Measurement of endometrial tissue blood flow: a novel way to assess uterine receptivity for implantation.
OBJECTIVE
To assess endometrial receptivity in terms of endometrial tissue blood flow (ETBF) measured hysterofiberscopically by laser blood-flowmetry, and to examine the technique's effectiveness in an in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) program.


METHODS
A prospective clinical study.


METHODS
IVF program in a university hospital.


METHODS
A total of 75 infertile women with normal menstrual cycles undergoing IVF/ICSI.


METHODS
ETBF, conventional ultrasonographic, endocrinologic, and histologic parameters for receptivity and immunoreactivity for vascular endothelial growth factor (VEGF) in endometrium were assessed between days 4 and 6 of the luteal phase in a spontaneous menstrual cycle. Then all patients underwent IVF/ICSI.


METHODS
Achievement of clinical pregnancy by IVF/ICSI.


RESULTS
ETBF, VEGF expression, and the number of embryos were significantly higher in the women who became pregnant than in those who did not. By stepwise multiple logistic regression, significant predictors of pregnancy were the number of embryos and ETBF but not conventional receptivity markers. The rate of pregnancy was significantly higher in women with ETBF values of at least 29 mL/min per 100 grams of tissue than in women with lower values (42 vs. 15% in 36 and 39 women, respectively). ETBF was significantly greater in morphologically normal than abnormal uteri. In normal uteri, ETBF was greatest in the fundus. Correspondingly, in normal uteri 85% of gestational sacs were implanted in the fundus.


CONCLUSIONS
ETBF is superior to conventional parameters for determining endometrial receptivity for implantation.
Jinno
M
M
Department of Obstetrics and Gynecology, School of Medicine, Kyorin University, Tokyo, Japan. jinno@kyorin-u.ac.jp
Ozaki
T
T
Iwashita
M
M
Nakamura
Y
Y
Kudo
A
A
Hirano
H
H
D000328:Adult; D001706:Biopsy; D001783:Blood Flow Velocity / Q000502:physiology; D010064:Embryo Implantation / Q000502:physiology*; D004717:Endometrium / Q000098:blood supply* / Q000000981:diagnostic imaging; D016228:Endothelial Growth Factors / Q000032:analysis; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D015907:Hysteroscopy; D007150:Immunohistochemistry; D008222:Lymphokines / Q000032:analysis; D008297:Male; D008856:Microscopy, Fluorescence; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012044:Regression Analysis; D018615:Ultrasonography, Doppler, Color; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin