Modifications in uterine and intraovarian artery impedance in cycles of treatment with exogenous gonadotropins: effects of luteal phase support.
OBJECTIVE
To determine the effects of induction of multiple ovulation and of luteal P supplementation on the impedance to blood flow in the uterine and intraovarian arteries during the luteal phase.


METHODS
A prospective study using transvaginal color flow Doppler imaging.


METHODS
A university-based infertility center.


METHODS
Fifty-six women with unexplained or male factor-related infertility undergoing IUI.


METHODS
The patients were studied either during spontaneous cycles (n = 16) or in cycles of induction of multiple follicular development with purified FSH (n = 40). In 18 treated cycles, the luteal phase was supplemented with natural P.


METHODS
The pulsatility index was recorded from uterine and intraovarian arteries on the day of E2 peak and 5 and 10 days thereafter. On the same days, E2 and P plasma levels were measured by RIA.


RESULTS
The intraovarian pulsatility index was significantly lower in FSH-treated than in spontaneous cycles on the day of E2 peak. Also, the uterine pulsatility index was significantly lower in treated cycles than in spontaneous cycles on the day of E2 peak and 5 days thereafter. In the late luteal phase, P supplementation was correlated with a significant decrease in uterine pulsatility index as compared with both spontaneous cycles and FSH-treated cycles without luteal support.


CONCLUSIONS
Multiple follicular development is associated with a significant reduction in the impedance to perifollicular blood flow. Progesterone, as well as E2, seems able to decrease the impedance to blood flow in uterine arteries in women.
Strigini
F A
FA
Department of Gynecology and Obstetrics, University of Pisa, Italy.
Scida
P A
PA
Parri
C
C
Visconti
A
A
Susini
S
S
Genazzani
A R
AR
D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D008183:Luteal Phase; D010053:Ovary / Q000098:blood supply*; D010062:Ovulation Induction; D011374:Progesterone / Q000627:therapeutic use; D011446:Prospective Studies; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D014599:Uterus / Q000098:blood supply*; D014655:Vascular Resistance / Q000187:drug effects*
D006062:Gonadotropins; D011374:Progesterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone