Subendometrial arterial spectral doppler assessment during IVF cycles and its correlation with treatment outcome

Subendometrial blood flow changes by 3-dimensional power Doppler ultrasound after hysteroscopic lysis of severe intrauterine adhesions: preliminary study

OBJECTIVE

To evaluate the changes in subendometrial blood flow and endometrial volume after hysteroscopic lysis of severe intrauterine adhesions (IUAs).

DESIGN

A pilot observational study. Forty infertile women with severe IUAs served as their own controls and were included in this study only once, to avoid selection bias.

INTERVENTION

Three-dimensional power Doppler ultrasound was performed in all patients 1 day before hysteroscopic lysis of severe IUA, and repeated 1 month later, to assess subendometrial blood flow [as measured by vascularization index (VI), flow index (FI), and vascularization flow index (VFI)] and endometrial volume. Main outcome measures were subendometrial blood flow (VI, FI, VFI) and endometrial volume.

RESULTS

There were statistically significant postoperative increases in endometrial volume, VI, FI, and VFI. Subendometrial blood flow improved in 14 women (35%), and menstrual improvement occurred in 15 women (37.5%).

CONCLUSION

Hysteroscopic lysis of severe IUAs improves subendometrial blood flow, with subsequent increases in endometrial volume.

Impact of obesity on endometrial blood flow in women without polycystic ovarian syndrome during intracytoplasmic sperm injection

BACKGROUND

Obesity may exert a negative effect on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. However, the effect of obesity on the endometrium remains unknown. This study was designed to assess the effect of isolated body mass index (BMI) on endometrial blood supply in non-polycystic ovary syndrome (PCOS) women during ICSI by power Doppler Ultrasound.

METHODS

An observational prospective study was carried out. A total of 206 patients without PCOS were divided into 4 groups based on Chinese BMI classification (kg/m(2): underweight (BMI < 18.5), normal weight (18.5 less than or equal to BMI < 24), overweight (24 less than or equal to BMI < 28), and obese (BMI greater than or equal to 28). Endometrial thickness, endometrial pattern, endometrial spiral arterial resistance index (RI) and pulsatility index (PI) values and systolic/diastolic ratio (S/D) were assessed on the day of human chorionic gonadotropin administration.

RESULTS

Obese patients required more doses of gonadotrophin and longer stimulation duration than the normal weight patients (P < 0.05). Endometrial thickness and pattern were not statistically different between the 4 BMI subgroups (P > 0.05). Subendometrial blood flow was detected in 165 (80.1%) patients and spiral arterial PI was significantly higher in the obese group than in the normal weight and underweight groups (P < 0.05). All parameters of ICSI outcome were comparable, including pregnancy and miscarriage rates.

CONCLUSIONS

Obesity (BMI greater than or equal to 28 kg/m(2)) appears to exert a negative effect on endometrial and subendometrial blood flow based on the Chinese standard of obesity; however, it seems to have no significant effect on ICSI outcomes in non-PCOS women.