International Journal of Reproductive BioMedicine
ISSN: 2476-3772
The latest discoveries in all areas of reproduction and reproductive technology.
Comparison of Doppler ultrasound indices of uterine artery and sub endometrial blood supply in frozen embryo transfer with and without repeated implantation failure: A cross-sectional study
Published date: Dec 14 2023
Journal Title: International Journal of Reproductive BioMedicine
Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 21, Issue No. 11
Pages: 937–942
Authors:
Abstract:
Background: Uterine blood supply has been identified as a potential factor in implantation failure.
Objective: This study aimed to investigate Doppler indices in the uterine artery, including vascular flow and resistance, as well as the amount of sub-endometrial blood supply in women with a history of repeated implantation failure (RIF) compared to the non-RIF group.
Materials and Methods: This cross-sectional study was conducted with 139 women candidates for frozen embryo transfer in Yazd Reproductive Sciences Institute, Yazd, Iran from February to July 2023. Group A (n = 68) included women with a history of more than 2 RIF, and group B (n = 71) included women candidates for implantation for the first time without RIF. Doppler ultrasound indices of uterine artery and sub-endometrium, including sub-endometrial flow, uterine artery flow, uterine artery resistance, and peak systolic velocity, were recorded.
Results: No significant differences were observed in uterine artery Doppler pulsatility index and peak systolic velocity between groups, but the uterine artery resistance index was significantly higher in the A group (p < 0.001). A significant difference was observed in the perfusion area between groups. 60/68 women in the group A had endometrial perfusion in areas 2 and 3 (p < 0.001).
Conclusion: Our study revealed that women with RIF exhibited higher resistance index in sub-endometrial arteries compared to the non-RIF group.
Key words: Doppler ultrasound, Frozen embryo transfer, Repeated implantation failure.
References:
[1] ESHRE Working Group on Recurrent Implantation Failure, Cimadomo D, de los Santos MJ, Griesinger G, Lainas G, Le Clef N, et al. ESHRE good practice recommendations on recurrent implantation failure. Hum Reprod Open 2023; 2023: hoad023.
[2] Bahrami F, Eftekhar M, Zanbagh L. Uterine artery doppler and endometrial blood flow in frozen embryo transfer: A cohort study. Int J Reprod BioMed 2023; 21: 205–212.
[3] Martins RS, Oliani AH, Oliani DV, de Oliveira JM. Subendometrial resistence and pulsatility index assessment of endometrial receptivity in assisted reproductive technology cycles. Reprod Biol Endocrinol 2019; 17: 62.
[4] Nandi A, Martins WP, Jayaprakasan K, Clewes JS, Campbell BK, Raine-Fenning NJ. Assessment of endometrial and subendometrial blood flow in women undergoing frozen embryo transfer cycles. Reprod Biomed Online 2014; 28: 343–351.
[5] Yu J, Li B, Li H, Li Q, Nai Z, Deng B, et al. Comparison of uterine, endometrial and subendometrial blood flows in predicting pregnancy outcomes between fresh and frozen-thawed embryo transfer after GnRH antagonist protocol: A retrospective cohort study. J Obstet Gynaecol 2023; 43: 2195937.
[6] Wu J, Sheng J, Wu X, Wu Q. Ultrasound-assessed endometrial receptivity measures for the prediction of in vitro fertilization-embryo transfer clinical pregnancy outcomes: A meta-analysis and systematic review. Exp Ther Med 2023; 26: 453.
[7] Amini M, Ranjkesh M, Nikanfar S, Fattahi A, Farzadi L, Hamdi K. Alterations of uterine blood flow during the follicular phase in patients with recurrent implantation failure: A doppler ultrasonographic study. Int J Women’s Health Reprod Sci 2021; 9: 217–221.
[8] Son JB, Jeong JE, Joo JK, Na YJ, Kim ChW, Lee KS. Measurment of endometrial and uterine vascularity by transvaginal ultrasonography in predicting pregnancy outcome during frozen-thawed embryo transfer cycles. Fertil Steril 2013; 100: 1661–1667.
[9] Tong R, Zhou Y, He Q, Zhuang Y, Zhou W, Xia F. Analysis of the guidance value of 3D ultrasound in evaluating endometrial receptivity for frozen-thawed embryo transfer in patients with repeated implantation failure. Ann Transl Med 2020; 8: 944.
[10] Nardo LG. Vascular endothelial growth factor expression in the endometrium during the menstrual cycle, implantation window and early pregnancy. Curr Opin Obstet Gynecol 2005; 17: 419–423.
[11] Demir R, Kayisli U, Cayli S, Huppertz B. Sequential steps during vasculogenesis and angiogenesis in the very early human placenta. Placenta 2006; 27: 535–539.
[12] Prakash A, Li TC, Laird S, Nargund G, Ledger WL. Absence of follicular phase defect in women with recurrent miscarriage. Fertil Steril 2006; 85: 1784–1790.
[13] Son JB, Jeong JE, Joo JK, Na YJ, Kim CW, Lee KS. Measurement of endometrial and uterine vascularity by transvaginal ultrasonography in predicting pregnancy outcome during frozen-thawed embryo transfer cycles. J Obstet Gynaecol Res2014; 40: 1661–1667.
[14] Eftekhar M, Zare Mehrjardi S, Molaei B, Taheri F, Mangoli E. The correlation between endometrial thickness and pregnancy outcomes in fresh ART cycles with different age groups: A retrospective study. Middle East Fertil Soc J 2020; 24: 10.
[15] Mayer RB, Ebner Th, Weiss Ch, Allerstorfer Ch, Altmann R, Oppelt P, et al. The role of endometrial volume and endometrial and subendometrial vascularization parameters in a frozen embryo transfer cycle. Reprod Sci 2019; 26: 1013–1018.
[16] Zhang Ch-H, Chen Ch, Wang J-R, Wang Y, Wen S-X, Cao Y-P, et al. An endometrial receptivity scoring system basing on the endometrial thickness, volume, echo, peristalsis, and blood flow evaluated by ultrasonography. Front Endocrinol 2022; 13: 907874.
[17] Li Zh, Wang X, Guan Y, Yu X, Liu J, Zhang Zh. Uterine artery blood flow and microvessel density by vaginal color Doppler ultrasonography in embryo implantation failure. Exp Ther Med 2017; 14: 4797–4800.
[18] Ibrahim AM, El-Mandooh MM, Mohammed Gad HF, Al Hariri H. Ovarian and uterine blood flow indices in patients with unexplained infertility undergoing ICSI and their relation to clinical pregnancy rate. J Evid Based Women’s Health 2020; 10: 188–200.
[19] Zebitay AG, Tutumlu M, Verit F, Ilhan G, Gungor E, Cetin O, et al. A comparative analysis of arterial blood flow in unexplained infertility, tubal infertility and fertile groups. Gynecol Endocrinol 2016; 32: 442–445.