Abstract
BackgroundTo investigate the effect of pelvic floor Neuromuscular Electrical Stimulation (NMES) Therapy in improving endometrial thickness in women with thin endometrium.Methods41 patients undergoing assisted reproduction with a thin endometrium (less than or equal to7 mm) were recruited and advised to go for a pelvic floor NMES in frozen-thawed embryo transfer cycle. PHENIX Neuromuscular Electrical Stimulation Therapy System was used according to the manufacturer's recommended protocol for 20 to 30 minutes of intermittent vaginal electrical stimulation on the treatment days.ResultsA total of 20 and 21 were included in the NMES and non-NMES groups respectively. 12 out of 20 (60%) patients developed endometrial thickness equal to or more than 8 mm after the NMES therapy, which was the primary outcome. The mean thickness of endometrium before and after was respectively 5.60 mm (0.82 mm) and 7.93 mm (1.42 mm) in the therapy group versus 5.50 mm (1.00) and 6.78 mm (0.47) in the control group; the difference was statistically significant (P = 0.002). There was higher pregnancy rate in the NMES group (42% versus 35%) but the difference was not statistically significant.ConclusionNeuromuscular Electrical stimulation therapy may be effective for the patients with a thin endometrium. Further studies are needed to investigate its effectiveness.
Highlights
To investigate the effect of pelvic floor Neuromuscular Electrical Stimulation (NMES) Therapy in improving endometrial thickness in women with thin endometrium
There are many studies concerning different managements of women with thin endometrium to modulate uterine artery blood flow and improve endometrial thickness, there is no agreement in the literature about a consensus treatment
NMES is the application of electrical stimulation to a group of muscles through electrodes placed on the skin
Summary
To investigate the effect of pelvic floor Neuromuscular Electrical Stimulation (NMES) Therapy in improving endometrial thickness in women with thin endometrium. By the time of ovulation, many assisted reproductive technologies (ART) practitioners like to see the endometrium at least 8 mm thick. There is no officially accepted definition of “thin lining”. The commonly accepted cut off would be less than 8 mm on the day of LH surge or HCG administration day [4]. Thin endometrium at the time of ovulation can be a concern and has been demonstrated to be an important factor in implantation failure [5]. There are many studies concerning different managements of women with thin endometrium to modulate uterine artery blood flow and improve endometrial thickness, there is no agreement in the literature about a consensus treatment
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