Uterine and ovarian perfusion during the periovulatory period assessed by transvaginal color Doppler.
OBJECTIVE
To measure the flow velocity of the uterine, radial, spiral, and ovarian arteries during the periovulatory period in spontaneous and induced ovarian cycles with confirmed ovulation.


METHODS
Daily measurements during the periovulatory period in 78 patients attending an infertility clinic because of the male factor in infertility.


RESULTS
Uterine flow velocity in spontaneous cycles has a pulsatility index (PI) of 3.16 2 days before ovulation and starts to decrease the day before ovulation (PI = 2.22). In stimulated cycles these changes do not occur, and mean PI of 3.06 remains at that level during the periovulatory period. Clear flow velocity waveforms are obtained from the endometrium and myometrium around the time of ovulation. Data obtained from the radial arteries suggest better myometrial perfusion in patients with natural cycles. Spiral artery flow velocity in spontaneous cycles has a PI of 1.13 the day before ovulation and a nadir of 0.72 is reached the day after ovulation. On the contrary, the mean PI of the spiral artery blood flow in the group with ovulation induction rises during the day before ovulation (PI = 2.32) and reaches a nadir of 1.09 the day after ovulation.


CONCLUSIONS
These data suggest the presence of better uterine receptivity during the periovulatory phase of natural cycles compared with induced ovarian cycles. Endometrial perfusion presents accurate noninvasive assay of uterine receptivity that may be used to predict implantation success rate, to reveal unexplained infertility problems, and to select patients for correction of endometrial perfusion abnormalities by an appropriate treatment.
Kupesic
S
S
Ultrasonic Institute Medical School, University of Zagreb, Croatia.
Kurjak
A
A
D001783:Blood Flow Velocity; D002996:Clomiphene / Q000494:pharmacology; D003116:Color; D005260:Female; D006801:Humans; D008596:Menotropins / Q000494:pharmacology; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging*; D010060:Ovulation; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D014621:Vagina
D002996:Clomiphene; D008596:Menotropins