Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 10 , ISSUE 2 ( April-June, 2018 ) > List of Articles

Guest Editorial

How to improve Thin Endometrium in Cases of Female Infertility

Gangadhar Sahoo, Vishy Agrawal

Keywords : Endometrium thickness, Granulocyte colony-stimulating factor, Infertility, Stem cell therapy, Thin endometrium

Citation Information : Sahoo G, Agrawal V. How to improve Thin Endometrium in Cases of Female Infertility. J South Asian Feder Obs Gynae 2018; 10 (2):81-83.

DOI: 10.5005/jp-journals-10006-1565

Published Online: 01-01-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Thin endometrium is frequently encountered during the treatment of female infertility. It is associated with lower implantation and pregnancy rates. Adequate growth is an integral step in endometrial receptivity and embryo implantation. Several modalities have been studied and include extended estrogen, pentoxifylline, tocopherol, low-dose aspirin, acupuncture, neuromuscular stimulation, L-arginine, vaginal sildenafil, granulocyte colonystimulating factor (G-CSF), and stem cell therapy. Studies show that vaginal sildenafil appears to be the first-line therapy option, G-CSF appears to be a potential second option, while stem cell therapy appears a new promising treatment modality.

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  1. Gonen Y, Casper RF. Prediction of implantation by sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF). J In Vitro Fert Embryo Transf 1990 Jun;7(3):146-152.
  2. Elnashar A, Afifi A, Donia D. Endometrial thickness and pregnancy rates in infertile couple undergoing AIH. Behna M J 1995;12:1-9.
  3. Miwa I, Tamura H, Takasaki A, Yamagata Y, Shimamura K, Sungio N. Pathophysiology features of “thin endometrium”. Fertil Steril 2009;91:998-1004.
  4. Chen MJ, Yang JH, Peng FH, Chen SU, Ho HN, Yang YS. Extended estrogen administration for women with thin endometrium in frozen-thawed in-vitro fertilization programs. J Assist Reprod Genet 2006 Jul-Aug;23(7-8):337-342.
  5. Chiao TB, Lee AJ. Role of pentoxifylline and vitamin E in attenuation of radiation-induced fibrosis. Ann Pharmacother 2005 Apr;39(3):516-522.
  6. Lédée-Bataille N, Olivennes F, Lefaix JL, Chaouat G, Frydman R, Delanian S. Combined treatment by pentoxifylline and tocopherol for recipient women with a thin endometrium enrolled in an oocyte donation programme. Hum Reprod 2002 May;17(5):1249-1253.
  7. Acharya S, Yasmin E, Balen AH. The use of a combination of pentoxifylline and tocopherol in women with a thin endometrium undergoing assisted conception therapies—a report of 20 cases. Hum Fertil (Camb) 2009 Dec;12(4):198-203.
  8. Wada I, Hsu CC, Williams G, Macnamee MC, Brinsden PR. The benefits of low-dose aspirin therapy in women with impaired uterine perfusion during assisted conception. Hum Reprod 1994 Oct;9(10):1954-1957.
  9. Hsieh YY, Tsai HD, Chang CC, Lo HY, Chen CL. Low-dose aspirin for infertile women with thin endometrium receiving intrauterine insemination: a prospective, randomized study. J Assist Reprod Genet 2000 Mar;17(3):174-177.
  10. Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril 2002 Apr;77(4):721-724.
  11. Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril 2006 May;85(5):1341-1346.
  12. Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod 1996 Jun;11(6):1314-1317.
  13. Ho M, Huang LC, Chang YY, Chen HY, Chang WC, Yang TC, Tsai HD. Electroacupuncture reduces uterine artery blood flow impedance in infertile women. Taiwan J Obstet Gynecol 2009 Jun;48(2):148-151.
  14. Sher G, Fisch JD. Vaginal sildenafil (Viagra): a preliminary report of a novel method to improve uterine artery blood flow and endometrial development in patients undergoing IVF. Hum Reprod 2000 May;15(4):806-809.
  15. Zinger M, Liu JH, Thomas MA. Successful use of vaginal sildenafil citrate in two infertility patients with Asherman's syndrome. J Womens Health (Larchmt) 2006 May;15(4):442-444.
  16. Takasaki A, Tamura H, Miwa I, Taketani T, Shimamura K, Sugino N. Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in patients with a thin endometrium. Fertil Steril 2010 Apr;93(6):1851-1858.
  17. Jensen JR, Witz CA, Schenken RS, Tekmal RR. A potential role for colony-stimulating factor 1 in the genesis of the early endometriotic lesion. Fertil Steril 2010 Jan;93(1):251-256.
  18. Lucena E, Moreno-Ortiz H. Granulocyte colony-stimulating factor (G-CSF): a mediator in endometrial receptivity for a patient with polycystic ovary (PCO) undergoing in vitro maturation (IVM). BMJ Case Rep 2013 Apr;2013:008115.
  19. Barad DH, Yu Y, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Gleicher N. A randomized clinical trial of endometrial perfusion with granulocyte colony-stimulating factor in in vitro fertilization cycles: impact on endometrial thickness and clinical pregnancy rates. Fertil Steril 2014 Mar;101(3):710-715.
  20. Padykula HA, Coles LG, McCracken JA, King NW Jr, Loncope C, Kaiserman-Abramof IR. A zonal pattern of cell proliferation and differentiation in the rhesus endometrium during the estrogen surge. Biol Reprod 1984 Dec;31(5):1103-1118.
  21. Padykula HA, Coles LG, Okulicz WC, Rapaport SI, McCracken JA, King NW Jr, Longcope C, Kaiserman-Abramof IR. The basalis of the primate endometrium: a bifunctional germinal compartment. Biol Reprod 1989 Mar;40(3):681-690.
  22. Gargett CE. Uterine stem cells: what is the evidence? Hum Reprod Update 2007 Jan-Feb;13(1):87-101.
  23. Gargett CE, Nguyen HP, Ye L. Endometrial regeneration and endometrial stem/progenitor cells. Rev Endocr Metab Disord 2012 Dec;13(4):235-251.
  24. Cervello I, Mas A, Gil–Sanchis C, Peris L, Saunders PT, Critchley HO, Simón C. Reconstruction of endometrium from human endometrial side population cell lines. PLoS One 2011 Jun;6(6):e21221.
  25. Taylor HS. Endometrial cells derived from donor stem cells in bone marrow transplant recipients. JAMA 2004 Jul;292(1):81-85.
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