Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensional power Doppler angiography

Nick Raine‐Fenning, N J Raine-Fenning, B K Campbell, N R Kendall, J S Clewes, I. R. Johnson
Human Reproduction · 2004 · vol. 19(2) , pp. 330–338 · doi:10.1093/humrep/deh056 · PMID:14747176 · W2120153951
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Three-dimensional power Doppler angiography quantified endometrial and subendometrial vascularity during the menstrual cycle, revealing a pre-ovulatory peak and post-ovulatory nadir in vascular indices.

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Abstract

BACKGROUND: We used three-dimensional power Doppler angiography (3D-PDA) to examine the periodic changes in endometrial and subendometrial vascularity during the normal menstrual cycle in 27 women without obvious menstrual dysfunction or subfertility. METHODS: 3D-PDA was performed on alternate days from day 3 of the cycle until ovulation and then every 4 days until menses. Virtual organ computer-aided analysis and shell-imaging were used to define and to quantify the power Doppler signal within the endometrial and subendometrial regions producing indices of their relative vascularity. RESULTS: Both the endometrial and subendometrial vascularization index (VI) and vascularization flow index (VFI) increased during the proliferative phase, peaking approximately 3 days prior to ovulation (P < 0.001) before decreasing to a nadir 5 days post-ovulation (P < 0.001). Thereafter, both vascular indices gradually increased during the transition from early to mid-secretory phase. The flow index (FI) showed a similar pattern but with a longer nadir post-ovulation. Smoking was associated with a significantly lower VI and VFI. The FI was significantly lower in women aged > or = 31 years and significantly higher in parous patients. CONCLUSIONS: Endometrial vascularity, as assessed by 3D-PDA, varies significantly during the menstrual cycle and is characterized by a pre-ovulatory peak and post-ovulatory nadir during the peri-implantation window.

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MeSH descriptors

Endometrium Menstrual Cycle Ultrasonography, Doppler Adult Aging Endometrium Estradiol Estradiol Female Follicular Phase Humans Luteal Phase Ovulation Parity Progesterone Progesterone Ultrasonography, Doppler

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