Thin endometrium in assisted reproductive technology.
OBJECTIVE
To review the etiology, diagnosis and clinical importance of thin endometrium during assisted reproductive technology cycles and to find out better ways to deal with it.


RESULTS
Precise and specific endometrial maturational development is crucial in allowing implantation following assisted reproduction. As endometrial biopsy is invasive and hormonal milieu assessment inaccurate, the need to evaluate endometrial development encouraged the use of high-resolution ultrasonography as an alternative non-invasive method of assessment for uterine receptivity. Ultrasonographic endometrial thickness measurement, endometrial pattern investigation, endometrial volume computation, uterine and subendometrial blood flow analysis by Doppler sonography are just some of the methods that we can utilize to have an idea of uterine receptivity and consequently to better predict pregnancy outcome following assisted reproductive technology cycles. There is a lot of debate on the administration of low-dose aspirin, estrogen, vaginal sildenafil citrate, pentoxifylline, vitamin E, and gonadotropin-releasing hormone agonist for the management of thin endometrium with an aim to increase the pregnancy and implantation rates in assisted reproductive technology cycles.


CONCLUSIONS
Various recent modalities proposed for the treatment of thin endometrium seem to be useless and inefficient from an evidence-based medicine point of view. At the moment, evaluation of endometrium using different ultrasonographic markers seems to be superior to all those therapies.
Senturk
Levent M
LM
Istanbul University Cerrahpasa School of Medicine, Division of Reproductive Endocrinology, IVF Unit, Istanbul, Turkey. leventsenturk@superonline.com
Erel
C Tamer
CT
D010064:Embryo Implantation / Q000502:physiology; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D027724:Reproductive Techniques, Assisted; D014463:Ultrasonography