Treating patients with "thin" endometrium - an ongoing challenge.
OBJECTIVE
To review the literature regarding inadequate growth ("thin") of the endometrium and to present the hitherto published methods aimed to improve endometrial thickness and the consequent endometrial receptivity.


METHODS
A literature review was conducted for all relevant articles assessing the effect of various treatment modalities on "thin" endometrium and the consequent reproductive outcome.


RESULTS
Several treatment modalities have been offered to patients with "thin" endometrium, including hysteroscopic adhesiolysis, hormonal manipulation by estrogen and GnRH-agonist, vasoactive measures such as aspirin, vitamin E, pentoxifylline, l-arginine or sildenafil, intra-uterine infusion of growth factor such as G-CSF and the recent application of regenerative medicine. In spite of the vast diversity of treatment, most of the options accomplish only minor change in the endometrium thickness and subsequent pregnancy rate, and when they fail, patients are usually referred to surrogacy.


CONCLUSIONS
"Thin" endometrium is known to adversely affect reproductive performance. Treatment of "thin endometrium" remains a challenge and future large researches are required to further elucidate and optimal management of patients with "thin" endometrium.
Infertility and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel and Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
Oshrit
O
Lebovitz
Raoul
R
Orvieto
D003131:Combined Modality Therapy; D018432:Drug Resistance, Multiple; D004717:Endometrium / Q000098:blood supply / Q000187:drug effects / Q000473:pathology*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D014591:Uterine Diseases / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use
D005300:Fertility Agents, Female; D014665:Vasodilator Agents
Endometrial receptivity; pregnancy; treatment.; “thin” endometrium