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  1. faith123
  2. Infertility Discussion
  3. Thursday, 16 January 2014
  4.  Subscribe via email
Dear Doctor,

I took clomid for two cycles, and for both cycles I have "homogeneous lining" with thickness of >15mm on day 12. Thinking about IVF in the near future.

1) Is homogeneous lining a bad prognosis with less successful rate?
2) Is thickness >15mm a bad prognosis with less successful rate?
3) How thick of a lining is considered as too "thick" and may possibly affect implantation?
4) Does homogeneous lining or lining being too thick (>15mm) suggest IVF will less likely be successful?
5) Will an IUI/IVF cycle be canceled if lining is homogeneous?
6) What can be the cause of a homogeneous/lack of trilaminar structure (if HSG show normal uternine lining)?
7) Will Clomid possibly cause homogeneous rather than trilaminar structure?
8) What can be done to cause lining to become more trilaminar?

Thanks so much for your help!!! I truly appreciate it.

Faith
Responses (2)
DrPeck Accepted Answer Pending Moderation
Thank you for your inquiry. Here is the answer to your questions. Hope it helps!
1) Is homogeneous lining a bad prognosis with less successful rate?
Generally we look for a “trilaminar lining” before ovulation. That would be the best prognosis in terms of lining. Note that this detail can be subjective based on who is doing the ultrasound.

2) Is thickness >15mm a bad prognosis with less successful rate?
Not necessarily. However, you would want to be sure that there is nothing in the uterus such as a polyp that contributes to the thickness. Either a saline sonogram or hysteroscopy around day 6-10 of your menstrual cycle would help. Hysterosalpingograms may miss small lesions in the uterus.

3) How thick of a lining is considered as too "thick" and may possibly affect implantation?
It would be patient dependent. Usually a lining less than 8 mm in any given patient would give a worse prognosis. "Too thick" could implicate a lesion and should be evaluated. A lining 8-13 mm midcycle is an average thickness.

4) Does homogeneous lining or lining being too thick (>15mm) suggest IVF will less likely be successful?
For a lining to be ready for implantation many things are happening. Some are anatomic, some hormonal, some molecular. It’s the coming together of these things that make timing of implantation ideal. If there is something in the way of an embryo implanting, if the progesterone level rises earlier than anticipated, if the right molecular architecture is not there, your chances of implantation will be lower.

5) Will an IUI/IVF cycle be canceled if lining is homogeneous?
Not necessarily. You need to look at the whole picture: patient characteristics, size and number of follicles, level of hormones such as estradiol, progesterone or LH, to decide on cancellation. Ideally the lining should be check more thoroughly before IVF if there is any question on the lining.

6) What can be the cause of a homogeneous/lack of trilaminar structure (if HSG show normal uterine lining)?
Missed lesion, unreceptive endometrium, side effects of clomid.
  1. more than a month ago
  2. Infertility Discussion
  3. # 1
DrPeck Accepted Answer Pending Moderation
Continued from above.


7) Will Clomid possibly cause homogeneous rather than trilaminar structure?
Clomid can have an effect on the endometrial growth, more often exhibited by a thin lining (dometrial development on clomid, using other ovarian stimulating medications may be alternatives.

8) What can be done to cause lining to become more trilaminar?
You can consider using estrogen therapy prior to ovulation to help the lining grow under the guidance of your treating physician. If there is an anatomic abnormality it should be removed or corrected.


Good luck.
Dr. Alison Peck
  1. more than a month ago
  2. Infertility Discussion
  3. # 2
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