Endometrial Rejuvenation Endometrial Rejuvenation a solution for Women who struggle to become pregnant because of poor endometrial thickness, can now conceive naturally and give birth. What is Endometrial Regeneration? Pregnancy requires not just a healthy embryo, but also a healthy and mature endometrium, which ensures the implantation of the embryo and the onset of your long-awaited pregnancy. if the endometrium isn't thick enough, the embryo will simply not be able to attach to the wall of the uterus. Endometrial Rejuvenation is the process to enhance quality of Endometrium for successful implantation of embryo by improving the endometrial thickness & blood supply which helps embryos for implantation giving them proper nutrition & hormones. The membrane lining the uterus is called the endometrium, the endometrium thickens during the menstrual cycle in preparation for the implantation of an embryo. If the implantation has not occured the membrane is shed, Shedding and regenerating its functional layer once every cycle is the unique capacity of the healthy endometrium , which is regulated by the hormones, progenitor cell populations and inflammatory mediators. The functions of the endometrium are to make optimal conditions for implantation of an embryo within the uterus. However, if any of those factors are perturbed, the result will be endometrial disorders with intrauterine scar formation, dysregulated proliferation and heavy menstrual bleeding. Without a healthy endometrium, pregnancy is impossible. The condition of the endometrium determines the likelihood of a successful pregnancy. If the endometrium is not thick enough, the embryo will simply not be able to attach to the wall of the uterus thus it plays an important role in successful pregnancy. The minimal endometrial thickness required for embryo transfer is about 7 mm at the end of natural or medically induced follicular phase Which conditions need this treatment? Poor endometrial thickness is the most common reasons for infertility .Constantly thin endometrium having thickness below 7 mm because of following conditions.
• Low levels of Estrogen hormone
•Trauma to the uterus (cesarean sections, repetitive curettage),
•Previous anti- tumoral treatments (radiotherapy, chemotherapy, surgery) ∙ Asherman's syndrome,( formation of adhesions (scar tissues) inside the endometrial cavity either post D&C or because of pelvic infections. )
• Chronic infections (Endometritis, Pelvic Inflammatory Disease)
• Conditions which cause inadequate blood flow (stress, malposition of uterus, fibrosis),
• Clomiphene citrate -(a drug used for ovarian stimulation) if used excessively
• Patients with low estradiol values
• Post hysteroscopic surgeries done for removal of polyps, fibroids & adhesions – mainly because of excessive use of electric cautery.
• Chronic Endometritis, polyps, endometrial hypoplasia,
• Uterine synechiae . Who can have the benefit of this treatment?
• Women who have experienced several failed IVF programs because of the uterine factor.
• Women who are diagnosed with Asherman´s syndrome.
• Women who are diagnosed with female infertility caused by uterine hypoplasia Treatment plans done for Endometrial Rejuvenation -Several treatments are proposed over the years to enhance the endometrial thickening. Platelet Rich Plasma (PRP) has effect on endometrial cell proliferation, PRP increases proliferation not only on fibroblasts but also on mesenchymal cells, which are progenitors of various types of cells, including endometrial cells. Fresh whole blood collected from the same person is used to prepare Platelet Rich Plasma (PRP) also called autologous PRP, which is processed to separate platelets from the other blood Components. Infusion of PRP into the uterus is seen to improve endometrial growth and implantation. Since autologous blood is used for PRP concerns regarding immunogenic reactions and disease transmission is eliminated.Patients considered for a PRP application must undergo hematological evaluation (blood tests) to exclude blood disorders or platelet dysfunction.Bone Marrow Mesenchymal Stem Cells (BM-MSCs) provide an alternate source for regenerating the endometrium and repairing endometrial injury according to the recent studies. – Supplements of Estrogen & Progesterone hormones. -Granulocyte colony stimulating Factor (GCSF), a protein which stimulates bone marrow is infused into the uterus to produce more blood. Pretty effective, as it’s directly infused into uterus, the part which needs blood. – Sub Cutaneous infusion of GCSF – the same as above, but instead of infusing into uterus, its injected in skin. It should be given in regulated quantity, because if an excessive amount of White Blood Cells (WBC) are pulled in reproductive organs, there might not be enough left in body to fight the infection. – Vasoactive medicines like aspirin, vitamin E, l-arginine, sildenafil. These activate the blood vessels to extend flow towards uterus, endometrium.- Intrauterine infusion of Platlet Rich Plasma during which patient’s own plasma is extracted from her body, enriched with platelets then infused back to uterus. – A new research giving good results in improvement of Endometrial Thickness is perivascular stem cell therapy. It can generate endometrial cells. However its still in research stage. – Hysteroscopy is done for diagnosis of endometrial infection, removal of fibroids, polyps, adhesions to enhance the endometrial surface quality & then Endometrial Rejuvenation Programme is started till the time effective results are achieved. – To avoid post-surgical adhesions & improvement of cell growth in endometrial tissue, Intra-Uterine Contraceptive Device (IUCD) is kept in few cases. – Associated treatment to enhance blood supply of Endometrium include acupuncture, stress management, Exercise, Nutrition plan, yoga, Fertility message, castor oil packs. Success factors Endometrial Rejuvenation Treatment is successful if:
1 – Endometrial Thickness above 9 mm with good blood supply is formed after treatment.
2 – There is Sub-endometrial blood supply up to Zone 4( the zone which is closest to the embryo). Doctors and biotechnologists have developed an innovative and extremely effective treatment to resolve the problem of poor endometrial health. Endometrial Rejuvenation Treatment helps successful embryo implantation. The pregnancy is achieved through Natural Fertilization, and if that doesn't work IVF and IUI is done. Endometrial regeneration provides a true alternative to surrogacy for ladies who suffer from infertility because of uterine factors – who struggle with conditions like Asherman's syndrome, endometrial hypoplasia, uterine synechiae and poor endometrial thickness
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