Improvement of pelvic floor neuromuscular electrical stimulation (nmes) on endometrial thickness and blood perfusion of infertile women with thin endometrium

Objective: Neuromuscular Electrical Stimulation (NMES) has been used in clinical treatment of problems related to gynaecology and obstetrics department, including stress urinary incontinence (SUI), low back pain, sexual dysfunction, pelvic pain, and constipation. However, its effect on endometrial thickness and blood perfusion in infertile women with thin endometria is still unknown. We aimed to evaluate the effect of pelvic floor neuromuscular electrical stimulation (NMES) therapy for improving endometrial thickness and blood perfusion in infertile women with thin endometria through different current intensity and duration of NMES current. Methods: 284 patients with infertility and thin endometria were recruited and divided into two groups, both of which were continuously monitored in regard to endometrial thickness and endometrial vascular resistance index (RI) during mature follicles days of two menstrual cycles. The control group of 134 patients was treated with estradiol valerate. The experimental group of 150 patients was treated with estradiol valerate and pelvic floor NMES. Endometrial thickness and RI were measured during the mature follicles days. Results: The mean endometrial thickness and RI were higher after NMES in the experimental group than in the control group; the difference was statistically significant (P<0.05). Further, the mean endometrial thickness, RI and luteinizing hormone (LH) were increased followed by the increased current intensity (P<0.05). Whereas the mean of endometrial thickness, RI and luteinizing hormone (LH) were unchanged when the patients were treated with different duration of NMES current. Also, we found that the endometrial thickness was related to the time of the electric stimulate P<0.05, and the longer is the treatment time, the thicker is the endometrial thickness. However, the intensity of the current is not associated with endometrial thickness, P>0.05. Conclusion: This study suggests that pelvic floor NMES not only increases endometrial thickness, but also improves endometrial perfusion. Therefore, NMES therapy may be effective for patients with thin endometria.