Women who are trying to conceive with clomid (clomiphene citrate) are prone to having an underdeveloped uterus lining which is often too thin for successful embryo implantation to occur. A thin uterus lining often remains a 'hidden' problem when women receive clomid from an OB/GYN who is not a fertility specialist because all to often an ultrasounds are not performed to check in on how the uterus lining is developing.

One great advantage of seeing a fertility specialist for clomid treatment is that your lining will usually be measured (along with your follicles) and steps can then be taken to optimize the lining to increase your chances of success if it is found to be too thin (below 8 mm).

A number of treatments have been proven to thicken a thin uterus lining: estrogen - orally and in suppositories - can help as can herbs such as black cohosh, medications such as sildenafil as suppositories and natural treatments such as acupuncture.

One small study (1) measured the effectiveness of Sildenafil suppositories and acupuncture to thicken the uterus lining with good success during IVF.

Four infertility patients who had failed to develop a uterus lining greater that 8 mm were given five acupuncture treatments at specific times during the IVF cycle and administered Sidenafil suppositories daily. All four women developed a healthy uterus lining greater than 9 mm after the treatments which included one woman whose lining in a previous cycle did not exceed a a scant 5 mm. The thickness of the uterus lining continued to thicken after hCG administration too. The authors concluded that:

"Our pilot study is consistent with previous reports that acupuncture improves uterine lining measurements over previous cycles."

"We combined both the Sildenafil with acupuncture since data on Sildenafil alone in improving endometrial thickness remains controversial, even though our center believes in its efficacy."

"However, the combination of our acupuncture protocol with Sildenafil may be of further benefit to those with lining issues. Because acupuncture has been shown to improve nitric oxide production, we hypothesized that lining improvements would be related to such an increase. However, we found that lining thickness improved substantially even in a patient who had received Sildenafil in a previous cycle. This may suggest that acupuncture may be improving lining thickness through a mechanism independent of nitric oxide..."

If you are trying to conceive with Clomid make sure that your uterus lining is measured either with a follicle check just before ovulation or ideally at five days after ovulation when implantation is expected. If you are experiencing a thin uterus lining whether in IVF, natural cycles or other assisted cycle ask your physician about using Sildenafil suppositories, acupuncture and other techniques which have been proven to help.

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Fertility and Sterility Vol 87, issue 4- supplement April 2007 p. s 23
A Pilot Study Evaluating the Combination of Acupuncture with Sildenafil on Endometrial Thickness.
Yu, W.1; Horn, B.1; Acacio, B.1; Ni, D.1; Quintero, R.1; Nouriani, M.1