Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women

Kurjak, Asım; Kupesic-Urek, Sanja; Schulman, Harold; Žalud, Ivica

doi:10.1016/s0015-0282(16)54657-3

Cited by 167 publications

(81 citation statements)

References 14 publications

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“…We observed that a reduction in intraovarian blood vessel resistance was necessary to achieve pregnancy. Some investigators have reported that the intraovarian arterial blood flow resistance decreases after follicular rupture (3,4). However, in our study half of the infertile women with regular menstrual cycles showed increased, not decreased pulsatility index (PI) values after ovulation.…”

Section: Division Of Reproductive Medicine Department Of Perinatalcontrasting

confidence: 67%

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Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

Nakagawa

Takahashi

Ito

et al. 2006

J Assist Reprod Genet

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Purpose:Intraovarian arterial blood flows before and after follicular rupture in ovulation induced cycles were examined by transvaginal color flow Doppler imaging. The changes observed in the intraovarian arterial resistance before and after ovulation in relation to the regularity of menstruation and several other parameters were analyzed. Methods: In a prospective study, 22 patients undergoing infertility treatment in our center were recruited. Patients were divided into two subgroups, according to their menstrual regularity (regular menstrual group and oligomenorrheal group) and 42 cycles were studied. All patients received the same FSH low-dose stimulation treatment. The relationship between the post and preovulatory arterial pulsatility indexes (PI) was analyzed. Cycles that showed a decrease in their PI after ovulation of 10% or more were considered "profoundly decreased cycles." Cycles from the same patients without ovulatory stimulation (natural cycles) were used as control. Results: In the regular menstrual group the rate of profoundly decreased cycles during FSH stimulation was 63.2%, which was similar to the rate observed in natural cycles. In the oligomenorrheal group the rate of profoundly decreased cycles during natural cycles was 14.3%, but in FSH ovulation induction cycles this rate was significantly increased (47.6%, p < 0.05). In addition, the pregnancy rate per cycle in the oligomenorrheal group was significantly higher than that in the regular menstrual group (p = 0.03). Conclusions: Oligomenorrheal patients presented a higher rate in the decrease of their PI values after FSH stimulation, which is essential to achieve pregnancy. This elevated rate of reduction implies that oligomenorrheal patients have increased incidence of disturbance in their ovulatory process when compared to normal cycling patients. Thus, ovulation induction with FSH, in oligomenorrheal patients resulted in a higher pregnancy rate in this group.

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Section: Division Of Reproductive Medicine Department Of Perinatalcontrasting

confidence: 67%

“…It has been reported that intraovarian blood flow changes dramatically during ovulation (3,4,11). (2).…”

Section: Discussionmentioning

confidence: 99%

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Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

Nakagawa

Takahashi

Ito

et al. 2006

J Assist Reprod Genet

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“…The addition of color Doppler imaging permits the accurate localization of vessels, and high-frequency pulsed Doppler ultrasonography has improved the resolution of flow velocity waveforms. A number of studies have reported on the use of color Doppler ultrasonography to assess differences in uterine blood flow impedance between fertile and infertile women (1,2) and to study uterine receptivity in women undergoing in vitro fertilization (3). Doppler ultrasonography has also been used to assess changes in blood flow to the uterus and ovaries during menstrual cycles (4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…Several investigators have reported that intraovarian blood flow changes dramatically during ovulation (1,7,8). It has been reported that intraovarian blood velocity increases approximately 29 h before the time of follicular rupture and that the mean values for intraovarian PI tend to be lower during the immediate periovulatory period (1,8).…”

Section: Introductionmentioning

confidence: 99%

A Reduction in Intraovarian Arterial Blood Flow Resistance After Ovulation is Necessary to Achieve Pregnancy in Natural Cycle

Nakagawa

Ozawa

Takamatsu

et al. 2005

J Assist Reprod Genet

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Purpose : Color Doppler imaging permits the accurate localization of vessels and highfrequency pulsed Doppler ultrasonography has improved the resolution of flow velocity waveforms. In this study, intraovarian arterial blood flow before and after follicle rupture in the natural cycle was examined using transvaginal color flow Doppler imaging and changes in intraovarian arterial resistance in relation to the outcome of infertility treatment was analyzed. Methods : In a prospective study, 227 spontaneous cycles in 118 infertile patients who were undergoing infertility treatment at the division of Reproductive Medicine in our center were recruited in this study. The impedance to flow in intraovarian vessels was measured by means of transvaginal color flow Doppler imaging during the periovulatory period in the natural cycle of all patients. The pulsatility index (PI) of intraovarian arterial blood flow and pregnancy rate was evaluated. Results : On the basis of PI values before and after follicular rupture, 227 cycles were classified into severely decreased (113 cycles) and not-severely decreased groups (114 cycles). The pregnancy rate per cycle in the severely decreased group was 18.6% (21/113), significantly higher than that in the not-severely decreased group (7/114; 6.1%, p = 0.004). The miscarriage rate was similar in the two groups. Conclusions : A reduction in intraovarian blood vessel resistance is necessary to achieve pregnancy in a natural cycle.

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In vivo perfusion, T₁, and T₂ measurements in the female pelvis during the normal menstrual cycle: A feasibility study

Hoad

Fulford

Raine‐Fenning

et al. 2006

Magnetic Resonance Imaging

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Purpose: To quantify T 1 , T 2 , and regional tissue perfusion in uterine tissues, with MR imaging in clinically feasible imaging times, using echo planar imaging (EPI) techniques over a single menstrual cycle. Materials and Methods:A total of 24 healthy ovulating women were scanned; however, complete data sets through the menstrual cycle were not obtained from all women. Three scans were performed to coincide prospectively with the follicular, periovulatory, and luteal phases of the cycle. T 1 and perfusion were measured simultaneously using flow alternating inversion recovery (FAIR), while T 2 was measured using a single Hahn spin-echo (SE) EPI sequence. Results:Between the follicular and periovulatory phases, statistically significant increases (P Ͻ 0.05) were seen for the T 2 of the endometrium and perfusion of the myometrium as well as the T 2 /T 1 ratio for both endometrium and myometrium. A statistically significant decrease was seen in the endometrial T 2 between the periovulatory and luteal phases of the cycle. Tissue differentiation was achieved using the parameters measured, with T 1 and T 2 being statistically greater for the endometrium than for the myometrium, and endometrial perfusion being statistically lower than myometrial perfusion. Conclusion:These results show the feasibility of using these techniques to measure T 1 , T 2 , and perfusion in uterine tissues and of extending this work to study pathological conditions.

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Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women

Cited by 167 publications

References 14 publications

Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

A Reduction in Intraovarian Arterial Blood Flow Resistance After Ovulation is Necessary to Achieve Pregnancy in Natural Cycle

In vivo perfusion, T₁, and T₂ measurements in the female pelvis during the normal menstrual cycle: A feasibility study

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Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women

Cited by 167 publications

References 14 publications

Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

A Reduction in Intraovarian Arterial Blood Flow Resistance After Ovulation is Necessary to Achieve Pregnancy in Natural Cycle

In vivo perfusion, T1, and T2 measurements in the female pelvis during the normal menstrual cycle: A feasibility study

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In vivo perfusion, T₁, and T₂ measurements in the female pelvis during the normal menstrual cycle: A feasibility study