Impact of Thin Endometrium in Frozen Embryo Transfer: Thesis Summary Article

Sakthi A

Abstract

Thesis

Impact of Thin Endometrium in Frozen Embryo Transfer: Thesis Summary Article

Sakthi A*

Published: 13 June, 2025 | Volume 8 - Issue 2 | Pages: 037-056

Background: Endometrial Thickness (EMT) is considered an important prognostic factor in assisted reproductive technology (ART), particularly in frozen embryo transfer (FET) cycles. Thin endometrium (< 7 mm) is often associated with implantation failure and reduced pregnancy rates, although its precise impact remains controversial.
Objective: This thesis summary evaluates the role of thin endometrium in FET cycles, discusses etiologies, diagnostic modalities, treatment approaches, and reviews available patient data.
Methods: We retrospectively analyzed 69 patients who underwent FET at Saveetha Medical College. Endometrial thickness was assessed via transvaginal ultrasound. Various treatment strategies including hormonal therapies (estradiol, progesterone), vasoactive agents, granulocyte colony-stimulating factor (G-CSF), platelet-rich plasma (PRP), L-arginine, sildenafil citrate, vitamin E, pentoxifylline, and stem cell therapy were reviewed for their efficacy in improving endometrial receptivity.
Results: Endometrial thickness < 7 mm correlated with lower pregnancy rates compared to patients with thickness ≥ 7 mm. Hormonal and adjuvant therapies reported varying degrees of success in improving EMT and subsequent pregnancy outcomes. Vascularity, angiogenesis, and Doppler studies also demonstrated a significant association with endometrial receptivity.
Conclusion: Thin endometrium remains a critical challenge in ART cycles. Multimodal therapeutic approaches may improve outcomes; however, larger prospective studies are required to establish standardized protocols. Our patient data support that even minimal increases in EMT can enhance implantation success.

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Keywords:
Thin Endometrium; Frozen Embryo Transfer (FET); Endometrial Thickness (EMT); Endometrial Receptivity; Assisted Reproductive Technology (ART); Platelet-Rich Plasma (PRP); Granulocyte Colony Stimulating Factor (G-CSF); Angiogenesis

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Hunter RK 2nd, Nevitt CD, Gaskins JT, Keller BB, Bohler HC Jr, LeBlanc AJ. Adipose-derived stromal vascular fraction cell effects on a rodent model of thin endometrium. PLoS One. 2015;10(12):e0144823. Available from: https://doi.org/10.1371/journal.pone.0144823
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Gil-Sanchis C, Cervello I, Khurana S, Faus A, Verfaillie C, Simon C. Contribution of different bone marrow-derived cell types in endometrial regeneration using an irradiated murine model. Fertil Steril. 2015;103(6):1596-605.e1. Available from: https://doi.org/10.1016/j.fertnstert.2015.02.030
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Qublan H, Amarin Z, Al-Qudah M, Diab F, Nawasreh M, Malkawi S, et al. Luteal phase support with GnRH-a improves implantation and pregnancy rates in IVF cycles with endometrium of ≤7 mm on day of egg retrieval. Hum Fertil (Camb). 2008;11(1):43-7. Available from: https://doi.org/10.1080/14647270701704768
Garrido-Gomez T, Ruiz-Alonso M, Blesa D, Diaz-Gimeno P, Vilella F, Simon C. Profiling the gene signature of endometrial receptivity: clinical results. Fertil Steril. 2013;99(4):1078-85. Available from: https://doi.org/10.1016/j.fertnstert.2012.12.005
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