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Assessment of uterine receptivity by endometrial and sub-endometrial blood flow using SlowflowHD in hormone prepared frozen embryo transfer cycles: a pilot study

  • Assisted Reproduction Technologies
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Abstract

Purpose

Utilizing SlowflowHD as a measurement of endometrial and sub-endometrial blood flow in women with infertility undergoing frozen embryo transfer (FET) cycles and correlation with pregnancy outcomes.

Methods

A prospective pilot study of 99 women undergoing hormone replacement FET cycles. Ultrasounds were performed with Voluson E8 at 3-time points: day 15, day of transfer, and 11 days post transfer (T + 11). SlowflowHD Doppler blood flow indices in the endometrium and sub-endometrium were compared in women who achieved pregnancy with those who did not.

Results

Using SlowflowHD, both pregnant and non-pregnant women had similar trends with decreased endometrial blood flow day of transfer compared with day 15. However, there was a borderline significantly lower mean percentage decrease of endometrial blood flow in women achieving a pregnancy (28.3% vs 42.9%). Significantly higher numbers of pregnant women had a 20% or less decrease in blood flow (21 vs 9) with increases in mean percentage blood flow on T + 11 (pregnant 39.59% vs non-pregnant 25.20%). The RI and S/D ratio in the spiral arteries was also significantly higher on transfer day in women who had a live birth RI (0.68 vs 0.65) and S/D (3.91 vs 3.17).

Conclusion

There are blood flow changes both in pregnant and non-pregnant patients with decreases in blood flow after progesterone replacement. Pregnancy and live births were associated with a lower mean percentage drop in blood flow from day 15 to the day of transfer and elevated RI and S/D ratio on transfer day.

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Data availability

Data provided upon request.

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Funding

No external funds were used in this work. However, GE Healthcare provided the loaner Voluson E10 Ultrasound machine used for this study.

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Authors and Affiliations

  1. The Jones Institute for Reproductive Medicine, Department of ObGyn, Eastern Virginia Medical School, Norfolk, VA, USA

    Seifeldin Sadek & Tamar Matitashvili

  2. Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA

    Alessandra Kovac

  3. Division of Reproductive Endocrinology, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Hadi Ramadan

  4. The IVF Center, 5901 Brick Court, Winter Park, FL, 32792, USA

    Laurel Stadtmauer

  5. University of Central Florida, Orlando, FL, USA

    Laurel Stadtmauer

Authors
  1. Seifeldin Sadek
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  2. Tamar Matitashvili
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  3. Alessandra Kovac
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  4. Hadi Ramadan
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  5. Laurel Stadtmauer
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Corresponding author

Correspondence to Laurel Stadtmauer.

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EVMS IRB approval number 17–11-FB-0224.

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Sadek, S., Matitashvili, T., Kovac, A. et al. Assessment of uterine receptivity by endometrial and sub-endometrial blood flow using SlowflowHD in hormone prepared frozen embryo transfer cycles: a pilot study. J Assist Reprod Genet 39, 1069–1079 (2022). https://doi.org/10.1007/s10815-022-02454-8

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  • DOI: https://doi.org/10.1007/s10815-022-02454-8

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