Endometrial and subendometrial blood flow measured during early luteal phase by three-dimensional power Doppler ultrasound in excessive ovarian responders.
BACKGROUND
Impaired implantation in assisted reproduction cycles with high serum estradiol (E(2)) concentrations may be related to suboptimal endometrial perfusion. Endometrial and subendometrial blood flow were compared between excessive responders (serum E(2) on the day of HCG >20 000 pmol/l) and moderate responders (E(2) < or =20 000 pmol/l).


METHODS
Three-dimensional (3D) ultrasound examination with power Doppler was performed 2, 4 and 7 days after HCG in 32 patients who did not have embryo transfer in order to measure endometrial thickness, pulsatility index (PI)/resistance index (RI) of uterine vessels, and endometrial volume, vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions.


RESULTS
Excessive responders tended to have lower endometrial and subendometrial VI/VFI on HCG +2 and more absent endometrial/subendometrial blood flow. They had significantly higher endometrial FI and subendometrial VFI than moderate responders on HCG +7. Only in the excessive responder group, uterine PI/RI declined significantly from HCG +2 to HCG +7 and endometrial VI/VFI increased significantly from HCG +4 to HCG +7.


CONCLUSIONS
Changes in uterine Doppler flow indices, and endometrial and subendometrial 3D power Doppler flow indices during the early luteal phase were significantly different between moderate and excessive responders.
Ng
Ernest Hung Yu
EH
Department of Obstetrics and Gynaecology, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong, People's Republic of China. nghye@hkucc.nku.hk
Chan
Carina Chi Wai
CC
Tang
Oi Shan
OS
Yeung
William Shu Biu
WS
Ho
Pak Chung
PC
D000328:Adult; D001808:Blood Vessels / Q000000981:diagnostic imaging; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D004717:Endometrium / Q000098:blood supply* / Q000000981:diagnostic imaging*; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008183:Luteal Phase; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance
D006063:Chorionic Gonadotropin; D004958:Estradiol