How to Manage Thin Endometrium

Implantation and pregnancy are influenced by two main factors, embryo and endometrium. A healthy embryo and receptive en-dometrium are necessary for implantation.Endometrial pattern and thickness are evaluated by ultrasound examination. There is no agreement about the most recipient endometrium, however, most clinicians prefer endometrial thickness more than 7 mm for embryo transfer.In frozen embryo transfer cycles, patients should be counselled that endometrial thickness <7 mm may have a negative im-pact on pregnancy and live birth rates. Some in vitro fertiliza-tion (IVF) cycles are cancelled due to inadequate endometrial growth despite several treatments. For patients with a history of thin endometrium in assisted reproductive technology (ART), there is insufficient evidence that any specific protocol (natu-ral cycle or hormone replacement) for endometrial preparation provides better pregnancy outcomes.Different protocols such as extended estrogen treatment, Pen-toxifyline, low-dose Aspirin, Tamoxifen, vaginal Sildenafil, in-trauterine perfusion with granulocyte-colony stimulating factor (GCSF), and platelet-rich plasma (PRP) have been performed for the management of thin endometrium, but there is little con-sensus on the most effective one.