5.3.10 Uterine Lining and Its Role in Surrogacy: A Comprehensive Guide

Understanding the Uterine Lining (Endometrium) in Surrogacy

The uterine lining, or endometrium, plays a critical role in the success of embryo implantation during surrogacy. A properly developed endometrial lining provides the necessary environment for an embryo to attach and grow, making it an essential factor in achieving a healthy pregnancy.

At GSHC Surrogacy & Egg Donation, we prioritize the health and well-being of both the surrogate mother and the intended parents by ensuring that all medical criteria, including endometrial health, are met before proceeding with an embryo transfer.

What Causes a Thin Uterine Lining?

A thin endometrial lining is typically defined as an endometrial thickness of less than 7 mm on ultrasound, though some clinics may use 6 mm or 8 mm as thresholds. Several factors contribute to a thin uterine lining, including:

1. Low Estrogen Levels – Estrogen is essential for endometrial growth. Insufficient estrogen may prevent the lining from reaching the optimal thickness for implantation.
2. Reduced Uterine Blood Flow – Poor circulation due to scarring, prior uterine surgeries (such as D&C), or underlying medical conditions may impact endometrial development.
3. Inflammation or Infections – Chronic endometritis or a history of infections may compromise endometrial health.
4. Long-Term Use of Certain Medications – Repeated use of Clomid or other fertility drugs can sometimes contribute to a thinner lining over time.
5. Hormonal Imbalances – Conditions such as PCOS (Polycystic Ovary Syndrome), thyroid disorders, or perimenopause may interfere with normal endometrial growth.

Medical Approaches to Improve Endometrial Thickness

For surrogacy candidates with a thin uterine lining, medical interventions may be recommended to improve endometrial thickness before confirming their eligibility for embryo transfer. These interventions may include:

• Estrogen Therapy (Estrace, Patches, or Injections) – Used to stimulate endometrial growth.
• Blood Flow Enhancers – Viagra suppositories, L-Arginine supplements, and acupuncture may help increase uterine blood circulation.
• Hysteroscopy – A procedure used to evaluate and remove potential uterine abnormalities, including scarring.
• Lifestyle Modifications – A nutrient-rich diet, hydration, regular exercise, and avoiding smoking can help improve overall uterine health.

What Happens If a Surrogate Mother’s Uterine Lining is Thin?

If a thin uterine lining is detected during screening, the fertility specialist may recommend:

• Additional Testing to identify potential underlying causes.
• Hormone Therapy (Estrogen-based treatment) to assess whether the lining responds to medical intervention.
• Follow-up Monitoring to evaluate endometrial growth over multiple cycles.

Does a Thin Uterine Lining Disqualify a Surrogate?

A thin uterine lining is not an automatic disqualification for surrogacy. The primary concern is whether the lining can respond to treatment and reach an adequate thickness for a successful embryo transfer.

Most fertility clinics require a minimum endometrial thickness of 7–8 mm, though some may accept 6 mm if the quality of the lining is favorable. If the lining does not respond to treatment, it may impact eligibility for surrogacy.

Next Steps for Surrogates with a Thin Lining

For prospective surrogate mothers, a thin uterine lining does not necessarily mean disqualification. Each case is evaluated individually, and treatment success rates vary among individuals. The medical team at GSHC Surrogacy & Egg Donation will carefully assess the surrogate's response to therapy before making a final determination.

Final Thoughts on Uterine Lining and Surrogacy

A healthy uterine lining is a key factor in successful surrogacy. While a thin endometrium may present challenges, medical interventions and monitoring can improve endometrial thickness, increasing the chances of a successful pregnancy.

For those considering becoming a surrogate mother, consulting with a trusted surrogacy agency like GSHC and working closely with a fertility specialist is the best approach to determining eligibility and optimizing pregnancy success.