Is persistently thin uterine lining due to immune issues??

Jules74

2 Posts
Reply Posted on: Mar 26, 2016 at 1:23am
Hi Dr Braverman,

In the past 12mths due to starting IVF, I have discovered that I have high anti thyroid peroxidase antibodies (140h in Australia), high ANA (again in Australia, my level was 1:2560), I also believe based on symptoms that I have raynauds (hands & feet turn blue when cold, then once they heat up they flush red, feel hot, tight & swollen- my GP has told me that diagnosis is based purely on symptoms?). My GP & RI have also tested me for an array of other auto immune issues which were negative. However I do have moderately high NK 56 cells & borderline NK57. My RI has told me I definitely have immune issues affecting my fertility, but that they aren't 'terribly bad'.I am 41 & have an AMH of 24.7 p/mol (again Australian measurement, but am aware that it is good/high for my age), I don't have PCO/S however.


I had a laparoscopy / hysteroscopy, D&C done in 2015, and was advised that everything looked good. Pathology was NAD. (It was done because it was thought I had a hydrosalpinx, however it turned out to be a large vein which on ultrasound appeared to be a hydrosalpinx).


In my 2 IVF cycles I have had between 15-20 follicles each time, then had 15 & 13 eggs collected respectively. My partner has varicoceles which have affected his sperm, so we have only ended up with 1 PGD normal embryo (frozen). We get about 50% fertilisation, and 2-4 embryos will make it to day 5, but either my age, or his sperm is clearly affecting our embryos by day 5.We now have this one precious embryo. And our big problem is my uterine lining. It will not thicken more than 6.8mm. My FS had me on aspirin, Vit E, prednisolone 15mg, GTN nitro dur patch, clexane, I also had intrallipids 10 days before planned transfer.. My FS was ok with a lining over 6. Mine got to 6.8... However after 5 days of progesterone my lining had reduced to 4mm!!! And our transfer was cancelled.My FS now has me on Trental 400mg BD & I'll be on it for 5 mths before we try another transfer.My question for you is this, is my thin & stubborn lining being affected by my immune issues? Is this related to the Raynauds? If so, what else can be done? It seems thin lining is not the most common of fertility issues & therefore not a lot of research or answers found. I'm really concerned that if the Trental doesn't help then we'll have no further measures to try?


I have been told by someone however that once you start progesterone there is no point in checking lining because it 'compacts' and therefore WILL appear to have reduced but is infact still ok.. Is this true?

Dr. Braverman

2026 Posts
RE: Is persistently thin uterine lining due to immune issues?? Posted on: Mar 26, 2016 at 5:15am
There appears to be quite a bit autoimmune going on here with the anti TPO , Reynauds and even with the large number of follilces I still suspect you have some form of PCOS. Read my blog on CRAMS on our website. I think this is your problem, and maybe your lining issues are releted. Fill out a consult form on the website and we can schedule a free consult to review your case in detail.
Braverman Medical Team
Braverman Reproductive Immunology P.C.

Jules74

2 Posts
Reply RE: Is persistently thin uterine lining due to immune issues?? Posted on: Mar 26, 2016 at 6:37am
Thanks for your quick reply over a weekend doctor. I'm feeling a little hopeless and ur response is heartening.


Dr Braverman would CRAMS still be likely if I've NEVER been pregnant before? what I read about CRAMS seems to talk about miscarriages & anueploidy, I've never gotten that far to actually have a miscarriage.


Also I didn't realise that follicles numbers of around 15 was high? That was on a stim cycle of course. Without IVF drugs my follicle count was only around 9 altogether. Should I be concerned that I have PCOS also? Is PCOS considered auto immune?

The list of issues to contend with is starting to feel overwhelming. I'm beginning to wonder if I should just give up...