertility
  • Painful periods
  • Inadequate bleeding during periods

Causes of Thin Endometrium

Let us look at some of the most common causes of thin endometrium.

  1. Low Estrogen Level: If there is a lack of estrogen level in the body it may result in a thin endometrial lining. For this, the doctor conducts blood tests to determine the level of estrogen level in the body. If the estrogen levels are below the normal required range, the doctors may prescribe the patient some tablets and injections to replenish the estrogen levels.
  2. Decreased Blood Flow: If there is insufficient blood flow in the body it may lead to thinning of the endometrial lining. The blood flow to the uterus can be checked by ultrasound.
  3. Infection: If an individual has a thin uterine lining despite having an adequate amount of estrogen level it may be due to a uterine infection that has damaged the uterine lining and resulting a scar on the tissue.
  4. Uterine Fibroids: The benign growths of tissues that are found in the uterus are referred to as uterine fibroids. They can grow in different sizes and numbers. Also, uterine fibroids can alter the environment of the uterus, leading to complications such as embryo implantation issues, recurrent miscarriages, and preterm births.
  5. Chronic Endometritis: When there is inflammation and infection found in the endometrial cells, it is referred to as chronic endometritis. Though it is not a life-threatening infection, but still recommended by the specialist to get it treated as soon as it is detected.

How Thin Endometrium is Diagnosed?

The expert will run a physical examination to check the tenderness, swelling, or any painful areas by putting a slight pressure with fingers on the abdomen region. For further diagnosis and to detect the root cause, the doctor may advise a few tests such as:

  • Sonohysterography
  • Transvaginal ultrasound
  • Hysteroscopy  

Options for Thin Endometrium Treatment 

For a successful pregnancy, the endometrial lining should be examined well and treated to reach a standard thickness to allow embryo implantation for further development and successful pregnancy.  

Some of the thin endometrium treatment methods are discussed below.

  • Estrogen therapy: It may be given orally or in a gel form to make the endometrial lining thick so that an egg can implant easily.
  • Supplements: New and advanced growth hormones are given to increase the thickness of the endometrial lining.
  • Hysteroscopy: If intrauterine adhesions are to blame for the uterus’ thin lining, they can be removed during hysteroscopy, which will gradually allow the endometrial lining to reach proper thickness.
  • Embryo Freezing: The best course of action for patients who have a thin endometrial lining would be to freeze all embryos and transfer them over once the endometrial lining is thickened.

Pregnancy in Thin Endometrium

In conclusion, It is difficult and in some cases next to impossible to continue the pregnancy with thin endometrium. For a successful pregnancy, the patient should seek immediate assistance for effective treatment to achieve a standard endometrium thickness. Because even if the patient is pregnant with thin endometrium there are high chances that it will result in either implantation failure or recurrent miscarriages. Thickening of the endometrial lining before trying to conceive is essential to avoid any pregnancy complications. There are other options as well that can help a woman with a thin endometrial lining to pursue pregnancy. Doctors suggest the patient freeze the embryos and once with medication the endometrial lining is thickened, they can move ahead and transfer the embryos with the hope of conception. If you are diagnosed with thin endometrium and looking for effective treatment, contact our fertility expert today. You can either call us or book an appointment online by filling out an appointment form with the required details or visit our Fertility Centers.


  • How does a thin endometrium affect pregnancy?

Thin endometrium makes it difficult for the individual to hold a pregnancy for full-term, it will either lead to miscarriage or implantation failure.

  • Is thin endometrium normal?

No, thin endometrium is not normal. Thin endometrium can lead to abnormal concentrations of oxygen in the epithelial cells that can cause an increase in free radicals lead to toxicity in the cells and affect the embryo implantation, leading to implantation failure.

  • How to thicken the endometrium?

Certain medications or injections are given to improve the blood flow throughout the body and once the endometrial lining is thickened, the embryo is transferred. 

  • Can thin endometrium cause pain?

Thin endometrium can result in heavy bleeding, irregular and painful periods.

  • Can endometriosis be cured by diet?

Effective treatment can help manage endometriosis but there is no cure for endometriosis. Certain dietary changes may help manage the symptoms.

Written by:
Dr. Swati Mishra

Dr. Swati Mishra

Dr. Swati Mishra is an internationally trained obstetrician-gynecologist and reproductive medicine specialist Her diverse experience, both in India and the USA, has positioned her as a respected figure in the field of IVF.  expert in all forms of laparoscopic, hysteroscopic, and surgical fertility procedures which includes IVF, IUI, Reproductive Medicine and Recurrent IVF and IUI Failure.
Over 18 Years of Experience
Kolkata, West Bengal

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