Q: What can be done about thin uterine lining?

A: The endometrium, the lining of the uterus, is needed for implantation of the embryo. Lining problems are usually not a major cause of infertility. The uterine lining around ovulation should be at least 8-9 mm. There are several tests than can be done to find out what's going on:

  • Transvaginal ultrasound. Most polyps and fibroids will show up on ultrasound. If there is a question, there are three options:
  • A hysterosalpingogram. It offers an assessment of the fallopian tubes as well.
  • Sonohysterogram, saline sonogram, saline contrast sonography. This procedure is like an HSG that replaces X-ray with ultrasound and replaces X-ray contrast with saline (water and salt) solution. It is at least as accurate in identfying a lining problem as HSG (although it gives only minimal information about the fallopian tubes) and it an be done in the office rather than a radiology suite
  • Surgical hysteroscopy -- the insertion of a fiberoptic scope through the cervix and into the uterus to look directly at the lining of the uterus. This can be done in the office or in an operating room and is both diagnostic and therapeutic -- if an abnormality is discovered it can be removed at the same time.