A Study of Endometrial Perfusion in Unexplained Infertility

Abstract

Background: Infertility in itself represents a wide spectrum of disorders explaining the inability to conceive. Series of investigations are required to depict the potential cause of infertility, yet there exist a small percentage (10 -25%) of couples in which no obvious cause is delineated. these groups of patients are classified as ‘unexplained infertility. The endometrium has dynamic features: cyclical growth, desquamation and regeneration. Its main function is to provide the possibility of the time-limited support of implantation of the embryo for further development. Most part of the menstrual cycle, the endometrium is resistant to the embryo but acquires special receptive properties in a limited space and time interval of the luteal phase, known as the ‘‘implantation window’’. Aim: The aim of this study was to evaluate the uterine perfusion, particularly the endometrial blood flow in women with unexplained infertility. Methodology: The patients recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital seeking fertility compared to other fertile group coming to hospital with non specific gynecological problems or for routine checkup at the same period. The study conducted on two groups of women: Group1(study group) 40 women with unexplained infertility, Group 2 (control group) 20 fertile women who had normal physical and pelvic examination, regular menstrual cycles, didn't have intrauterine device or oral contraceptive, and gave a birth year ago. Results: As regard the mean, the resistance index in the study group was 0.69 ranged from 0.39 to 0.96, while the resistance index in the control group was 0.61 ranged from 0.58 to 0. 73 and the difference between both groups was statistically significant pulsatility index in the study group was 1.3 ranged from 0.51 to 1.99 while the pulsatility index in the control group was 1.16 ranged from 0.88 to 1.7 and this difference between both groups was statistically significant. From the results of our study we could say that uterine perfusion, particularly the endometrial blood flow in women with unexplained infertility different from that in fertile women. Recommendation: We recommend further study on large numbers of women and the possible role of perfusion enhancer's drugs in improving utero-ovarian circulation as a treatment of unexplained infertility.