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The therapy started on day 3 of the cycle and the duration of the estrogens administration ranged from 14 to 82 days, with a mean value of 30 days.In the study group, the mean endometrial lining increased significantly from 6.7 mm to 8.6 mm (P=0.031).Reports from observational studies and RCT suggest some advantages: a) better endometrium in natural cycles for implantation, b) pregnancy rates are increased following FET, c) lower maternal and infant morbidity and mortality after FET.

Low estradiol values and excessive use of Clomiphene Citrate are other causes of thin endometrium, given the antiestrogenic effect of the latter (17).Antitumoral treatments, such as radical surgery, chemotherapy and radiotherapy (RT) can permanently affect present or future reproductive function both in males and females (18).Knowledge on the effects of radiation on uterine function is derived from patients treated in childhood for abdominal malignancies (Hodgkin’s disease, Wilms tumors, unilateral ovarian dysgerminoma, etc.) (19–21).The clinical incidence of uterine radiation injury varies according to various factors: patients are asymptomatic with a low RT dose (20Gy) (22), while a prepubescent uterus or “microuterus”, with an atrophic endometrium, may be observed as a consequence of higher doses (40Gy) (23).In clinical practice, when we have a thin endometrium despite the use of conventional therapy, cancel the cycle and embryo cryopreservation is recommended to avoid embryo wastage (13).

The incidence of thin endometrium varies according to the chosen cut-off; Bu et al.Adequate endometrial growth is considered essential for successful implantation and its evaluation is performed using grey-scale ultrasound (7).The minimal endometrial thickness required for embryo transfer is now considered about 7 mm at the end of natural or medically endometrial preparation cycle (1).Address for correspondence: Roberta Venturella, Unit of Obstetrics and Gynaecology, Magna Graecia University, Viale Europa, loc.Germaneto, 88100 Catanzaro, Italy, Phone/Fax: 390961883234, E-mail: [email protected] the “elective single blastocyst transfer” policy has led to an unquestionable improvement in success rates of Assisted Reproductive Technology, it is now becoming clear that the endometrium plays a more active role than previously thought in determining whether the embryo will implant or not.Frozen/thawed embryos may be transferred into the uterus in a natural cycle, a hormone replacement cycle or a stimulated cycle.