Abstract
Objective: To characterize the velocity profiles of the uterine and hypogastric vessels before and after ovarian stimulation in the setting of in-vitro fertilization (IVF), using MSDA and GASP software. Methods: The MSDA system consisted of commercial ultrasound machine (Aloka SSD1400), a personal computer and a proprietary electronic board. Interogated vessels consisted of the uterine and hypogastric arteries and veins in a total of 21 women (15 IVF recipients and 6 egg donors) during ovarian stimulation at different time points. Velocity profiles, relative wall distension rate [WDR (%)] and shear rate [WSR (1/s)] were calculated over multiple consecutives cardiac cycles. The designation of arterial laminar flow was applied if one peak occurred in systole, while if >1 peak in systole was classified as turbulent. Statistical analysis consisted of Spearman correlation. Results: All vessels displayed a laminar flow pattern, except in 4 cases (2 egg donors and 2 IVF patients), where the arterial flow was turbulent. Interestingly, there were qualitative differences in the velocity profiles in circumstances where conventional Doppler waveforms were identical. Hypogastric artery WDR (left, 2.5 ± 0.5; right,1.9 ± 1) was highly correlated withthe ipsilateral uterine WDR (left, 2.6 ± 0.5 ;r ight,1.9 ± 1 ,r s= 1.00, p < 0.01). The hypogastric artery WSR (left, 455 ± 217 ;r ight,389 ± 212) was highly correlated with the ipsilateral uterine WDR, (rs = 0.883, p < 0.01). Uterine wall shear rate (left, rs = 0.703; right, 0.805, p < 0.01) but not wall distension rate, was highly correlated to the cycle day. Conclusion:Realtimevelocity profilesare nowpossible using MSDA and GASP software. We found substantial differences between our new technology and conventional Doppler. These parameters are being evaluated in ongoing studies to determine their relationship to endometrial receptivity, ovarian function and success or failure of IVF attempts.
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