Assesment of changes in uterine and subendometrial blood flows: the use of prediction outcome in IVF cycles

OBJECTIVE: The aim of this study is to evaluate the relationship between uterine Doppler flow and endometrial and subendometrial blood flows and uterine receptivity during IVF cycles. DESIGN: This is a prospective observational study which is conducted at Zekai Tahir Burak Women’s Health Research and Education Hospital, Reproductive Endocrinology Clinic. MATERIALS AND METHODS: Sixty-eight patients from our infertility programme were recruited for this prospective observational study, after giving informed consent. Eight of them were excluded because of total fertilization failure (5 patients) and no sperm extraction in TESE (3 patients). A color Doppler ultrasound examination performed on the day of hCG injection and midluteal phase. Pulsatility and resistance indices of uterine vessels, and vascularization and flow endometrial and subendometrial region were assumed. No Doppler study was done on the endometrium in midluteal phase. RESULTS: There were no significant differences in the age of patients, BMI of patients, duration of infertility,cycle lenght or total number of embryos transferred between women who became pregnant (n 1⁄416) and those who did not (n 1⁄4 44). There were no difference in mean endometrial thickness between the two groups on hCG day and 5-6days after embryo transfer. Mean uterine arterial resistance index (RI) and Pulsatility Index (PI) values were not significantly different in both group on hCG day but both indices were significantly lower in the pregnant than in the non-pregnant group in mudluteal phase (p1⁄40.05 and 0.016, respectively). Also no significant differences were found between the two groups in subendometrial blood flow. CONCLUSION: Patients undergoing IVF-ICSI and embryo transfer, Doppler ultrasound examination of the uterine artery and subendometrial blood flow on hCG day do not discriminate between cycles resulting in conceived and non-conceived but especially low mean PI of uterine artery in 5-6 days after ET can predict pregnancy. Supported by: ZTB Women’s Health Research and Education Hospital, Turkey.