Uterine Artery and Endometrial Doppler Velocimetry before Embryo Transfer in Intra-cytoplasmic Sperm Injection: Influence on Cycle Success

Abstract

Background: Unfortunately, seeking in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) procedure is not a guarantee of success or achieving live birth. Recurrent failure of implantation remains a distressing event. There are strong efforts to assess endometrial receptivity particularly in cases subjected to assisted reproductive technology. Objective: To assess the role of estimating uterine artery blood flow (UABF) as well as endometrial blood flow via Doppler ultrasound prior to embryo transfer in IVF/ET cycles in prediction of pregnancy rate. Subjects and methods: A prospective observational investigation that was carried out on 80 women who were scheduled for ICSI cycles that was conducted at the private ICSI centers, durıng the perıod from October 2021 tıll October 2022. Results: The mean endometrial thickness was higher in women who got pregnant after ICSI compared to non-pregnant women after ICSI) [10.24± 1.6mm vs. 9.5±1.89 mm; respectively; P=0.05]. Additionally, the sub endometrial indices '' PI, RI, and S/D'' & uterine artery RI and S/D ratio were all significantly lower in women who get pregnant than in nonpregnant women after ICSI, (P<0.001). Besides, uterine artery PI was also significantly lower in pregnant cases after ICSI (P=0.001). Conclusion: Both uterine artery RI, and uterine artery S/D ratio had significantly the best diagnostic accuracy followed by sub-endometrial RI and sub-endometrial S/D ratio. So uterine artery and sub endometrial Doppler indices may be used independently or better combined with the other factors for configuration of a predictive algorithm for ICSI implantation or pregnancy rates prediction.