The inner fever of the uterus is called endometrial, it plays a major role in the fertile period. The normal endometrial thickness of the cycle day varies. What should it be in this or that period? We will try to answer this question.
How to determine the thickness of the layer, and why do you need?
Endometrium thickness norms by cycle days are changing under the influence of female genital hormones. This is how optimal conditions are created for the introduction of the embryo in the wall of the uterus.
For the onset and prosperous pregnancy flow, an important role belongs to the thickness of the inner layer of the uterus. To determine it is carried out ultrasound and analyze echographic signs. It must correspond to certain indicators, because it is under such conditions that the fruit egg will attach and will be introduced into the wall of the uterus. Its implantation occurs with the subsequent germination of the placenta.
If the condition of the mucous meter in thickness does not correspond to the cycle, they indicate the impossibility of pregnancy against the background of endometrial deficiency. And in such cases, painstaking hormone therapy is required.
Basal and functional - here are two layers that form the inner dillery of the uterus. At the beginning of menstrual bleeding, motion and rejection of the functional layer occurs, but due to the regeneration of the basal layer, it is restored to the beginning of the following menstrual cycle. The necessary thickness of the inner layer is gradually formed for productive implantation.
The mucous membrane of the uterus is sensitive to the level of genital hormones, which varies in different days of the menstrual period. By the end of the cycle, the basal part reaches its maximum sizes, and then after menstruation, it becomes completely fine. Due to the regeneration processes, the endometrium thickness changes during the cycle.
Endometrial Layer Thickness Norms
Let's figure out how the state of the uterus changes in different days of the cycle. For clarity, consider the consolidated table.
Thus, it can be seen that during the cycle, the state of the mucous layer changes. However, it happens that these indicators may be less norm. This is possible with a long cycle.
For a long cycle, the norm is a lag in the development of endometrial and transitions from one phase to another with a delay depending on individual features female organism. The beginning of menstruation is the phase of desquamation, the bleeding phase. During this period, on the 2nd day of bleeding, the inner membrane of the uterus has a thickness of 0.5 to 0.9 cm.
But on the 5th day of menstruation, regeneration begins, and the thickness of the basal department already reaches 0.3-0.5 cm. On average, the endometry thickness rate should not exceed 2 cm in the final stage of menstruation.
In the middle there comes the phase of proliferation (after completing the early proliferation, which falls on the 5-7th day). Usually on the 6th day, the basal layer corresponds to the thickness of 6 to 9 mm.
Due to the action of gestagen hormones on the seventh day, the endometrium cycle should not be too developed. But on the 8th day, the cycle takes the beginning of the second - the middle stage, which is marked with a thickness of 8 mm to the 1st cm. Sometimes this period may occur for the 10th day, and maybe so that the thickness does not match Cycle Day.
Then there is a prerequisite for the fact that with a monthly cycle of 30 days, menstruation will not start on the 30th day. In such situations, up to 9 days of delay and more can be marked.
Follicular Stage
Detailed information about this stage is given in Video:
The third - late stage, also called follicular, occurs on the 11th, sometimes on the 14th day of the cycle, and the inner layer of the uterus in this phase has an indicator of 0.9-1.3 cm with an average thickness of 11 mm. Thus, it can be seen that endometrial thickness norms change through the phases of the cycle.
After these phases, the second period begins - the secretion phase or selection. At the first stage of this phase, the beginning of which falls on the 15th day, the endometrium begins to grow rapidly. This is the most favorable cycle day to conceive a new life. This period of fertility ends on the 18th day. By the way, the fertility period is often changing in different cycles. Sometimes it comes already on the 12th day of the cycle with a short monthly period. It is important to take into account these features if a procedure is planned artificial fertilizationSince it affects the day of the substregnation, which is chosen for Eco.
Then, on the 19/23th day comes the following stage, while on the 22nd day there is a maximum layer thickening - from 1.0 to 2.1 cm. This time is the perfect moment for attachment fruit egg. And already at the later stage of the secretion phase, about the 24-27th day, the endometrial shell begins to thread and reaches a level of 1.0-1.8 cm.
Let us try to streamline the restructuring in the female sexual area under different days of the cycle:
- The first phase - the phase of proliferation. it initial stage (first three days after completion of menstruation). In the 1st phase of the cycle, the thickness of the layer is 2 mm. The structure of its homogeneous, single or two-layer. On the 7th day, the endometrium cycle will be equal to 4-5 mm thick, and its structure will acquire a three-layer structure for the follicular phase. Such structural changes occur in the first half of the cycle.
- The second average phase lasts 6-7 days for which the endometrium structure changes.
- Third late phase (3-4 days). The follicular layer increases in thickness by another 2 or 3 mm, and in front of the ovulatory moment, its maximum thickness is 8 mm. Continuously with the growth of estrogen endometrials contribute to the development of a secretory mechanism in the slide mucosa and to its full function at the end of the cycle.
Non-compliance of the thickness of the phase
In the photo - the phases of the menstrual cycle of women With menopause, the maximum thickness of the endometrial layer in a woman should be no more than 5 mm. At the same time, the size of 8 mm is considered critical, and the diagnostic scraping is necessary. During menopause, women begin to occur age-related changes, under which there is a fetching function, there is a shortage of genital hormones. As a result, inside the uterine cavity is possible the development of pathological hyperplastic processes.
Many women are lost in guesses, on what day the cycle doctors check the thickness of the endometrium ... the day of the cycle depends on what is going to reveal a gynecologist. If a woman has functional bleeding, then for diagnostics their causes of ultrasound spend several times, on different days, tracking the dynamics of changes. For example, they do an ultrasound on the 9th day, and then on the 25th day, while the structural changes that occurred during this period are clearly visible, and it is possible to conclude whether they correspond to the phase.
The main impairment of the structure of the endometrial layer is considered to be hyperplasia and hypoplasia. In the first case, there is a significant excess of the thickness of the endometrial layer compared with typical indicators. At a 21-day cycle, or if a cycle is 30 days, such a progressively increasing thickness speaks about the progressive development of Blastuly on early timing Pregnancy.
In other cases, it is about thinning the endometrium layer. For example, on ultrasound, it can be seen that the indicator is in the middle of a cycle of 6 mm, at a rate of 10-14mm. In both cases, such violations are noted by the inconsistency of the thickness of the cycle phase, and require medical intervention and treatment.
If the endometrium of the inhomogeneous structure is observed, then there may be a pathological process. In medicine, it is called endometriosis.
If on the 28th day, menstruation did not start, perhaps, fertilization occurred. Despite the fact that test manufacturers to determine pregnancy affirm their effectiveness from the 1st day of the delay, as statistics show, many women test shows a positive result when a delay of 7 days and more, i.e. On average on the 40th day. It is worth noting that there are cases when pregnancy is, and the test shows a negative result, even when the delay is 10 days or more. In this case, if there is clinical manifestations, allowing to suspect pregnancy, you need to seek your doctor as soon as possible.
Why do hormonal contraceptives prescribe?
Another reason for inconsistencies may be a change hormonal backgroundwhich clinically will manifest the lengthening of menstruation. In this case, for correction is prescribed hormonal contraceptives, for example, the record. The essence of their admission is that the drug is accepted on 21 days, with a seven-day break. After the 21st day of reception of the Regularone, menstruation comes, and then on the 29th day you need to start receiving a new course of the drug again. Thus, for example, with a cycle of 36 days, it gradually normalizes and becomes a 28-day.
In conclusion, we want to note that all of the above materials are provided only to familiarize themselves. They cannot serve soil for self-diagnosis of the health status of your body.
In the body of a woman, cyclic changes occur monthly associated with the transformation of the inner layer of the uterus. What should be the structure and thickness of the endometrial?
The inner surface of the uterus, which is called endometrial, consists of basal and functional layers. The upper functional layer is rejected monthly in the form of bloody menstrual discharge. The basal layer is a reservoir of cells with a high regenerating capacity, it is thanks to them that the functional layer of the endometrium occurs.
What is the main function of the inner layer of the uterus?
The main function of the endometrium is the creation of the most favorable conditions for the implantation of the fetal egg into the wall of the uterus and the further development of pregnancy. Here, its transverse size is of fundamental importance. What does the endometrial thickness depend on? First of all, sex hormones affect its condition: estrogens, progesterone, at least testosterone.
Depending on the phase of the menstrual cycle (proliferative or secretory steps), the structure of the inner layer of the uterus can change. Below is the linear dependence of its thickness and days of the cycle:
- In the proliferation phase (5-7 days round), the parameters range from 2 mm (sometimes only 1 mm) to 6 mm, on average 5 mm (sometimes in conclusion, you can find data in centimeters, for example, if specified 0.38, meaning 3.8 mm)
- The phase of the middle proliferation (8-10 day of the cycle) - an average of 8.5 mm (thickness ranges from 4 mm to 9 mm) According to the ultrasound data, this is the so-called three-layer endometrium
- The phase of late proliferation (11-14 day of the cycle) - the thickness of the inner layer of the uterus is up to 11 mm (oscillations from 8 mm to 14 mm)
- In the second phase of early secretion (15-18 day of the cycle) -10-16 mm, on average 13 mm
- The phase of the middle secretion (19-23 days) - endometry reaches the maximum thickness, on average 14 mm (oscillations from 12mm to 16 mm)
- Late secretion phase (24-27 cycle day) - endometrium becomes a bit thinner, 12 mm (oscillations from 10 mm to 17 mm).
When are deviations in the endometrium thickness?
Cases when the discrepancy of endometrial thickness is revealed by normal indicators, arise due to functional and pathological factors. Functional reason is the onset of pregnancy. During this period, physiological thickening of the inner layer of the uterus occurs. It should be noted that the change in endometrial thickness occurs after fertilization on the seventh day of pregnancy, at that moment the fruit egg is not yet in the uterus itself.
On the 30th day of pregnancy, the optometrium thickness is optimal for the development of pregnancy, 20 mm. Not only thickness, but also its structure, is important for fertilization.
There are cases when there is a lack of menstruation with 10 mm endometrial thickness. Upon delay, re-research is needed, usually in a month.
Such a mismatch of thickness indicates a hormonal "failure" in the body. TO pathological reasons Changes in endometrial thickness include its hypoplasia and hyperplasia.
Additional information about endometrial diseases are posted in video:
What are the causes of endometrial hypoplasia?
The main reasons for reducing the thickness of the endometry are:
- Congenital diseases (infantilism, gonadotropic nanism) when there is insufficient endometrial proliferation
- Damage to the uterus and its inner layer after abortion
- Transferred inflammatory diseases of the uterus.
With such pathology, the small thickness of the endometrium is noted, it does not reach 7 mm. In such cases, the main complaint of the patients is the absence of pregnancy. This means that the fruit egg is not able to attach to the wall of the uterus, and the pregnancy does not occur.
What are the causes of endometrial hyperplasia?
In some cases, under ultrasound, it is possible to determine too significant, exceeding the endometrium thickness. This indicates the presence of endometrial hyperplasia.
The main cause of such pathology, in which the inconsistency of the thickness of the inner mucosa of the uterus is observed with normal indicators, today is an excessive education in the body of a hormone of estrogen. Additional factors provoking the disease are genetic predisposition, inflammatory gynecological diseases, diseases of the endocrine glands.
What are the symptoms of the disease?
For hyperplasia, endometrial is characterized by impairment of the menstrual cycle with a tendency to strengthen bleeding: menstrual blood loss are becoming more and more than usual, the selection of lumps or particles of the epithelium. In addition, bleeding from sex tracts that are not related to the menstrual cycle may be marked. There may be a delay of monthly or early start.
External factors can provoke bleeding, for example, a hot tub affects the volume of blood loss. Repeated cases of bleeding, as a rule, lead to development iron deficiency anemia. Special alertness should occur when uterine bleeding In women in the period of menopause, their presence may indicate development malignant neoplasm Uterus - adenocarcinoma.
Infertility is also one of the symptoms of endometrial hyperplasia. It is associated with excessive formation of estrogen in the body and the formation of annevoral (without ripening egg) cycle.
Endometrial hyperplasia diagnosis methods
The main diagnostic method is an ultrasound study. Ultrasound of the small pelvic organs allows you to find out the parameters of the thickness of the inner layer of the uterus at different phases of the cycle.
The study of Echo is best carried out in the second phase of the menstrual cycle, it is better to determine the thickness that is better to determine these days, otherwise the results will be inaccurate. Some patients say the width of the endometrium, having in mind the thickness, it is an incorrect term.
You can also visualize the presence of concomitant cysts and polyps of the uterus, to identify the areas of the uneven thickness of the endometrium. The non-uniformity of the basal layer speaks of the presence of inflammatory process In the uterus, endometritis.
Sometimes there is a question why it is impossible to measure the endometrium in the presence of volume formations In the uterus (mioma, tumor). This is due to big errors in parameters, in such cases are carried out. computer tomography The small pelvis organs, it allows you to most accurately measure the thickness of the inner layer of the uterus. Without its results, the scraping of the uterus is not recommended.
Normal parameters for diagnostics range from 9 mm to 11 mm. If the indicator does not match the thickness in the norm and increases to 15 mm, you can think about the presence of hyperplasia. If the endometrium is determined by the endometrium with a thickness of 21 mm (or more, for example, 24 mm or 26 mm), and its structure is uneven, one can assume the presence of malignant neoplasm - adenocarcinoma.
In any case, the echo study allows only to suspect the presence of pathology, the final phase of diagnostics is hysteroscopy with subsequent diagnostic scraping and histological examination of the material. The procedure is not dangerous, is carried out under intravenous anesthesia short action. In the future, after cleaning, the morphological structure of the endometrium will determine, it allows you to learn about the presence of atypical cells in it.
Medical and surgical treatment
Surgical treatment in many cases is a more preferred method, since it is more efficient. Food methods include diagnostic scraping (cleaning) of the uterine cavity, followed by histological examination of the material obtained. Especially shown cleaning with a thickness of 21 mm. If hyperplasia is combined with the presence of polyps, in parallel during the operation, they are removed under the control of the hysteroscope. After the scraping ("cleaning"), minor bleeding can be occurred for several days, it does not represent health hazards.
About the treatment of endometrial disease is told in the video:
One of the most radical treatment methods is ablation (destruction) endometrial. It is carried out by women usually during menopause (50- 52 years), which have repeated recurrences of bleeding after the previously surgical treatment.
Medical treatment includes a number of hormonal drugs affecting the thickness and endometrial state. Most often for the treatment of this pathology, combined oral contraceptives (COC) are used, such as Zhinin, Yarina. They are also used as a means to eliminate bleeding in cases where it is not recommended to conduct therapeutic scraping. For example, young women who have broken women.
With ineffectiveness medical therapy Cleaning (scraping of the uterine cavity). Against the background of Kok, the normalization of endometrial thickness and its structure occurs. When receiving oral contraceptives Various side effects may be observed: liver function disorders, veins thrombosis, a change in the color of the skin.
The second group of drugs for the treatment of hyperplastic processes in endometrial is derived progesterone, gestagens. These include the uremines and duphaston. The thickness of the inner layer of the uterus is changing after taking upringness in the direction of its decrease. To this group can also be attributed intrauterine spiral Mirena, which contains a Gestagen and is able to provide local action on endometrium.
The third group of drugs is the so-called gonadorpine-rillation agonists (Zoladex, Bususorelin). They are introduced in the form of injections once a month, the thickness of the endometrium is also normalized. The disadvantages include side Effects In the form of a feeling of "tides", the mood is often changing. Proper dosage The medication avoids these unpleasant consequences.
Preparation of endometrial in front of extracorporeal fertilization
In the past few decades, the most effective method The treatment of infertility is the method of extracorporeal fertilization. In eco, success depends largely on the state of the endometrium at the time of the procedure. In the presence of pathological changes (hyperplasia, hypoplasia), appropriate treatment is carried out using estrogen and progesterone, depending on the cycle phase. If there are no pathologies, in any case, drug preparation of the endometrium is needed before the embryo shock (with cryoperenne), the required thickness should be 6-8 mm.
The change in endometrial thickness by cycle days is regulated by the production of sex hormones and plays a decisive role in the process of conception. To learn the height of the mucous layer can not be independently. To diagnose this parameter, ultrasound scanning devices are used.
The uterus is a hollow organ reproductive systemperforming the most responsible function in the process of pregnancy. Outside it is covered with a shell, which is called perimetry. In the middle of a childbearing organ with a myometrium.
Due to this muscular layer, the uterus is reduced during pregnancy, childbirth and menstruation. The inner part is functional and is called endometrium. This layer is extremely important for the implementation of the main tasks: monthly menstruation, conception and tooling the fetus.
The endometrium thickness is an important parameter for which it is possible to determine the performance of a childbearing organ and appendages. Under the action of hormones in the first phase of the cycle, the mucosal surface increases in the amount, and with the beginning of the next bleeding in the absence of pregnancy, it is separated and comes through the cervical canal.
The inner layer of the childbearing organ, in turn, is divided into two parts:
- basal, which adjies directly to the myometrium and is the foundation for dividing new cells in the subsequent menstrual cycle;
- functional, whose task becomes an increase in volumes for the adoption of the fetal egg and rejection in the absence of pregnancy.
The basal layer is practically not subject to change and is slightly regulated by changing the hormonal background. Its thickness is constant and is about 1-1.5 mm.
How and why it is measured
The thickness of the endometrium is determined using a sonographic study, which is more known under the abbreviation ultrasound. Diagnostics involves the use of a special sensor and can be transvagant or abdominal. The characteristic of the mucous layer gives the corresponding echogenicity. During the procedure, the specialist measure the zone located above the basal layer covering the myometrium.
Purpose diagnostic procedure The determination of the functionality of the reproductive system is becoming. If you can see that the endometrium is a normal thickness corresponding to days at the beginning and at the end of the cycle, then it is possible to conclude about the established work of the ovaries and the absence of pathologies in the uterine cavity. The study is carried out by women planning pregnancy or those who use hormonal drugs. The thickness of the layer is necessarily indicated in the protocol comprehensive examination Small pelvis organs and is an indirect indicator of women's health.
How is it connected with conception?
In medicine, it is established which endometrial thickness for conception is normal, and which is insufficient or excessive. If deviations have been identified during the ultrasound, they need to be corrected. With help medicines This parameter can be adjusted, which is especially important when planning conception.
Normal endometrial thickness by cycle days
The menstrual cycle is divided into several phases, which determine the state of the mucous layer. The norm of the thickness of the endometrial of the uterus is installed for each day.
- During the bleeding phase, the woman's mucosa layer passes two stages: separation (desquamation) and recovery (regeneration). By changing the thickness, the functional surface is updated and prepares for the active growth of fresh cells.
- At the second stage, the endometrium passes the phase of proliferation. It is divided into early, medium and late. Proliferation is characterized by the active growth and division of cells.
- The third stage, which is subject to endometrium, is called secretory. During this period there is no such active growth as in the previous one. However, the mucosa undergoes serious changes, preparing for the adoption of a fruit egg.
The final period will be a pregnancy and subsequent conversion of endometrial or no conception and regular bleeding.
For 1-4 day: bleeding phase
The first day of the cycle is considered the moment when menstruation began. Even if the selection is inconvenient for several days, the countdown of a new cycle still begins. If the first day definition may be errors and inconsistencies in diagnosis and, as a result, an erroneous diagnosis.
Endometrial thickness in 1 day of bleeding varies from 4 to 9 mm. During this period, the temporary vascular channel is thinned and destroyed. So begins menstruation. The width of the mucous layer in the first two days of the bleeding phase is regulated by the intensity of menstruation. By the third day, the stage of desquamation is completed, and regeneration begins. The thickness of the functional layer at this time is minimal, ranges from 2-3 to 5 mm. By the fifth day, the bleeding phase is completed, despite the fact that menstruation in some women goes longer. Normal monthly should not be less than 2 or more than 8 days.
For 5-7 days
On day 5 from the beginning blood discharge Starts the phase of proliferation. Some women can only start for 7 days, but it is rare. Endometrium begins to gradually increase, increasing with 2 mm.
5-7 days have the name of the phase of early proliferation. Typically, the width of the mucous layer at this time corresponds to the day of the cycle. So, on 6 day endometrium 6 mm. It has a low density and is uniformly. By completing the week from the beginning of the endometrium menstruation of 7 mm.
For 8-10 days
After the first week monthly cycle The period of medium proliferation begins. Active growing endometrium at this time acquires a more pink layer and gradually increases the density. Normally, if its thickness continues to match the day. Therefore, when performing an ultrasound examination, a healthy woman is found at a functional layer with a thickness of 7-8 mm for 8 days, 8-9 mm for 9 days and 9-10 mm for 10 days. Echogenicity remains reduced, but continues to increase daily.
For 11-14 days
On the 14th day of the cycle at the average woman there is ovulation. At the exit of the egg from the ovary of the soil for the adoption of the future embryo should be fully prepared. Therefore, by the middle of the menstrual cycle, late proliferation is completed. Endometrial thickness during ovulation is normal.
If on the 12th day of the cycle to make an ultrasound study, then it will show the larger thickening zone in the bottom of the uterus. The average value to which the mucous layer increases in 2 weeks, is 13-15 mm. If a woman has a long menstrual cycle, the first part of which lasts 21 days, then such a magnitude of the mucous layer will be achieved for a longer period.
For 15-18 days
After the output of the egg from the ovary took place, the state of the hormonal background of the woman changes. The secretory phase starts 14-15 days at the average 4-week cycle duration.
Endometrium in this period undergoes changes due to the activity of the yellow body, which is formed on the site of the burst follicle. It ceases to grow so actively, begins to cast yellowish color, which is observed by hyperhechene.
Endometrial thickness for conception should be at least 11 mm. If in two weeks from the start of menstruation, this indicator is 15 mm, on the 18th day it can be only 16 mm. This is enough for the occurrence of pregnancy. If the endometrium thickness for implantation is not enough, then a fruit egg, even subject to fertilization, will not be able to gain himself on the uterus wall.
For 19-23 days
The secretory phase by 19-20 days of the menstrual cycle passes into the middle stage. The thickness of the functional layer is endometrial - during this period, it may vary from 15 to 18 mm. Slime layer Continues to modify under the action of a hormonal background. It is subjected to modification: it becomes more dense and wide.
In the event of a merger of female and male genital cells, fertilization occurs. Within 6-7 days, continuing to share, the new organism moves towards the direction of the parent body. The endometrium rate for conception for 20-21 days should be about 16 mm, but this indicator can also vary from 14 to 18 mm.
For 24-28 days
This period is characterized by late secretory stages. The mucous membrane of the uterus at this time was already determined in the lifeline behavior. At the occurrence of pregnancy, it continues to transform, and in the absence of a fruit egg, it is prepared for the next menstruation.
Endometrial thickness before monthly is 18-20 mm. The height of the shell is 22 mm less determined. The yellow body is subjected to involution, as the pregnancy has not come. Reducing progesterone indicators launches the atrophy of the mucous layer atrophy. If during this period to do ultrasound, then you can see areas with an extended capillary mesh and forming blood clots. Such signs indicate the full preparation of the body to menstruation.
With delay
When conception, the thickness of the endometrium is normal, it may slightly increase. According to this indicator, pregnancy can be suspected before the delay. If the absence of menstruation is provoked by other reasons (stress, hormonal failure, diseases), then the mucous membrane does not undergo changes. It does not increase and does not decrease, remains in the phase of late secretion.
If the endometrium ultrasound is 12 mm, the test is negative and there is a delay, the reason is likely to be some pathological process. The detection of the thickness of the mucous layer 11 mm during the delay can be an indirect sign of the anhibition cycle, which is confirmed by the inspection of the ovaries (they do not have a yellow body and there are no signs of the discontinuity of the dominant follicle), as well as additional parameters (hormone examination, cervical position).
Deviations from the norm
The inconsistency of the endometrial thickness of the cycle phase may be detected even in healthy women. If the anoint cycle is repeated not more than 2 times within one year, there are no reasons for concern. When conducting an ultrasound next month, the situation should be different. When the endometrium norms do not correspond to several cycles in a row detected in the patient, the cause of deviations should be seen.
Thin endometrium
If the middle of the menstrual cycle is 5 mm endometrial thickness, instead of a 10-15 mm laid, then a pregnant woman will not be able to become pregnant. Underdevelopment of the mucous membrane may have different reasons: from stress to serious violations in the authority. Endometrial hypoplasia is characterized by thinning functional layer. At the beginning of the menstrual cycle, the endometrium is 2 mm, as well as in healthy women, but by the middle and completion has a thickness twice less than the norm.
Thick endometrium
Excessive growth of the functionally layer is also not a good indicator. Endometrial thickness with hyperplasia exceeds 21 mm, and in separate areas it can reach 60 mm. If this parameter is 20 mm to the middle of the cycle, it will not be pregnant either. The sign of hyperplasia will also be a state when, after menstruation, the endometrium thickness is 18 mm.
One of the important functions children's organs belongs to a special layer inside the uterus - endometrial. In a certain period of menstruation, it creates optimal conditions for the formation of the fetus. It is the necessary endometrium thickness by the day of the cycle of the key to successfully fix the embryo in the uterus.
The uterus consists of several layers: the outer is perimetry, medium-myometrium. From the inside the cavity is endometrial, whose size varies depending on the day of the menstruation cycle. The internal cellular layer of the organ consists of epithelial tissue, blood vessels and secretory glands. During one cyclic period, the constitution of internal tissues is changing all the time.
The inner surface is composed of basal and functional coating. The latter is rejecting and occurs, if no fertilization occurred. At the beginning of the next cycle, this part is restored with the participation of the basal layer. Running, the functional layer is prepared for the possible embryo introduction. If the fetal egg fastensed on the wall of the uterus, the placenta will subsequently formed from the scratched endometrial and blood vessels.
The growth of the inner membrane of the uterus occurs under the influence of cyclic oscillations of the hormonal background. For the successful introduction of a fetal egg thickness internal surface ranges from 9 to 15 mm. If for any reason, the endometrium cannot match the norm, it may mean that the chances of getting pregnant from a woman are minimal. However, medicine has data when pregnancy fell with a thickness of about 6 mm. Hypertrophy is also an obstacle to fixing the embryo. In such cases, a woman will need a qualified treatment - hormone therapy.
Stages of the development of the inner layer
Depending on the fluctuations in the level of hormones and their balance, monthly in the life of a woman there are cyclic changes in the uterus. It is impossible to determine its thickness in the usual examination of the gynecologist. It is determined only with ultrasound examination. In each stage of the cycle, the endometrium has a certain size of the wall thickness. In accordance with this, the menstrual cycle is divided into certain phases of the development of endometrial:
- deskvamation - Stage of Bleeding;
- proliferation - changes in the basal section;
- the secretion phase is the growth of the functional surface.
Deskvamation - the heated stage corresponds to the first five days of the cycle. At the same time, the norm in the first two days ranges from 5 to 9 mm. In the next two days, regeneration is observed, and the thickness is 3 mm.
Endometrial phases are divided into temporary stages. The endometrium phase of proliferation, as well as the phases of secretion, include early, middle and late development stage. The first stage is counted from 5 days cycle, gradually increases to 6 mm layer thickness. The middle stage lasts three days, and the endometrium rate is about 8 mm. The last phase of proliferation is the final stage, the indicator increases to 14 millimeters, the echo density increases. This is determined by dominant.
After that, the secretory phase occurs. This stage lasts about 15 days and is particularly important for each woman. At this time, the surface structure changes little. IN early period The wall thickness increases by 2-3 mm, the echo structure gradually rises. In the middle period, the layer acquires the maximum thickness to 18 mm. At this time, ovulation usually occurs, fertilized eggs can gain a foothold in the uterus. Late secretory stage is characterized by a decrease in the thickness of the endometrium layer.
| Days of a monthly period | Stages of proliferation | Medium thickness (mm) | Possible options |
| 5–7 | early | 6 | 3–7 |
| 8–10 | average | 8 | 7–10 |
| 11–14 | late | 12 | 10–14 |
| Stadissection | |||
| 15–18 | Early | 11 | 10–16 |
| 19–23 | average | 14 | 10–18 |
| 24–27 | late | 12 | 10–17 |
The table makes it possible to trace changes in the inner layer in accordance with the period. It is important to understand that the indicators of the thickness of the endometrial are given averaged, and individual vary and depend on the duration of the menstrual cycle of each particular woman. So, with a long cycle, the indicators are lower, which means the transition from one phase to the other will be delayed.
Normal inconsistencies and causes of pathology
It comes in about the second phase of secretion. If the inner layer does not correspond to the cycle phase, the embryo will not be able to resist in the uterus. Its subsequent development will be impossible due to lack of oxygen. The egg cell will not be able to resist on very thin endometry. With such pathology is possible ectopic pregnancy or miscarriage.
There are several of the most common options for the pathology of the inner layer of the uterus:
- Effective growth associated with the effect of excess estrogen and lack of progesterone hormone.
- Excessive growth of foci of fabric, which turn into polyps.
- The appearance of endometrial cells outside the uterus and in general the sexual system called endometriosis.
It should be remembered, even with insignificant deviations from the norm, a woman should seem like a doctor. If the impaired endometrial thickness is not treated on time, pathology can turn into infertility.
In women during the regression of childbearing functions, with a lack of genital hormones, hyperplastic education may appear. At that time normal indicator Thickness of the endometrial layer to 5 mm. When the number reaches 6-7 mm, it dangerous symptomindicating the development of tumor processes. Such a patient is recommended an ultrasound examination every 3 months to eliminate the oncological disease.
During the menstrual cycle, the woman's uterus underwent changes under the influence of female sex hormones. The most important changes occur in the endometry of the uterus. There is a complete restructuring of its structure, preparations for possible pregnancy and menstruation.
Endometrium
The structure of the uterus is represented by three layers: internal (endometrial), medium (minerium) and outer (perimerium). The inner mucosa of the uterus normally consists of two levels of epithelium: functional and basal. Pierce its many blood vessels. Under the influence of hormones, the inner membrane of the uterus undergoes changes in the structure, changes its thickness. The purpose of these transformations is the preparation of the uterus to the implantation of the embryo in fertilization. The process of restructuring and changing the thickness of the shell occurs during the entire menstrual cycle. You can trace the uterus using M-Echo.
M-Echo
This study can be called differently. ultrasound examination cavity of the uterus and its structure. The principle of operation is that the special sensor emits an ultraviolet stream that penetrates into the uterus, reflected from its structures, and the response signals are recorded in the form of an image on the instrument screen. The main estimated feature is the thickness of the endometrium layers. In the norm, the mucosa during the cycle passes three phases:
- The initial or phase of bleeding (starting the cycle).
- Middle or proliferative (expanding and restructuring phase).
- Finite or secretory.
Each of them includes several periods, each phase and day corresponds to the specific endometrium thickness on the days of the cycle. If M-ECHO meets the norm, it can be concluded that the hormonal balance in the body and the normal period in the life of a woman.
Consider specific changes in the inner shell and follicles by phases and days.
Phase bleeding
As you know, the cyclic period of women always begins from the first day of menstrual bleeding. This bleeding is associated with rejection of the functional layer of the endometrial shell. This period of time lasts an average of five to seven days, includes two periods: the stage of desquamation (rejection) and regeneration. Thickness of endometrial on the days of the cycle in the first phase:
- In the rejection step at 1 and 2 days of the cycle, the thickening is from 0.5 centimeters to 9 mm. On the M-echo we see the hypo echogenicity of the mucous (decrease in density), since the layer loss occurs. Accompanied by bleeding.
- In the recovery stage or regeneration, which occurs on the third - fifth days, the epithelium demonstrates the smallest height, respectively, for days, only 3 mm (on the third day) and 5 (on the fifth).
Phase proliferation
The proliferation stage begins with 5 days and lasts until 14-16 days. Endometrium grows, rebuilding, prepares for ovulation, fertilization and implantation of an egg. Three periods, including various dates:
- From 5 to 7 day phase (early proliferative stage) - on the M-echo in the norm of the epithelium of the uterus of hypooechogenene (reduced density), its height from 5 to 7 mm. For the sixth day - 6, on the seventh about 7 millimeters.
- In the middle proliferative period, the mucous membrane varies as follows: thickened, it grows. On 8 day, an 8 mm high. This stage ends on 10 day, the epithelium reaches the value of 1 centimeter (10-12 millimeters).
- From 10 days by 14, the proliferation stage is completed. The inner membrane of the uterus at this moment is normal from 10 to 12-14 mm high (almost reaches 1.5 centimeters). The density of the layer increases, which is manifested by an increase in echogenicity. In addition, at this time the ripening of follicles in the egg begins. On 10 Day, the follicle is 10 mm in diameter, by 14-16 days up to 21 millimeters.
Secretor phase
This period of time is the longest and important. It proceeds from 15 days to 30 (with a normal cycle duration). It can also be an early, middle and late. The structure varies significantly:
- From 15 to 18 days early restructuring begins. The mucous layer grows slowly, gradually. On average, different values. Rolls from 12 to 14-16 mm. The M-Echo looks like a layer in the form of a drop. At the edges of hyperehogenene, and in the center the density is reduced.
- The average secretion period proceeds from 19 to 24 days. The endometrial shell is minimized to the level of 1.8 centimeters, it should not be more than this value. The average value for this time from 14 to 16 mm.
- Finally, late secretory stage proceeds from 24 days to the beginning of the next first phase. Gradually decreases the size of the shell to about 12 mm or slightly below. The peculiarity is that it is at this time the highest density of the mucous layer, we see a hyperheogenic portion of the uterus.
With delay
When the girl has a latency of menstruation (starting bleeding), its cyclic period is lengthened. More often cause is hormonal disbalance. The reasons for this: stress, dysfunction: not so much diet, how much consumption of vitamins, gynecological diseases, endocrine diseases, and so on.
When the delay does not work out the necessary hormones, material epithelium It remains in the amount that was in the secretion phase (from 12 to 14 tenth centimeters), and does not reduce its height to the required value. No rejection comes, respectively, do not begin monthly.
Endometrium before menstruation
Before the monthly mucous membrane is in the period of secretion. It is about 12 mm (1.2 centimeters). Under the influence of estrogen and progesterone, there is an impact on the functional layer, and it is brazed. Endometrial shell, losing one of the levels, is sophisticated to 3-5 mm.
Endometry thickness changes are presented in the table:
|
Cycle Day |
Endometry thickness |
| 0.5-0.9 cm | |
| 0.6-0.9 cm | |
| 0.8-1.0 cm | |
| 15–18 | |
| 19–23 | |
| 24–27 |
Norms of follicles by cycle days:
Thickness for conception
In order to favorably, the process of conception occurred, or rather, the implantation of an egg in the endometrium, it is necessary to achieve a certain state. The most favorable period for conception is the ovulation time, occurring in the middle of the cycle, at the end of the phase of the proliferation of the mucous membrane. The perfect size of the mucous layer from 11 to 12 mm.
Inconsistency
The width of the layer may not correspond to the phase of the cycle. This can be observed in the physiological process - pregnancy. With it, the shell increases significantly, it germinates with vessels (spiral arteries). Already to the second week can reach two centimeters and more. But in other cases, the change in the width of the epithelium is a pathological condition. Allocate two main disorders:
- Gypoplasia mucosa. When a smaller value is revealed during M-echo than it should be. May be less than 3 mm. Perhaps when inflammatory diseases occur (endometritis).
- Hyperplasia. The situation is reverse. The thickness is much higher, the pathological growth of the epithelium of the uterus occurs. In the initial period, the values \u200b\u200bof more than 10 mm reaches. May develop with tumors (including moma), cystic diseases, endometriosis, chronic inflammatory diseases And others.
Thus, the endometrium undergoes huge changes during the entire menstrual cycle of a woman. It changes its structure, thickness, the ratio of structures under the influence of genital hormones. The process takes place correctly if the body is hormonal balance. It is important to maintain the normal functioning of the endometrial, since it is he who plays an important role in the implementation of the process of conception and forming the future fetus.
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