Abstract
BackgroundTo investigate the effect of fertility stress on endometrial and subendometrial blood flow among infertile women.MethodsThis case–control study was conducted in The First Affiliated Hospital of Zhengzhou University. The fertility problem inventory (FPI) was adopted to evaluate fertility stress. Three-dimensional power Doppler ultrasonography (3D PD-US) was performed during the proliferative phase of the menstrual cycle (days 5–11) to measure endometrial thickness, pattern, endometrial and subendometrial volume (V), the vascularization index (VI), the flow index (FI) and the vascularization-FI (VFI) index. Then, 300 infertile women were separated into two groups (high-score group and low-score group) based on total FPI scores and 80 healthy women were selected as controls.ResultsNo differences were found among all three groups with regard to general characteristics, endometrial thickness, pattern, endometrial and subendometrial V, VI and VFI. The endometrial and subendometrial FIs associated with different stress levels significantly differed among the three groups (F = 33.95, P < 0.001; F = 44.79, P < 0.001, respectively). The endometrial and subendometrial FIs in the control group were significantly higher than those in the high-score group and low-score groups. The endometrial and subendometrial FIs in the low-score group were significantly higher than those in the high-score group. The total FPI score was closely related to the endometrial and subendometrial FIs (r = −0.304, P < 0.001; r = −0.407, P < 0.001, respectively).ConclusionFertility stress was associated with endometrial and subendometrial flow index. Whether fertility stress might affect pregnancy outcome by reducing endometrial and subendometrial blood flow requires further research.
Highlights
To investigate the effect of fertility stress on endometrial and subendometrial blood flow among infertile women
A total of 300 infertility women who were diagnosed with pure tubal factor and unexplained factor from June 2015 to June 2016 were enrolled in this study.(hysterosalpingography (HSG) and hysteroscopy were used as the criterion for diagnosing of tubal factors.80 healthy women without fertility stress were selected as the control group at the Physical Examination Centerof the First Affiliated Hospitalof Zhengzhou University
The U Mann–Whitney testresults showed there were no differences among the 3 groups in terms of age, residence, infertility duration, infertility type, cause of infertility, childbearing history, examination date or menstrual cycle (P > 0.05)
Summary
To investigate the effect of fertility stress on endometrial and subendometrial blood flow among infertile women. In vitro fertilization (IVF) has helped many infertile couples become pregnant, those who choose to undergo IVF often suffer from the costs of medical treatment, the complexity of the procedures and unsuccessful cycles [1, 2]. Previous studies have revealed a possible association between stress and reproductive outcomes. The specific pathways or mechanisms regarding how stress affects these. Dong et al Reproductive Biology and Endocrinology (2017) 15:15 pregnancy outcomes. How fertility stress affects pregnancy outcomes through the neuroendocrine and immunologic systems remains unclear. Histologic and molecular studies are invasive [10, 11]
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