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Archives of Gynecology and Obstetrics

, Volume 297, Issue 2, pp 539–545 | Cite as

Effect of intramural fibroid on uterine and endometrial vascularity in infertile women scheduled for in-vitro fertilization

  • Ahmed KamelEmail author
  • Akmal El-Mazny
  • Wafaa Ramadan
  • Suzy Abdelaziz
  • Sherine Gad-Allah
  • Hany Saad
  • Ahmed M. Hussein
  • Emad Salah
Gynecologic Endocrinology and Reproductive Medicine
  • 188 Downloads

Abstract

Purpose

To study the effect of intramural fibroids on uterine and endometrial vascularity in infertile women scheduled for in-vitro fertilization (IVF).

Methods

3D power Doppler was used to measure the endometrial volume and blood flow indices in 182 women with intramural fibroids not affecting the uterine cavity and compared them to a matched control group without fibroids.

Results

There was significantly increased vascularity in the endometrium of the fibroid group as denoted by higher endometrial VI (p = 0.018), FI (p = 0.027) and Endometrial VFI. No significant difference in mean uterine artery RI (p = 0.277) or PI (p = 0.187). Among the fibroid group 62.6% had a fibroid > 4 cm. Women with fibroids > 4 cm had a significantly higher Endometrial FI (p = 0.037), and VFI (p = 0.02). Uterine artery blood flow was not affected, as uterine RI (p = 0.369) and PI (p = 0.321) were not statistically different. Compared with the control group (non fibroid), women with fibroids > 4 cm had significantly higher endometrial VI (p = 0.013), FI (p = 0.004), and VFI (p < 0.001), whereas women with fibroid ≤ 4 cm had no statistically significant differences in VI (p = 0.292), FI (p = 0.198), and VFI (p = 0.304).

Conclusion

Intramural fibroids > 4 cm significantly increase endometrial vascularity. This increase in blood flow may be a factor that affects the outcome of IVF.

Keywords

3D power Doppler Endometrial vascularity and blood flow Intramural fibroids IVF Uterine vascularity 

Abbreviations

ART

Assisted reproductive technologies

BMI

Body mass index

CI

Confidence interval

FI

Flow index

ICC

Intraclass correlation coefficient

IVF

In-vitro fertilization

PI

Pulsatility index

RI

Resistance index

TVUS

Trans-vaginal ultrasound

VFI

Vascularization flow index

VOCAL

Virtual organ computer-aided analysis

VI

Vascularization index

Notes

Author contributions

AK and AE-M: Protocol/project development, Data analysis, Manuscript writing/editing. WR, SA and AMH: Data collection or management, manuscript writing/editing. SG-A: Protocol/project development, Data collection or management, manuscript writing/editing. HS: Data collection or management, Data analysis. ES: Protocol/project development, Data collection or management.

Funding

This research did not receive any specific Grant from any funding agency in the public, commercial or not-for-profit sector.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Faculty of MedicineCairo UniversityCairoEgypt

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