The role of endometrial and subendometrial blood flows measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during IVF treatment

Abstract

A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. We aimed to evaluate the role of endometrial and subendometrial blood flows in the prediction of pregnancy during IVF treatment. Patients undergoing the first IVF cycle were recruited. A three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval to determine endometrial thickness, endometrial pattern, pulsatility index (PI) and resistance index (RI) of uterine vessels, endometrial volume, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) of endometrial and subendometrial regions. Uterine RI, endometrial VI and VFI were significantly lower in the pregnant group than the non-pregnant group. There was a non-significant trend of higher implantation and pregnancy rates in patients with absent endometrial or subendometrial blood flow. The number of embryos replaced and endometrial VI were the only two predictive factors for pregnancy. Receiver operator characteristic curve analysis revealed that the area under the curve was approximately 0.5 for all ultrasound parameters for endometrial receptivity. Endometrial and subendometrial blood flows measured by 3D power Doppler ultrasound were not good predictors of pregnancy if they were measured at one time-point during IVF treatment.