Uterine artery Doppler and endometrial blood flow in frozen embryo transfer: A cohort study.

Bahrami F, Fereshteh Bahrami, Eftekhar M, Maryam Eftekhar, Leila Zanbagh, Zanbagh L
International journal of reproductive biomedicine · 2023 · doi:10.18502/ijrm.v21i3.13196 · PMID:37122892 · PMC10133733
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This cohort study of 250 women undergoing frozen embryo transfer found that lower uterine artery pulsatility index and higher endometrial perfusion were significantly associated with positive clinical pregnancy outcomes.

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This cohort study evaluated the predictive value of uterine artery Doppler indices and endometrial perfusion zones for clinical pregnancy outcomes in 250 women undergoing frozen embryo transfer. The researchers found that a higher pulsatility index in the uterine artery and restricted endometrial blood flow limited to the endomyometrial junction significantly increased the risk of negative pregnancy rates compared to more extensive sub-endometrial perfusion. While uterine artery resistance was elevated in non-pregnant patients, the study highlighted that the zone of endometrial vascularization served as a stronger independent predictor for implantation success. This paper is centrally about endometriosis — specifically laparoscopic excision of deep infiltrating lesions.

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Abstract

BackgroundThe implantation rate after assisted reproductive technology depends on 2 important factors, good quality embryo and endometrial receptivity. Endometrial receptivity is mainly assessed by ultrasound measurement of endometrial thickness and morphology.ObjectiveThis study aimed to investigate the relationship between uterine artery Doppler indices/endometrial perfusion and pregnancy rate.Materials and methodsThis cohort study was done on 250 women who were candidates for frozen embryo transfer from January to July 2022. For assessing endometrial receptivity, we performed a Doppler ultrasound of the uterus before embryo transfer with apparently desirable endometrium (endometrial thickness ≥ 7 mm and 3 line endometrial pattern). In addition, the women were divided into 2 groups according to assisted reproductive technology outcome (clinical pregnancy), group I positive clinical pregnancy, and group II negative clinical pregnancy, and uterine artery indices and endometrial perfusion were compared between these groups.ResultsUterine artery Doppler showed that the pulsatility index was significantly different between positive and negative clinical pregnancy groups, but resistance index and peak systolic velocity (PSV) did not have statistically significant differences. Also, endometrial perfusion was significantly different between the 2 groups of clinical pregnancy. Endometrial perfusion was significantly better in positive clinical pregnancy groups.ConclusionDoppler ultrasound can help to assess endometrial receptivity.
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Endometrial perfusion in zones II and III improves the pregnancy rate. It appears that the combined measurements of uterine artery PI, endometrial perfusion, and ET can be good contributing factors for pregnancy rate. Furthermore, our findings align with the generally accepted notion that a good endometrial blood supply is required for successful implantation.

Coi Statement

The authors declare that there is no conflict of interest.

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