title: Endometrial spiral artery Doppler parameters in unexplained infertility patients: is endometrial perfusion an important factor in the etiopathogenesis?
abstract: OBJECTIVE
  Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls.
  
  
  METHODS
  Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetric and Gynecology with the diagnosis of unexplained infertility after standard diagnostic work up constituted the study group and they were compared with a fertile control group admitted to hospital with non specific gynecological complaints or for check-up in the same period. Mid luteal transvaginal color Doppler ultrasonography was applied to each patient by the same radiologist who was blind to the diagnosis of the particular patient and, RI (resistance index) and PI (pulsatility index) values were calculated.
  
  
  RESULTS
  There were no significant differences between the two groups, in respect to age, body mass index, basal hormonal and mid luteal progesterone levels (p>0.05). For the fertile control group, mid luteal-peri-implantation phase endometrial spiral artery mean RI values were calculated as 0.48±0.08 SD and mean PI values as 0.65±0.18 SD. For the study group, mean RI values were calculated as 0.54±0.07 SD, PI values were calculated as 0.80±0.16 SD. The differences for RI (p=0.009) and PI (p=0.004) were statistically significant.
  
  
  CONCLUSIONS
  According to Doppler parameters, unexplained infertility patients have high impedance blood flow in spiral arteries which means that peri-implantation blood flow in these patient is lower than fertile controls. These findings suggest that endometrial perfusion may have an important contribution to etiopathogenesis of unexplained infertility.
authors.affiliation: Department of Gynecology and Obstetrics, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Selda
authors.initials: S
authors.lastname: Uysal
authors.affiliation: Department of Gynecology and Obstetrics, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Elif Pelin Özün
authors.initials: EP
authors.lastname: Ozbay
authors.affiliation: Department of Gynecology and Obstetrics, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Tekin
authors.initials: T
authors.lastname: Ekinci
authors.affiliation: Department of Gynecology and Obstetrics, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Hayri
authors.initials: H
authors.lastname: Aksüt
authors.affiliation: Department of Radiology, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Sebnem
authors.initials: S
authors.lastname: Karasu
authors.affiliation: IRENBE IVF Center, Izmir, Turkey.
authors.forename: Ahmet Zeki
authors.initials: AZ
authors.lastname: Işık
authors.affiliation: Department of Gynecology and Obstetrics, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Ferit
authors.initials: F
authors.lastname: Soylu
keywords: Unexplained infertility; colored Doppler; endometrial blood flow; endometrial receptivity; transvaginal ultrasonograhy