[Contribution of diagnostic ultrasonography in cases of repeated embryonic implantation failure in fertilization in vitro].
BACKGROUND
To assess ultrasonic data in the context of repeated failure of implantation in assisted reproduction medicine.


METHODS
We reviewed ultrasonic data (uterine score at follicular and luteal phase). The same ultrasound exploration was repeated for two consecutive cycles to assess the changes in abnormalities observed and compare findings in 16 patients with repeated failure of implantation and in 14 controls. The controls were women who became pregnant within the three months following the exploration. We then introduced acetylsalicylic acid and prednisolone as first line treatment and nitroglycerin as second line treatment to measure the effects induced in 14 pathological uterine scores.


RESULTS
The score obtained under hormonal treatment was representative of other cycles (r = 0.812, p < 0.0014). The score was significantly lower and the luteal uterine artery pulsatility index was significantly higher in the repeated failure group than in the control group (p < 0.0001 and p = 0.008 respectively). For the 14 patients, treatment improved the uterine score in 8 with acetylsalicylic acid and prednisolone and in 4 with nitroglycerin. Two patients did not respond to treatment. Concerning the effect of therapy, of 14 patients, 8 had an improved uterine score with A + P, and with T; 2 patients did not respond to any treatment.


CONCLUSIONS
The uterine score and luteal artery pulsatility index may be valuable tools for patients with implantation failure who all do not respond to the same therapy.
Lédée-Bataille
N
N
INSERM U131, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine-Béclère, 92140 Clamart. Ledeenathalie@aol.com
Doumerc
S
S
Olivennes
F
F
Kadoch
J
J
Chaouat
G
G
Frydman
R
R
D001158:Arteries; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011673:Pulsatile Flow; D015203:Reproducibility of Results; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging*
D011239:Prednisolone; D005996:Nitroglycerin; D001241:Aspirin
Apport du diagnostic échographique en cas d'échecs répétés d'implantation embryonnaire en fécondation in vitro.