Abstract
ObjectiveTo evaluate Subendometrial and Uterine artery resistance and pulsatility index continuous analysis as a predictor of Endometrial receptivity in Assisted Reproductive Technology (ART) Cycles.DesignSerial 2D transvaginal coloured power doppler ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. One hundred sixty-nine subjects on a prospective case control study were assessed. Uterine artery and Subendometrial resistance and pulsatility index was performed to all subjects at baseline (prior to ovarian controlled stimulation), at day 6, 8 and 10 of controlled ovarian stimulation, at trigger day and at embryo transfer day. Also the ratio of fluxometric parameters between Subendometrial blood flow and uterine artery was measured.ResultsNo statistical difference was noted between two groups in terms of demographics and ART procedures and scores. Uterine artery resistance and pulsatility index showed statistical difference between the two groups (implantation versus non-implantation group). Also statistical significance was obtained between two groups in terms of Subendometrial vascularization. Ratio between Subendometrial and Uterine artery showed lower values of fluxometric parameters in all range for the Subendometrial territory.ConclusionsSerial Subendometrial and Uterine artery fluxometry may be a useful tool for clinicians in predicting endometrial receptivity enhancing elective embryo transfers in the same ART cycle.
Highlights
Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium [1]
Serial Subendometrial and Uterine artery fluxometry may be a useful tool for clinicians in predicting endometrial receptivity enhancing elective embryo transfers in the same Assisted Reproductive Technology (ART) cycle
Uterine artery resistency and pulsatility index, as well as subendometrial blood flow resistance and pulsatility index was obtained in all 169 cycles using 2D power doppler transvaginal ultrasound in continuous observations
Summary
Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium [1]. In ART cycles blood flow resistance in uterine artery and in the endometrial territory has been reported to be a predictive indicator of implantation. Using this method is still controversial in clinical applications, and many studies reported a small sample size or a single one moment observation. With the introduction of high-resolution transvaginal probes, the non-invasive, accessible transvaginal sonography made it suitable for serial follow up throughout the stimulated cycle. The aim of this prospective study is to further evaluate the capability of serial measurement of subendometrial fluxometry dopppler flow as a non-invasive procedure to determine endometrial receptivity [9–11]
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