Abstract
Purpose of the Study
To study the role of endometrial and subendometrial blood flow measured by 3D power Doppler as predictors of pregnancy in frozen embryo transfer (FET) cycles.
Methods
A hospital-based prospective study of two hundred and twenty-one (221) women undergoing FET cycles with a triple-line endometrium ≥7 mm on day 14 endometrial and subendometrial blood flow was assessed using 3D power Doppler, and various indices endometrial volume, subendometrial volume and their vascularisation index (VI), flow index (FI) and vascularisation flow index (VFI) were obtained and compared between the pregnant and the non-pregnant group. Primary outcome was clinical pregnancy.
Results
Out of 221 women, 97(43.89 %) became pregnant, while 124 (56.10 %) failed to become pregnant. The endometrial volume was comparable between the two groups. Endometrial VI, FI and VFI were significantly higher in the pregnant as compared to the non-pregnant group. There was a significant difference in subendometrial VI and VFI between the two groups, but FI was similar.
Conclusions
Endometrial and subendometrial vascularity by 3D power Doppler can be a useful parameter in predicting pregnancy in FET cycles.
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References
Mercé LT, Barco MJ, Bau S, et al. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome? Fertil Steril. 2008;89:111–7.
Friedler S, Schenker JG, Herman A, et al. The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum Reprod Update. 1996;2:323–35.
Merce LT. Ultrasound markers of implantation. Ultrasound Rev Obstet Gynecol. 2002;2:110–23.
Zollner U, Zollner KP, Specketer MT, et al. Endometrial volume as assessed by three-dimensional ultrasound is a predictor of pregnancy outcome after in vitro fertilization and embryo transfer. Fertil Steril. 2003;80:1515–7.
Schild RL, Knoblock C, Dorn C, Fimmers R, et al. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril. 2001;75:361–6.
Ng EHY, Chan CCW, Tang OS, et al. The role of endometrial and subendometrial vascularity measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during frozen thawed embryo transfer cycles. Hum Reprod. 2006;21:1612–7.
Wang L, Qiao J, Li R, et al. Role of endometrial blood flow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles. Reprod Biol Endocrinol. 2010;8:122.
Singh N, Bahadur A, Mittal S, et al. Predictive value of endometrial thickness, pattern and sub-endometrial blood flows on the day of hCG by 2D Doppler in vitro fertilization cycles: a prospective clinical study from a tertiary care unit. J Hum ReprodSci. 2011;4:29–33.
Wu HM, Chiang CH, Huang HY, et al. Detection of the subendometrial vascularization flow index by three-dimensional ultrasound may be useful for predicting the pregnancy rate for patients undergoing in vitro fertilization-embryo transfer. FertilSteril. 2003;79:507–11.
KupesicS Bekavac I, Bjelos D, et al. Assessment of endometrial receptivity by transvaginal color Doppler and three-dimensional power Doppler ultrasonography in patients undergoing in vitro fertilization procedures. J Ultrasound Med. 2001;20:125–34.
Ng EHY, Chan CCW, Tang OS, et al. Changes in endometrial and subendometrial blood flow in IVF. Reprod BioMed Online. 2009;18(2):269–75.
Zácková T, Järvelä IY, Tapanainen JS, et al. Assessment of endometrial and ovarian characteristics using three dimensional power Doppler ultrasound to predict response in frozen embryo transfer cycles. Reprod Biol Endocrinol. 2009;7:151.
Check JH, Dietterich C, Lurie D, et al. The relationship of color and power Doppler ultrasound parameters of pulsatility and resistance indices and sub-endometrial blood flow with endometrial thickness on day prior to progesterone administration and their relationship to clinical pregnancy rate following frozen embryo transfer. Fertil Steril. 2003;80:S123.
Tekay A, Martikainen H, Jouppila P. Blood flow changes in uterine and ovarian vasculature, and predictive value of transvaginal pulsed colour Doppler ultrasonography in an in vitro fertilization programme. Hum Reprod. 1995;10:688–93.
Ng EH, Chan CC, Tang OS, et al. Endometrial and subendometrial vascularity is higher in pregnant patients with livebirth following ART than in those who suffer a miscarriage. Hum Reprod. 2007;22:1134–41.
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Dr. Vineet V Mishra MD, Phd Professor and Head of Department, Obstetrics and Gynecology, IKDRC-ITS, Ahmedabad; Dr. Ritu Agarwal M.S. Senior Resident, Dept. Of Obstetrics and Gynecology, IKDRC-ITS, Ahmedabad; Dr. Urmila Sharma M.S. Clinical Fellow, Dept. Of Obstetrics and Gynecology, IKDRC-ITS, Ahmedabad; Dr. Rohina Aggarwal MS Associate Professor, Dept. Of Obstetrics and Gynecology IKDRC Ahmedabad; Dr Sumesh Choudhary MD Assistant professor, Dept. Of Obstetrics and Gynecology IKDRC Ahmedabad; Dr Pradeep Bandwal Senior Resident, Dept. of Obstetrics and Gynecology IKDRC Ahmedabad.
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Mishra, V.V., Agarwal, R., Sharma, U. et al. Endometrial and Subendometrial Vascularity by Three-Dimensional (3D) Power Doppler and Its Correlation with Pregnancy Outcome in Frozen Embryo Transfer (FET) Cycles. J Obstet Gynecol India 66 (Suppl 1), 521–527 (2016). https://doi.org/10.1007/s13224-016-0871-5
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DOI: https://doi.org/10.1007/s13224-016-0871-5