Comparison of uterine and spiral artery blood flow in women with unexplained and tubal infertility.

Abstract

To evaluate the possible difference in uterine and spiral artery impedance to blood flow among women with unexplained and tubal infertility during spontaneous and gonadotropin-stimulated cycles. We prospectively compared uterine and spiral artery pulsatility index and peak systolic velocity in a longitudinal study in women with either unexplained infertility (n = 20) or tubal infertility (n = 18). Measurements of uterine and spiral artery impedance were taken on days 11-12, 16-17 and 21-23 of the spontaneous cycle and on days 1, 5 and 10 during gonadotropin stimulation. In addition, measurements were taken on the days of oocyte pick-up and embryo transfer. A clinical pregnancy was achieved in 8/20 (40%) women with unexplained and 6/18 (33.3%) women with tubal infertility with in-vitro fertilization treatment. There were no differences in the uterine artery pulsatility index or peak systolic velocity during the spontaneous or the in-vitro fertilization cycle between the two groups. The impedance to blood flow in the uterine or spiral artery did not differ between women conceiving with in-vitro fertilization-embryo transfer and those who did not. However, the spiral artery pulsatility index on the 5th day of gonadotropin stimulation was significantly lower among women with unexplained infertility (0.96 +/- 0.25) compared to women with tubal infertility (1.24 +/- 0.30; P < 0.05), but on the other days of gonadotropin stimulation the spiral artery pulsatility index and peak systolic velocity were similar. Impaired uterine or spiral artery blood flow is not an important factor in unexplained infertility.