Comparison of Uterine Receptivity between Fertile and Unexplained Infertile Women by Assessment of Endometrial and Subendometrial Perfusion Using Contrast-Enhanced Ultrasound: Which Index is Better—Peak Intensity or Area under the Curve?

Chen, Minxia; He, Yanni; Zhang, Pengjie; Geng, Qiang; Liu, Qiu-Xiang; Kong, Linghong; Chen, Yihan; Wei, Qingzhu; Liu, Jianghuan; Guo, Suiqun; Li, Hongmei

doi:10.1016/j.ultrasmedbio.2015.11.008

Cited by 14 publications

(14 citation statements)

References 45 publications

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“…The receiver operating characteristic curve was drawn to judge the diagnostic value of the 4 indices, including the PI, Ttopk, area, and ATM. The results showed that the diagnostic values of the PI and area in the malignant and normal groups were clear, 5 but none of the 4 indices in the polyp and normal groups had diagnostic value (Figures 1 and 2 and Tables 1 and 2).…”

Section: Resultsmentioning

confidence: 94%

Diagnostic Value of Quantitative Analysis by Contrast‐Enhanced Ultrasound of Endometrial Lesions

Qiao

Xiong

et al. 2020

J of Ultrasound Medicine

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Objectives To explore the diagnostic value of time‐intensity curve parameters from contrast‐enhanced ultrasound (CEUS) examinations of endometrial lesions. Methods Fifty‐two patients with suspected endometrial lesions who received vaginal CEUS examinations were divided into a polyp group (n = 36), a malignant group (n = 11), and a normal control group (n = 5) based on the pathologic diagnosis. The midpoint of the myometrium at the same depth as the endometrial lesion was used as the reference point. The initial increase time, time to peak, area under the curve, and peak intensity were determined by the time‐intensity curve. The relative parameters, namely, the initial increase time difference, peak time difference, area ratio, and peak intensity ratio, were also calculated and analyzed statistically. Results The comparison results of the relative parameters among the groups showed that the differences in the time difference, intensity ratio, and area ratio were statistically significant. The differences in the intensity ratio and time difference between the malignant and normal groups were statistically significant (P < .001). The differences in the intensity ratio, area ratio, and time difference between the malignant and polyp groups were statistically significant (P < .001). The diagnostic value of the intensity ratio and area ratio was confirmed by a receiver operating characteristic curve. The sensitivity and specificity of the intensity ratio and area ratio in the groups were 100% and 77.5% and 85.7% and 85.0%, respectively. Conclusions The relative CEUS parameters in endometrial lesions provide more diagnostic value in differential diagnosis of benign and malignant lesions than the absolute parameters.

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Section: Resultsmentioning

confidence: 94%

Diagnostic Value of Quantitative Analysis by Contrast‐Enhanced Ultrasound of Endometrial Lesions

Qiao

Xiong

et al. 2020

J of Ultrasound Medicine

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“…18 Impaired uterine, sub-endometrial as well as ovarian perfusion has also been demonstrated in unexplained infertility cases by color Doppler study. [19][20][21] Zebitay and colleagues agreed to this finding, in addition, they also stated that this difference does not exist among women with tubal factor infertility compared to fertile women; reserving this association to unexplained infertility. 8 In this study, we found that unexplained infertility was associated with a significantly impaired uterine as well as sub-endometrial perfusion which was in agreement with previous reports.…”

Section: Discussionmentioning

confidence: 99%

Effect of nitric oxide donors on uterine and sub-endometrial blood flow in patients with unexplained infertility: a randomized controlled trial

Hafeez

Kortam

Youssef

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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Background: Impaired sub-endometrial perfusion might reduce endometrial receptivity and possibly contribute to unexplained infertility. A favorable effect on sub-endometrial blood flow has been demonstrated with nitric oxide.Methods: This randomized controlled trial evaluated the effect of nitroglycerine on uterine and sub-endometrial blood flow in women with unexplained infertility. Sixty women were randomized into 2 equal groups. The study group received 5mg nitroglycerine patch daily from day 2 of the cycle till the evaluation day and the control group received no treatment. Independent of the study arms, 30 parous women were included as the fertile group. Six to eight days after detecting luteinizing hormone surge, women were assessed for endometrial thickness, uterine artery blood flow with color Doppler and sub-endometrial blood flow with three-dimensional power Doppler.Results: Compared to fertile women, cases with unexplained infertility (control group) had a significantly thinner endometrium, higher uterine artery Doppler indices and lower sub-endometrial blood flow. Women who received nitroglycerin showed a significant improvement in sub-endometrial blood flow while uterine artery blood flow did not show a significant difference; however, the values were also comparable to fertile women. In addition, no effect on endometrial thickness was found with nitroglycerin treatment. Nitroglycerin treatment side effects were headache, blurring of vision and hypotension. These adverse effects were not significant compared to controls.Conclusions: In women with unexplained infertility, nitroglycerin significantly improved the sub-endometrial blood flow but did not affect the endometrial thickness.

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“…14,15 Generally, endometrial receptivity is assessed based on endometrial thickness, and endometrial and uterine blood perfusion. 16 Transvaginal ultrasound has been widely accepted as the most timely, economical, and non-invasive way to evaluate uterine receptivity.…”

Section: Discussionmentioning

confidence: 99%

Low‐dose aspirin improves blood perfusion of endometrium of unexplained recurrent biochemical pregnancy loss

Zhang

Guo

Wang

et al. 2021

Intl J Gynecology & Obste

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Due to the advent of high-sensitivity pregnancy tests, biochemical pregnancy losses (BPLs) have been found to be much more common than previously thought, involving as many as 50%-60% of all pregnancies. 1 This is because most women who experience a BPL never even realize they are pregnant unless they are trying to conceive and are testing regularly and early. Unlike clinical early miscarriage, in which karyotypically abnormal embryos are the cause of 50% of losses, 2 the exact causes of BPL remain unknown. It is thought that BPL might be related to maternal age, reproductive malformation, autoimmune disease, inherited thrombophilia, and endocrine abnormality. 3,4 Herein recurrent biochemical pregnancy loss (RBPL) is defined as two or more BPLs that affect 2%-5% fertile women. 4 Moreover, RBPLs remain unexplained after an extensive assessment are known as unexplained RBPLs (URBPLs). 5 Studies demonstrated that appropriate endometrial receptivity is key to achieving a normal pregnancy. 6 Impaired blood perfusion of

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Comparison of Uterine Receptivity between Fertile and Unexplained Infertile Women by Assessment of Endometrial and Subendometrial Perfusion Using Contrast-Enhanced Ultrasound: Which Index is Better—Peak Intensity or Area under the Curve?

Cited by 14 publications

References 45 publications

Diagnostic Value of Quantitative Analysis by Contrast‐Enhanced Ultrasound of Endometrial Lesions

Diagnostic Value of Quantitative Analysis by Contrast‐Enhanced Ultrasound of Endometrial Lesions

Effect of nitric oxide donors on uterine and sub-endometrial blood flow in patients with unexplained infertility: a randomized controlled trial

Low‐dose aspirin improves blood perfusion of endometrium of unexplained recurrent biochemical pregnancy loss

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