Role of uterine artery Doppler in assessment of unexplained infertility

Zarad, Carmen Ali; Mohamed, Mohamed Hafez; Shanab, Waleed S. Abo

doi:10.1186/s43055-021-00430-3

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…16,30, 31 A recent comparative study by Zarad et al found significantly higher uterine artery Doppler indices in women with unexplained infertility as compared to fertile women. 16 The mean value of RI and PI was significantly higher in the infertile group as compared to the fertile group. They predicted cut off values of ≥0.67 and 1.95 for RI and PI respectively for increased resistance to uterine blood flow with sensitivity of 95%-100%, specificity of 86.7%-96.7%.…”

Section: Discussionmentioning

confidence: 83%

“…[11][12][13] High impedance to uterine blood flow is associated with unexplained infertility, poor endometrial receptivity and, recurrent miscarriages. [14][15][16] Optimum uterine blood flow is an important contributor to good endometrial receptivity. Studies have been done to compare conception and nonconception cycles of women for the difference in uterine blood flow.…”

Section: Introductionmentioning

confidence: 99%

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Role of uterine artery Doppler indices for predicting intrauterine pathology inconclusive on 2-dimensional transvaginal imaging among infertile women undergoing frozen embryo transfer cycle

Sindhu¹

2021

Int J Reprod Contracept Obstet Gynecol

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Background: Objective of current study was to correlate uterine artery Doppler parameters with endometrial findings on hysteroscopy and its importance for the prediction of intrauterine pathology inconclusive on 2-dimensional transvaginal imaging prior to frozen embryo transfer.Methods: This was a retrospective study conducted at Medicover fertility center, New Delhi, India. The study population comprised of women with infertility who have undergone hysteroscopy before frozen embryo transfer. Total 70 patients were recruited based on inclusion/exclusion criteria. Intrauterine pathology found in 57.2% (n= 40) patients and 42.8% (n=30) had normal endometrial cavity on hysteroscopy, they were categorized as group 1 and group 2 respectively based on their findings. Both the groups were compared for pre hysteroscopy uterine artery Doppler parameters, resistivity index and pulsatility index. Further clinical pregnancy rate and miscarriage rate were determined in both groups.Results: Both the groups were comparable for age, body mass index, duration, and type of infertility. Mean RI and PI was significantly higher in group 1 as compared to group 2 (0.90±0.025, 2.89±0.291 vs. 0.76±0.043, 1.82±0.27; p value <0.001). The best cut-off value of uterine artery RI was ≥0.87 with sensitivity of 90% (95% CI=0.7634-0.9721), specificity of 100% (95% CI=0.8843-1.0000) and PI was 2.46 with sensitivity of 100% (95% CI=0.9119-1.0000), specificity of 96.7% (95% CI=0.8278-0.9992).Conclusions: Uterine artery Doppler is a non-invasive, cost- effective useful add-on tool for routine endometrial evaluation and can be a good predictor for screening intrauterine pathology and valuable in decision making for pre-IVF hysteroscopy.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Role of uterine artery Doppler indices for predicting intrauterine pathology inconclusive on 2-dimensional transvaginal imaging among infertile women undergoing frozen embryo transfer cycle

Sindhu¹

2021

Int J Reprod Contracept Obstet Gynecol

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“…Балльная система оценки хронического эндометрита по ультразвуковым критериям Table 1. Scoring system for chronic endometritis assessment using the ultrasonic criteria стического компонента сосудистой стенки, составляет в норме 0,83 ± 0,06 (М ± SD), показатель систоло-диастолического соотношения не превышает 2,7 ± 0,09 [11,13].…”

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Effectiveness of Sanatorium Treatment Programs for Women with Chronic Endometritis: a Prospective Randomized Study

Konchugova,

Kotenko,

Yurova

et al. 2023

Bulletin of Rehabilitation Medicine

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INTRODUCTION. The problem of recurrent antibiotic-resistant urogenital infections is increasing, and standard therapy is becoming ineffective. Sanatorium-resort treatment of chronic inflammatory diseases of the pelvic organs in women allows us to solve these problems with the help of natural and preformed physical factors. AIM. To study the clinical effectiveness of comprehensive sanatorium treatment programs in patients with chronic endometritis. MATERIALS AND METHODS. A prospective randomized trial included 73 patients, aged 35 ± 10 years, diagnosed with chronic endometritis. The control group (n = 25) received «basic» therapy with amplipulstherapy, sodium chloride baths. The comparison group (n = 24) received «basic» therapy and manual therapy. The main group (n = 24) received «basic» therapy, high-intensity pulsed magnetic field and manual therapy. Diagnostic criteria: immunohistochemical examination of the endometrium, echographic examination, dopplerometry of pelvic vessels, laser Doppler flowmetry. RESULTS AND DISCUSSION. After treatment, an increase in the uterine arterial perfusion index was noted in all groups compared with baseline values. The median indicator increased in the study groups by 2.36 times, 2.4 times, and 2.6 times, respectively (p 0.05). The decrease in the maximum peak speed in the comparison group and the main group exceeded the indicators of the control group (p 0.001). The systolic-diastolic ratio decreased in the comparison group and the main group (p 0.05). A decrease in stagnation in the venular microcirculation, a normotonic type of microcirculation, improvement in endothelial function (p 0.01) were revealed in the main group. CONCLUSION. An algorithm has been developed. In case of endometrial hypoplasia, decreased uterine perfusion, increased uterine artery resistance index, «basic» therapy is recommended, including sodium chloride baths and amplipulstherapy. With an increase in the maximum peak blood flow rate, an increase in the systolic-diastolic ratio, it is necessary to add a course of manual therapy to the «basic» therapy. When detecting violations of venous outflow, it is recommended to include high-intensity pulsed magnetic therapy.

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“…Particularly during pelvic and gynecologic surgery, they have a crucial clinical role in a variety of medical disorders. The uterine arteries undergo significant modifications throughout pregnancy, growing larger and more tortuous, which has a significant impact on postnatal outcomes 1 .…”

Section: Introductionmentioning

confidence: 99%

Doppler Evaluation of Uterine Arteries in Different Phases of Menstrual Cycle in Young Adult Females with Regular Cycles

Mubashra,

Haider,

Fatima

et al. 2023

PJMHS

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Background: The menstrual cycle is nature's cyclical method of getting ready for pregnancy. The uterine lining grows each month in preparation for implantation by a fertilized ovum. Cyclic endometrium may be non-invasively assessed with Doppler sonography and leads to alterations in local vascular patterns. The pulsatility index (PI), which measures the uterine artery (UtA) impedance, displays a predictable pattern during the typical menstrual cycle. Aim: To evaluate the flow of blood through the uterine arteries in young adult women with regular cycles during various menstrual cycle stages. Place of study and duration of study: Department of Radiology, University Ultrasonography Clinic in Green Town, Lahore. Between January 2022 and October 2022. Methodology: A comparative study was carried out at the University Ultrasonography Clinic in Green Town, Lahore, Pakistan. In this study, 180 patients between the ages of 16 and 35 were enrolled using a convenient sampling technique.All the married, and unmarried ages between 13- and 40 years old having regular periods once a month were involved in this study. Results: 180 patients in all were involved in this study comprising 60 females of each phase of the menstrual phase, 23 patients age were 25 age, 19 patients were 23 age, 20 patients were 18 age, 15 patients were 22, and 9 patients were the age of 29,30,31 years. RI of the right ovary was 0.5938 ± 0.8, the mean RI of the left ovary was 6.5083 ± 0.92357 forthe 10-20 days phase cycle, RI of the right ovary was 0.5937 ± .05266, the mean RI of the left ovary was 10.6967 ± 1.13466 of 11-20 days phase cycle, RI of right ovary was 0.5925 ± .05423, mean RI of left ovary was 6.7083±1.10258 of 21-30 days phase cycle.The uterine artery's resistivity index is compared in three menstrual cycle phases which are days 1 to 10, 11 to 20, and 21 to 30. No statistical difference was found in the right three means of the uterine artery's resistivity index as P-value=0.989 > ∞=0.05. The averages of the Resistivity index of the uterine artery(left)in the three phases of the menstrual cycle are proved to be equal as we failed to find statistically significant differences where P-value=0.975 > ∞=0.050. Conclusion: In this study, we have concluded that endometrial thickness and uterine artery resistivity index, determined ultrasonographically depend upon the phase of the menstrual cycle. The endometrialthickness progressively increases throughout the menstrual phase with no change in the resistive index of both uterine arteries. Keywords: Doppler ultrasound, uterine arteries, resistive index, pulsative index, endometrium stripe thickness.

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Role of uterine artery Doppler in assessment of unexplained infertility

Cited by 6 publications

References 20 publications

Role of uterine artery Doppler indices for predicting intrauterine pathology inconclusive on 2-dimensional transvaginal imaging among infertile women undergoing frozen embryo transfer cycle

Role of uterine artery Doppler indices for predicting intrauterine pathology inconclusive on 2-dimensional transvaginal imaging among infertile women undergoing frozen embryo transfer cycle

Effectiveness of Sanatorium Treatment Programs for Women with Chronic Endometritis: a Prospective Randomized Study

Doppler Evaluation of Uterine Arteries in Different Phases of Menstrual Cycle in Young Adult Females with Regular Cycles

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