I share everything I did to get pregnant with a thin uterine lining and recurrent miscarriage history in this detailed outline of my supplements, diet, lifestyle, procedures and drugs.
First of all, thank you soooo much for the overwhelming support I received in response to my pregnancy announcement on my Youtube channel. It was so reassuring to hear from all of you, especially considering the challenge I’ve had on this road. I got a lot of questions about my protocol, and everything I did to get pregnant for those who are struggling with infertility or are just worried about the process. So today I wanted to share, in detail, everything I did to get pregnant, specifically with a thin uterine lining and recurrent miscarriage history.
Huge disclosure, that I do not recommend anyone follow this protocol. This is for education and entertainment purposes only, and the fertility protocol for you would be highly dependant on your unique blood work and diagnosis. In some cases, taking one of these supplements may actually reduce your chances of pregnancy, so always make sure you’re working with your fertility team to ensure you have the safest protocol for you.
My Infertility Journey and Diagnosis
Okay so a quick recap if you’re just catching up. This was not a “natural” conception. I went through IVF or invitro fertilization to conceive because I don’t naturally ovulate with a diagnosis of PCOS. Ha, I don’t even ovulate with drugs but that’s a whole other blog post I guess. My main struggle with my previous embryo transfers and losses was that I have a thin uterine lining, and the uterine lining is important for an embryo to stick to to maintain a pregnancy. Generally speaking, they want your lining to be at least 8 mm before they transfer an embryo in to give you the best chance of pregnancy and mine just always struggled to get past 6 mm. As a result, I was suffering from recurrent miscarriages and chemical pregnancies with IVF (and definitely wasn’t even ovulating without it).
Okay so first let’s talk about what I did before I did my embryo transfer in preparation for pregnancy.
Everything I did pre-IVF transfer to get pregnant with thin uterine lining and recurrent miscarriage History
Prenatal (3 x day) – This one is mainly for both me and for baby’s health like preventing neural tube defects, and I do prefer to choose a prenatal with methyl folate instead of folic acid. Most supplements will have folic acid because it’s more stable, but your body has to then covert it to active methyl folate, and it’s estimated that up to 60% of women have gene variant that hinder this conversion. This gene is also linked to PCOS and miscarriage, so just to be safe, I always would choose a supplement with methyl folate if you have that option.
NAC (n-acetyl cysteine) (1500 mg) –There is some evidence for the use of NAC aka n-acetyl cysteine for recurrent miscarriage so that was a must for me.
L-arginine (6 grams aka 12 pills a day) – This is an amino acid that works through the nitrous oxide pathway to promote blood vessel dilation and improve blood flow. The hope was that this would help thicken my thin uterine lining. There is also some evidence that it helps poor responders in IVF, particularly those who struggle with thin uterine lining.
Wild yam complex (6 pills) – Wild yams contain a chemical called diosgenin which is thought to have estrogenic effects. Since my estrogen was chronically low, and this seemed to be my issue in general with my fertility, my naturopath suggested I take this supplement to see if it might help. Honestly, I haven’t been able to find a lot of research to back it up, but you know, I was kinda willing to do and try anything my team suggested.
Vitamin E (400 IU) – This was an important one since one research study found that Vitamin E supplementation helped increase the endometrial thickness of half of the women who took it.
Vitamin D (1000 IU) – There’s a lot of good evidence to support vitamin D supplementation in general, but particularly for IVF. It seems to benefit metabolic parameters in PCOS, but having optimal blood levels of between 5-70 ng/ml also can increase IVF success rates and pregnancy in general.
Omega 3 (2 x day) – I think most people can stand to take an omega 3 supplement, especially if you don’t eat a ton of fish. But there is some early evidence that omega 3 supplementation may help increase the likelihood of a successful pregnancy for women undergoing IVF.
Melatonin (3 mg)- So not only did I enjoy using melatonin for sleep, but there is also some benefits for fertility as well. Research has found that the implantation rates for people with PCOS is higher when supplementing with melatonin.
Magnesium (100-200 mg) – So this was solely for sleep and not so much for fertility, but of course, I do believe that better sleep was essential to my successful cycle, as all of the ones that ended in miscarriage took place while I was in the deep dark pits of insomnia. So magnesium activates the parasympathetic nervous system which is responsible for making you calm and relaxed. It also binds GABA receptors which helps to quiet down nerve activity.
Acupuncture twice weekly – Since my main fertility issue was that my lining didn’t seem to thicken, there is some evidence that acupuncture can help improve pregnancy rates, embryo transfer rates, and endometrium thickness. It also is kind of like forced meditation for an hour, so if for no other reason, it did help me relax throughout an otherwise stressful process.
Sleep and stress management- My doctor told me millions of times that stress doesn’t negatively impact my chances of getting pregnant, probably as a way to help me feel less stressed. But honestly, I intuitively knew that my stress and anxiety wasn’t helping the cause. Research has found that stress does decrease your chances of a successful pregnancy, but strangely that this doesn’t happen with men, just women. Of course. So I made an extra effort to improve my insomnia this last round. I have a whole video on my strategies to battle my insomnia here, so you can check that out, but in general, that meant limiting screen time or stressful work before bed, taking on fewer projects, taking a little more downtime, and lots of therapy.
Gentle exercise – For this cycle, I really toned down my exercise routine. I stopped any cardio, and dropped the weights down. So if I was used to bench pressing 25 lb weights, I went down to 15 lbs. Now I’m up to 20 lbs, and I’ll probably stick here for the duration of my pregnancy and pick it back up when I feel I’m ready postpartum. I really didn’t want to increase my heart rate too much and I didn’t want to spike my cortisol as high cortisol has been associated with infertility.
Diet For thin uterine lining
There are Chinese medicine recommendations for diet for thin uterine lining like eating red foods for blood flow but honestly, I haven’t been able to find any strong evidence for that. I did however completely cut out caffeine, I didn’t even have any chocolate. Okay so sometimes I would have a bite, but not much more than that. While a lot of women can continue their coffee drinking habits with no problem, there is evidence that women who consume more than 200 mg of caffeine per day doubled their miscarriage risk. Also, one of the drugs I was on, prednisone, caused anxiety and insomnia, so I didn’t want to perpetuate the side effects.
I also made an effort to just eat extra calories. I didn’t want my cortisol to increase and we know that underfueling can cause an uptick in cortisol. So lots of snacks, lots of healthy fats, and lots of nourishing meals.
Estrogen patches and injections (4 patches a day plus injections every 3 days) – It’s standard protocol to do either estrogen patches or suppositories as a way to thicken the uterine lining. But because my lining was so tempermental and my estrogen was so resistant to thickening, I had to also do injections every three days.
Progesterone suppositories and injections (suppositories 3 x day, injections every 2 days) – Progesterone is another non negotiable drug for IVF. You start the progesterone once your lining reaches the desirable thickness and it helps to maintain the lining and prevent miscarriage. In fact, a lot of women who are not doing IVF but who have a history of miscarriage will take progesterone in the first trimester to help stabilize things.
Vaginal Viagra (1 pill 2 x / day) – I remember when I went to the pharmacy to pick up Viagara and the pharmacist looked at the instructions that they were to be inserted vaginally and he was like, “I’m really sorry but can you tell me what this is for? I’ve never seen an order like this.” Basically Viagra increases blood flow to the nether regions, and since uterine lining requires good blood flow to thicken, the idea is that delivering the drug vaginally will help thicken the lining. There is also pretty good evidence that it can work for some women. Even though my super long drawn out cancelled cycle used Viagra with no success, I still wanted to use the kitchen sink approach and try everything I could. The one thing I want to mention about the Viagra is that with my failed cycle, I picked up the drug at the regular pharmacy and they gave me the usual blue pills. Well not only were they like $100 / day or something crazy, but I just never felt like they were dissolving. This is going to be TMI but any time I would insert a pill, would feel like a collection of pills inside me. With the cycle that did work, I went to the compounding pharmacy and they compounded the drug into an easy to dissolve clear suppository that completely dissolved. So part of me wonders if I was wasting my money the first time on a drug that wasn’t even dissolving or absorbing.
Low dose Aspirin (1 pill/day) – Aspirin is a vasodilator so it increases blood flow to the uterus which in turn helps the uterine lining thicken. Research has shown that adding the low dose aspirin can significantly increase the thickness of uterine lining and pregnancy rates.
Antihistamine CPP protocol (10 mg Prednisone daily, 10 mg Claritin and 20 mg Pepcid daily) – There is a theory that one of the reasons for recurrent pregnancy loss is that the “natural killer cells” in the immune system attacks the foreign fetus. So these drugs work to down-regulate the immune system, in the hopes that the fetus will be spared. There is some medium quality evidence that the protocol works, and a lot of fertility clinics do state that anecdotally it does sometimes help.
Intralipid infusions (once before transfer, and once after a positive pregnancy test)- So in this procedure, I was hooked up to an IVF for about 3 hours as a solution made up of legitimate mayonnaise was infused into my vein. Seriously though, the ingredients are the same as mayo – it’s like soy oil, egg yolk, glycerine and water. So no, it’s not vegan. This procedure is also based on the theory of the body’s natural killer cells attacking the fetus, and that the fatty acids in the solution help to stave off natural killer cell activity. There aren’t really any large randomized control trials using this treatment unfortunately, but early trials have been encouraging. Having said that, not everyone benefits from this but we do know that women with auto immune disorders, rheumatoid arthritis, endometriosis or a history of recurrent miscarriage tend to be those who can potentially benefit the most.
Uterine dilation (1 time the cycle before transfer cycle)- And here’s the voodoo mama magic that I believe made the greatest impact in getting me pregnant. My doctor asked me if I wanted to go to uncharted, non-evidence based territory and honestly, I was so desperate I was willing to try anything. He explained to me that when women have been on the pill for a long time or breastfed for an extended period of time, their “uterus kind of shrivels up and hardens up” (I’m sure this is not the technical process, but this is how he was explaining it in layman terms to me). He likened it to having a “egg shell” like coating on the uterus that makes it difficult for any estrogen (like the synthetic estrogen I was taking) to penetrate the uterus to thicken the thin uterine lining. So he was thinking about the experience one has when they have a muscle knot and they need to get a deep tissue massage to stimulate blood flow to that region. He thought, hey, what if I could massage the uterus to stimulate blood flow there to thicken the lining? Obviously he wasn’t going to stick his hand up me and manually massage my uterus (OUCH), but instead, he inserted a balloon into the uterus, and blew it up to “break the shell”. We then went on with a normal typical transfer cycle, taking estrogen to thicken my lining. Without any actual research on this, my doctor had performed this procedure on 8 women before me, all of which had similar thin uterine lining stories and multiple pregnancy losses. It worked for 7 out of the 8 so I signed up to be number 9.
Well guess what, it worked. It actually f*cking worked. My thin uterine lining, which would never get past 6 mm before, got to 8 mm without any extended drug protocol and THAT was the cycle that got me pregnant and kept me pregnant. It felt like a miracle.
How was the uterine dilation? Well the worst part honestly was that I had to take antibiotics for two weeks before the procedure and they made me super sick. The procedure itself, I was completely asleep for, so I didn’t feel a thing, and I only had mild cramping and discomfort afterwards. It also cost me only $500, which I get may seem like $500 too much, but in the grand scheme of IVF drugs and procedures, that is like a few days of medication.
What did I do after transfer to stay pregnant?
So after the embryo transfer, as I awaited my first pregnancy test, we had to eliminate a lot of the supplements and herbs just because they’re not tested in pregnancy. So at that point, this is what I was doing and taking.
- NAC – at a reduced the dose of 500 mg/d
- Vitamin D
- Omega 3
- Continued my progesterone and estrogen injections until I was 8 weeks pregnant
- Took my progesterone suppositories and estrogen patches until week 10 and then slowly weened off
- Continued my low dose aspirin until 7 weeks- which would normally be continued but I had a subchorionic hemorrhage so it was important to stop any blood thinners to reduce the bleeding
- Cut my prednisone dose in half to 5 mg and continued that until I was 8 weeks pregnant. I was so happy to get off that because it made me feel super loopy and bloated.
- Continued my Pepcid twice a day until 12 weeks pregnant
- Continued the Claritin once a day until 12 weeks pregnant.
Well, this was game time so I tried really hard to focus on stress reduction and sleep. I did meditations daily, continued to avoid any heavy exercise, and went to therapy pretty much every week.
I continued my acupuncture once a week, though the pressure points were a bit different than they had been when I was trying to conceive.
And finally, I made a huge effort to just eating whatever I could tolerate, as much as I could, because to be honest as I had bad morning / day sickness all first trimester so it was a struggle at first. I quickly learned what I could tolerate and really just had to listen to my body.
Final thoughts on my ivf protocol
Bottom line, I know if you’re reading this and haven’t struggled with infertility you might be thinking, wha?? I thought you just have to have unprotected sex to have a baby?! I wish it was that easy for me. Nothing about motherhood was easy for me, including getting to motherhood. I also acknowledge that my road is not the hardest it could be. There are so many blessings I have had in this journey – I have a supportive partner, I am able to access and afford infertility treatments, I am relatively young, and I actually have a child. I know so many women and couples who have struggled for years, mortgaged their homes, gotten divorced out of stress and are still without a child. I know I have a lot to be grateful for.
But my purpose with this blog is not to get any kind of sympathy, but rather, to open up a conversation for parents and intended parents to participate in. No one ever talks about infertility, and it makes us all feel so much more isolated and alone. So if you’re struggling, know you’re not alone, you can reach out any time if you want to chat about my experience or yours. I am happy to be a sounding board, a source of solicited advice, or just a supportive ear.
Infertility sucks and parenthood is hard, let’s build a better village.
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Are you struggling with thin uterine lining or recurrent miscarriage or chemical pregnancies?Are you embarking on an IVF journey? Leave a comment if this was helpful!
Updated on October 8th, 2020
Abbey Sharp is a Registered Dietitian (RD), regulated by the Ontario College of Dietitians. She is a mom, YouTuber, Blogger, award winning cookbook author, media coach specializing in food and nutrition influencers, and a frequent contributor to national publications like Healthline and on national broadcast TV shows.