P04.25: Subendometrial arterial blood flow assessment during IVF cycles and its correlation with treatment outcome

Abstract

Objective: To investigate the role of power Doppler in differentiating septate and bicornuate uterus prior to perform office operative hysteroscopy. Methods: Ten patients with previous hystory of infertility were referred to our US Dept. At the admission, transvaginal US axial scan of the uterus showed that the endometrium was as divided in two parts separated by hypoechoic tissue. B scan alone was unable to differentiate bicornuate from septate uterus. No shows difference could be found in uterine fundal contour. Power Doppler evaluation of uterine vascularization was performed in all patients. All patients were submitted to diagnostic laparoscopy. Results: In six patients the main branches of uterine arteries appeared to converge, at the uterine midline, in a single median arterial vessel flowing between the two emiuteruses, mimicking the greak letter gamma. Irregular vascular spots, at the uterine midline, have been found in the remaining four patients. Laparoscopy revealed that thẽ a (gamma) sign was peculiar in case of bicornuate uterus. Median irregular vascular spots had been found in case of septate uterus. Conclusions: Power Doppler study of uterine malformations and the presence of the gamma sign seem to be able to differentiate bicornuate uterus from septate uterus. P04.25Subendometrial arterial blood flow assessment during IVF cycles and its correlation with treatment outcome Z. Leibovitz, R. Gorokhovsky, J. Tal, S. Degani, I. Shapiro, I. Calderon, Y. Paltiely, G. Ohel Bnai-Zion Medical Center, IsraelObjective: The influence of blood flow impedance in subendometrial arteries on embryo implantation rate was investigated by transvaginal Doppler study before embryo transfer. Methods: A total of 36 women undergoing in vitro fertilization procedures were evaluated 3 times during the treatment cycle: upon completion of pituitary desensitization (Day 1), on the day of hCG administration and on the day of oocyte pick-up (OPU day) The patients had no uterine abnormality and no uterine surgery. Power and spectral flow imaging of subendometrial arteries was obtained to calculate PI, RI and S/D ratio. These indices were longitudinally assessed according to the examination day. The correlation between the Doppler parameters, endometrial thickness and pregnancy achievement was analyzed. Patients were grouped according to whether pregnancy was achieved (group A -13 cases) or not (group B -26 cases). Results: No significant difference was found between the two groups in mean age, days of gonadotropin stimulation, peak serum estradiol level, endometrial thickness and number of embryos transferred. Doppler measurements of RI and S/D did not differ between group A and B on any of the days on which the studies were done. In patients who have conceived, PI was significantly lower on Day 1 (1.09 ± 0.17) compared to hCG day (1.25 ± 0.15) and OPU day (1.32 ± 0.21) (p < 0.02). PI measurements obtained on Day 1in group A (1.09 ± 0.17) were significantly lower compared to group B (1.29 ± 0.34) (P = 0.019). Conclusions: Lower P...