Assessment of uterine receptivity by the endometrial-subendometrial blood flow distribution pattern in women undergoing in vitro fertilization-embryo transfer.
OBJECTIVE
To investigate the correlation of blood flow detected by color Doppler sonography in the endometrial-subendometrial unit with pregnancy outcome of IVF-ET treatments.


METHODS
Prospective clinical study.


METHODS
University setting.


METHODS
Six hundred twenty-three patients selected prospectively on the day of ET.


METHODS
Transvaginal ultrasound examination was performed before ET.


METHODS
Association between pregnancy outcome and distribution of endometrial-subendometrial blood flow (primary outcome measure) and between pregnancy rate and endometrial measurements as well as uterine arterial blood flow (secondary outcome measures).


RESULTS
The overall pregnancy rate was 28.4% (177/623) per ET. The pregnancy and implantation rates of patients with the presence of both endometrial and subendometrial flow were 47.8% (64/134) and 24.2% (94/388); for patients with subendometrial flow only, 29.7% (102/343) and 15.8% (153/967); and for patients with no detectable endometrial-subendometrial flow, 7.5% (11/146) and 3.5% (13/376), respectively. The presence of both endometrial and subendometrial blood flow is indicative of good endometrial receptivity, whereas the absence of both represents a poor uterine environment. Nondetectable endometrial-subendometrial flow was associated with women who were older, had a thinner endometrium, and had higher uterine arterial resistance compared with those women who had detectable flow.


CONCLUSIONS
Endometrial-subendometrial blood flow distribution pattern assessed by transvaginal color Doppler before ET is correlated with the implantation and pregnancy rate of IVF treatment.
Chien
Li-Wei
LW
Department of Obstetrics and Gynecology, Taipei Medical University and Hospital, Taipei, Taiwan.
Au
Heng-Kien
HK
Chen
Ping-Ling
PL
Xiao
Jean
J
Tzeng
Chii-Ruey
CR
D000328:Adult; D004624:Embryo Transfer; D004717:Endometrium / Q000098:blood supply* / Q000000981:diagnostic imaging; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007248:Infertility, Male; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012039:Regional Blood Flow; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color