QuestionI am a 31 yr old female with regular menstrual cycles around 28 days. I have not been on the birth control pill for 6 years. I have no children but we are planning on starting to try. I'm in good health with no medical conditions. I am probably considered underweight, however I have been 'petite' my entire life.
I have a biphasic temperature pattern indicating ovulation around day 12 or 13 (my temperature dips significantly for two days before the thermal shift).
About 4 months ago I began spotting mid-cycle (usually begins day 10-12). At first I thought this may just be ovulatory bleeding, however it lasts about 5-7 days. There is no pain.
After visiting the doctor, my bloodwork and pelvic exam came back normal so she sent me for an ultrasound to check for polyps/fibroids. The first ultrasound was on day 27 of my most recent cycle and revealed 2 hemorraghic cysts. Due to the late stage of my cycle, my endometrium was very thick (14mm) and made it difficult to see any pathologies so they recommended repeating the ultrasound. Subsequently, I did not get my period until day 33 of that cycle (late for me). My chart indicates ovulation day 12 and I had 19 days of high temps (there is no chance that I was pregnant). The period that followed was very heavy. This seems unusual to me...any idea what could have happened?
I had a second ultrasound on day 7 of this cycle. The results were that the two cysts had resolved but that my endometrium was 'unusually thick' given the day in my cycle (6.1mm). They recommended a sonohysterogram to further check for polyps.
I had the sono today (day 9)and it showed no polyps or fibroids. However my lining is still too 'thick', so they've scheduled me for a endometrial biopsy to check for hyperplasia.
My husband and I desperately want to start trying to conceive. So I have a few questions:
1. Could anything else be causing this?
2. What is a normal endometrial thickness? How abnormal are my measurements (Day 7 = 6.1mm, Day 27 = 14mm)?
3. Should we start trying or should I wait to have the biopsy?
Any insight would be greatly appreciated.
AnswerIf you were post-menopausal, an endometrial thickness of greater than 5mm would be abnormal. However, in younger women (such as yourself) the endometrium changes in relation to time of your cycle. At the beginning of the cycle (day 1) it is very thin, and continues to grow until it reaches a thickness of around 15mm by the end of your cycle. The purpose of the endometrium is to grow thick in order to accept implantation of a new fetus. You may have a slightly thick endometrium and your doctors are just being cautious by taking a bioipsy. I certainly would wait until the bioipsy is done before trying to conceive. However, as soon as the biopsy is taken and you are not bleeding, you can start trying to conceive. There appears to be nothing abnormal. Concentrate on having sex starting on cycle day #12 and continue every other day until cycle day #16. Good Luck to you.
