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.

Bayati F, Eftekhar M, Homayoon N, Fatehi H
International journal of reproductive biomedicine · 2023 · doi:10.18502/ijrm.v21i11.14657 · PMID:38292508 · PMC10823118
Observational OA: gold CC-BY-4.0
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This cross-sectional study evaluated Doppler ultrasound indices of the uterine artery and sub-endometrial blood supply in 139 women undergoing frozen embryo transfer, comparing those with repeated implantation failure to a control group without such history. The results indicated that while pulsatility index and peak systolic velocity did not differ significantly between groups, the resistance index was significantly higher in women experiencing repeated implantation failure. Additionally, the study found differences in endometrial perfusion areas, suggesting that altered vascular resistance may be associated with reduced endometrial receptivity. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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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.
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Section

This study revealed that women with RIF exhibited higher RI in sub-endometrial arteries compared to group B. Other studies have also linked implantation failure in IVF cycles with decreased or absent blood flow in the sub-endometrium. When assessing endometrial receptivity, it is crucial to consider multiple factors, including Doppler indices, endometrial thickness, volume, echo, peristalsis, and blood flow.

Coi Statement

The authors declare that they have no conflict of interest to disclose. We uphold the principles of integrity and transparency in our research and have no personal or financial affiliations that could influence the outcomes or interpretation of our work.

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