Difficulty having children can result from various factors, whether it is due to marrying later, deciding to have children at an older age, or work-related stress that reduces intimacy, among others. Additionally, there are health and physical causes, especially in the reproductive system, which can also lead to infertility. Today, we will discuss the issue of endometrium, which is a significant and common problem among those facing difficulty having children.
Getting to know the endometrium first
The endometrium is the lining of the inner wall of the uterus. Its function is to receive the implantation of the embryo and support pregnancy. The thickness of the endometrium varies at different times during a menstrual cycle. Specifically, during menstruation, the endometrium is at its thinnest because it sheds as menstrual blood and gradually thickens again. This thickening correlates with the growth of the ovarian follicle in that month, reaching its maximum thickness around ovulation. Afterward, the thickness may increase or decrease slightly to await embryo implantation. If implantation does not occur, the lining thins again when menstruation begins.
Therefore, the thickness of the endometrium is important for embryo implantation and pregnancy. At this point, many may wonder… Is it true that the thicker the endometrium, the easier it is to get pregnant? And is it true that the thinner the endometrium, the harder it is to conceive? What is the ideal thickness for embryo implantation? Today, we will answer these questions.
Endometrial thickness that makes pregnancy easier or harder
Normally, the thickness of the endometrium varies from person to person, and even in the same person, it varies in each menstrual cycle but remains within a similar range. A good endometrial thickness should be more than 8 millimeters. Several studies on embryo transfer during in vitro fertilization (IVF) have found that the optimal thickness for embryo implantation is between 8-14 millimeters, and implantation rates drop significantly when the endometrium is less than 7 millimeters thick.
Therefore, the idea that a thicker endometrium makes pregnancy easier is true. However, if it is too thick, meaning more than 14 millimeters, it can actually make conception more difficult. Excessive thickening of the endometrium may be associated with menstrual abnormalities, such as significantly delayed periods or menstruation occurring only every 2-3 months, or it may cause spotting or irregular vaginal bleeding.
If a woman has regular periods but experiences heavy bleeding or spotting, it is advisable to suspect the presence of uterine masses such as fibroids or polyps. However, if periods are delayed longer than usual, sometimes occurring only every 2-3 months or more, accompanied by spotting, one should consider abnormal thickening of the endometrium or endometrial cancer.
Therefore, if any woman has difficulty conceiving along with the above symptoms, she should promptly see a doctor to find the cause, as treatment can help improve the chances of pregnancy.
On the other hand, the statement that a thinner endometrium makes pregnancy harder is also correct because if it is too thin, embryo implantation becomes more difficult. How can we know if our endometrium is thin? It might be somewhat difficult to tell, but if there is a history of miscarriage and uterine curettage or dilation and curettage for other reasons, and the menstrual flow decreases, this may be due to intrauterine adhesions. Those experiencing such symptoms should consult a specialist.
In summary, the endometrium is truly important. Too thick makes pregnancy difficult, too thin makes pregnancy impossible. However, do not worry. If there are abnormal menstrual symptoms related to the uterus, you should consult a specialist because “every problem has a solution.”
Dr. Teerayut Jongwutiwes
Reproductive Specialist
Infertility Treatment Center, Phyathai 2 Hospital
