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Endometrium abnormality as a cause of infertility (2) by Prof Oladapo Ashiru

A thick and healthy endometrium is necessary for a healthy menstrual cycle and pregnancy.

Uterine fibroids

These non-cancerous tumors of the uterus may alter the blood flow to the endometrium by pressing on vital circulatory avenues that supply the endometrium with blood flow. Older uterine fibroids may calcify and become hard over time, further compromising blood flow.

 Uterine fibroid embolisation

It is a surgical procedure to cut off blood supply to the fibroids to starve them from the blood supply, essential reducing them in size or eliminating them. It may cut off vital blood supply to many areas of the uterus and damage the uterus, causing an even more significant reduction in circulation to the uterus.

 Uterine arterial constriction

The uterus relies on the uterine artery to bring in fresh blood. High-stress levels can stimulate the sympathetic nervous system to cause arterial constriction, reducing blood flow to the uterus. Not only does chronic high stress alter blood flow, but it alters hormone levels in the body, contributing to hormonal imbalance. Uterine arterial constriction may also happen due to any of the above reasons previously discussed.

 Repeated use of Clomid

Clomid is a medication used to stimulate ovulation. It is one of the first medications suggested by doctors for couples struggling to conceive. In some women, repeated use of Clomid has been shown to cause a thin uterine lining. Clomid tricks the body into acting as though estrogen levels are low, which stimulates the production of GnRH, which signals the pituitary to increase FSH. The hopeful result should be ovulation. Clomid sounds great for stimulating ovulation, but what about the fact that it is antiestrogenic?

Repeated use of Clomid, primarily when used for three cycles in a row, can block the stimulation of estrogen to thicken the endometrium. Clomid contains two isomers. Isomers are compounds that contain the same molecular formula, but different structural formulas. Isomers usually have different actions. When a woman discontinues the use of Clomid, one of the isomers leaves the body in a week; the other one remains, acting as an antiestrogenic for up to six weeks. Repeated use of Clomid causes a buildup of this isomer resulting in a thin uterine lining.

Remember that Clomid may help you get pregnant right away, but it does not solve the root of the fertility problem. It is a temporary boost, a band-aid, but Clomid cannot address all infertility-related issues.

 Long-term birth control use containing progestin

Long-term use of oral contraceptives containing higher amounts of progestin has a link to thinning of the uterine lining and uterine atrophy. The longer a woman uses progestin, the increased chance for a weak and thin uterine lining.

Natural therapies to build and protect the uterine lining

If you know you have a thin uterine lining, you must work to nourish and increase the endometrium once again. It may also be helpful to learn about using natural therapies to aid in healing damaged tissues. If damaged tissues are not repaired, they may never function properly ever again. If you are going for IUI or IVF and the uterine lining is not thick enough, those procedures are canceled.

No matter the reason for thin uterine lining, be sure to move your body every day. If you have a desk job, this is very important. Sitting all day compresses the reproductive organs. Walking is straightforward and moves the hips, allowing higher blood flow to the uterus. Fertility yoga is also an excellent way to enhance circulation to the reproductive organs. It helps to reduce stress, which helps to keep the uterine artery open. Be sure you are moving and stretching your legs, hips, abdomen and back to provide adequate circulation to the reproductive organs.

 Miscellaneous treatments

Occasional reports of IU autologous platelet-rich plasma infusion, IU administration of bone marrow stem/progenitor cells, luteal phase support with GnRH agonist, pelvic floor neuromuscular electrical stimulation for improving endometrial are in the literature, but none of the treatments have been substantiated.

 We in our center have made few successful attempts with the use of IU administration of PRP as well as the use of bioelectrical stimulation administered to patients during detoxification at the Mart-life Detox clinic.

Regenerative medicine – many research units are working on the use of stem cell therapy for regeneration of the endometrium. So far, it remains a research protocol and has not cleared for routine clinical use.

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