10 Replies
4everhopeful - October 20

Dear Dr Jacobs,

My new RE suggested I do short protocol for my third cycle, because my FSH came back at 9.5 on day 3 two months running.
(On previous cycles on l/p I got 7 eggs and 5 eggs)
However, when they scanned me, on day 3 of my period, they found my lining was still 6mm ??? so they advised me to take the pill for 21 days, and on day 2 of my period re-scan me.
It took 5 days for me to start bleeding after I stopped the pill, and the bleeding was fairly light. My day 2 scan showed that my lining had GROWN to 7mm :o despite being on the pill!

They're going to check me for polyps with a water scan, but the RE really doesn't think I have these, it's more to rule them out really. I was just wondering why I can't shed my lining and why my periods are so light. Is it possible that my hormones are failing me by not letting me get a proper period?

Another RE at the clinic has now suggested I do the L/P instead, so I'm currently back on the pill and have to start suprefact injections next week. Now that I'm down regging can this happen a third time? I down-regged fine on my last 2 cycles but I'm dreading my third B/L scan!

Also my lining grew really thick on my last cycle, was 19 mm on day 11 of stims, and was 29mm 7 days after e/t. Can a lining be too thick?

Many thanks
Nat :)


Barry Jacobs, M> D. - October 21

Te thickness and ultrasound of the endometrium are regulated by estrogens and progestins. The endometrium is typically thin on day 3 and thick from mid cycle until menstrual flow. Birth control pills make the endometrium very thin.
Good luck.


4everhopeful - October 21

Thank you for your answer Dr Jacobs :) But I'm confused :-\ if birth control pills typically make the lining thin, why had mine grown, whilst on the pill, to 7mm on day 2 of my menstural flow ???
Many thanks,
Nat :)


Barry Jacobs, M. D. - October 22

I am hard pressed to answer your question, without examining the entire record. A situation I had not mentioned, in some women with long standing anovulation, and polycystic ovaries, the endometrium can over grow, and become hyperplastic.
Good luck.


4everhopeful - October 22

Thank you again so much for your prompt answer Dr Jacobs :)

My RE and IVF nurses are all scratching their heads over this one I think! Although I was told I once had an indicator of polycystic ovaries (LH reading was higher one month than my FSH), they've since decided I don't have PCOS, because, aside from this one month, all subsequent blood tests showed LH to be lower than FSH :-\ My ovaries are also clear of cysts ??? RE has always said that U/S shows that my uterus and ovaries are very normal and healthy.
Blood tests, scans and CM have all indicated that I ovulate every month still... I just don't get heavy menstrual flow anymore, and can't seem to shed all of my lining ??? Could it be hormonal, seeing as my FSH is elevated (9.5 on day 3)? Are my hormones failing me?

Many many thanks for all your help,
Nat :)


Barry Jacobs, M. D. - October 22

Small volume of menstrual flow is rarely a problem. If, on ultrasound, you have at least 4 visible vollicles on each ovary, you are probably making enough ovarian hormones, and have adequate ovarian reserve.
Good luck.


4everhopeful - October 23

Thank you for your answer Dr Jacobs :)
I am feeling quite relieved!
RE has always maintained my uterus and ovaries are healthy and function normally. It's just stange that I can't seem to get rid of all my lining during AF and also that it grew despite being on the pill ???
With warmest regards,
Nat :)


Barry Jacobs, M. D. - October 23

You are not supposed to get rid of all your lining. It should be 4 to 6 mm thick, at a minimum, at the end of your flow.


4everhopeful - October 24

Thank you so much for telling me that Dr Jaconbs ;D You're a star!!!

I've been so worried, thinking there was something wrong with me, and now I know I'm okay!

My clinic just said they needed it to be 4 mm or less to be able to start s/p, so now they're putting me on the l/p instead. Hopefully the d/r will make the lining thin enough to be able to start stims :)

Many many thanks for your help :)
Nat :)


Gem - March 18

I am having trouble getting much information or straight answers, so am hoping someone may be able to help... Just recently I had an ultra sound at around day 11/12 into cycle, (for something unrelated) which showed a thin endometrium lining at under 3mm. I have been on the pill for the last 8 months but previous to that have had a couple of miscarriages so... Is the lining thickness possibly causing these? And if so, treatable? I am waiting to see a gynocologist in a few weeks...


BArry Jacobs, M. D. - March 18

I assume you mean you were on birth control pills. They do cause you to have a thin endometrium.
Good luck.



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