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.
Department of Obstetrics and Gynecology, Taipei Medical University and Hospital, Taipei, Taiwan.
Li-Wei
LW
Chien
Heng-Kien
HK
Au
Ping-Ling
PL
Chen
Jean
J
Xiao
Chii-Ruey
CR
Tzeng
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