Abstract Endometrial stripe thickness has been thought to impact the likelihood of live birth after embryo transfer. The literature on the definition of a “thin” endometrial stripe is unclear, as is the significance of endometrial stripe thickness. Some authors advocate a freeze- all strategy when endometrial stripe is estimated to be thin. Circulating estradiol levels do not appear to impact endometrial stripe thickness. A history of medication use such as clomiphene citrate, oral contraceptives and progesterone IUD use impact endometrial stripe thickness, but the impact on IVF pregnancy rates is unclear. In patients with a history of repair Asherman’s syndrome, endometrial stripe thickness appears to correlate with subsequent livebirth rates in IVF. Physiological variation in endometrial stripe thickness exists. A recent study of euploid embryo transfer outcomes and endometrial stripe thickness may have answered this question for those undergoing cryopreserved embryo transfer.