Can a thin endometrial lining be the cause of not getting pregnant?

Question

Hello doctor,

I am a 34-year-old woman currently trying to conceive my second child. With my first child, I got pregnant on the first try; however, I have been trying for more than six months for my second, and no result.

I went to an infertility specialist who did a transvaginal ultrasound, and everything looked normal. The endometrium was not very thick, only 7mm (this was day 11 after ovulation).

Then the doctor recommended I do hysterosalpingography. I wanted to go with HyCoSy (the one that uses ultrasound) so that I could avoid unnecessary radiation. The doctor, however, insisted that after a C-section with my first and possible adhesions, it is better to do the HSG - but they did not tell me more.

Can you help me understand why HSG is better than HyCoSy in some instances? Also, does the HSG involve a lot of radiation? Should I tell the doctor to use less X-rays, or less screening time, to reduce the radiation? I am afraid of getting ovarian cancer since I have a family history of breast cancer (my mother), and I know they could be related.

Answer 1

Hello,

Welcome to icliniq.com.

Hysterosonosalpingography is better than a hysterosalpingogram (HSG) as HSG involves the insertion of radio-opaque contrast, which can cause pain during the procedure and sometimes an anaphylaxis reaction. Hysterosonosalpingography involves the insertion of saline and air in the uterus, and the bubbles, if seen traveling through tubes, confirm patency. Thin endometrium indicates less serum estradiol levels which can be added exogenously to treat endometrium by your doctor.

Please share your ultrasonography report for review.