title: Correlation of subendometrial-endometrial blood flow assessment by two-dimensional power Doppler with pregnancy outcome in frozen-thawed embryo transfer cycles.
abstract: BACKGROUND
  Various markers have been proposed to evaluate endometrial receptivity, such as molecular markers and sonographic markers. Commonly used sonographic markers include endometrial thickness and pattern. A good endometrial blood flow is considered necessary for improved pregnancy outcome.
  
  
  OBJECTIVE
  The aim of the present study is to evaluate the role of subendometrial endometrial blood flow with two-dimensional-power Doppler (2D-PD) in predicting pregnancy outcome in hormone replacement frozen-thawed embryo transfer (FET) cycles.
  
  
  METHODS
  Prospective, non-randomized observational study. A total of 165 patients undergoing their first FET cycle were evaluated for subendometrial-endometrial blood flow by 2D-PD once the endometrium was ≥7 mm thick. Group A consisted of 127 women showing the presence of subendometrial-endometrial blood flow. Group B comprised of 38 women in whom subendometrial blood flow was absent. Progesterone supplement was added and transfer of 2-3 cleavage stage good quality embryos was done after 3 days.
  
  
  METHODS
  Independent two-tailed t-test and Chi-square test.
  
  
  RESULTS
  There was no significant difference in body mass index, endometrial thickness, follicle stimulating hormone, luteinizing hormone levels, number of mature oocytes, semen parameters and the number of good quality embryos in the two groups (P > 0.05). The mean age in Group A was 32.05 years and 33.73 years in Group B, and the difference was statistically significant (P = 0.04). Overall pregnancy rate (PR) was 30.90%. PRs were significantly higher in the presence of subendometrial-endometrial blood flow than in its absence (35.43% vs. 15.78%, P = 0.02). Furthermore, clinical pregnancy rate and implantation rate were significantly higher in Group A when compared to Group B (31.49% and 14.79% vs. 13.15% and 6.52%, P = 0.02 and 0.03, respectively).
  
  
  CONCLUSIONS
  The presence of endometrial blood flow significantly improves cycle outcome in hormone replacement therapy-FET cycles.
authors.affiliation: Department of Reproductive Medicine, Bangalore Assisted Conception Center, Bengaluru, Karnataka, India.
authors.forename: Divya
authors.initials: D
authors.lastname: Sardana
authors.affiliation: Department of Reproductive Medicine, Bangalore Assisted Conception Center, Bengaluru, Karnataka, India.
authors.forename: Amit Jitendra
authors.initials: AJ
authors.lastname: Upadhyay
authors.affiliation: Department of Reproductive Medicine, Bangalore Assisted Conception Center, Bengaluru, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Deepika
authors.affiliation: Department of Reproductive Medicine, Bangalore Assisted Conception Center, Bengaluru, Karnataka, India.
authors.forename: Gautham T
authors.initials: GT
authors.lastname: Pranesh
authors.affiliation: Department of Reproductive Medicine, Bangalore Assisted Conception Center, Bengaluru, Karnataka, India.
authors.forename: Kamini A
authors.initials: KA
authors.lastname: Rao
keywords: Frozen-thawed embryo transfer; power Doppler; subendometrial-endometrial blood flow