Does ovarian stimulation affect uterine artery impedance?

In: Journal of Assisted Reproduction and Genetics · 1996 · vol. 13(1) , pp. 15–18 · doi:10.1007/bf02068863 · PMID:8825161 · W1983315980
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AI-generated summary by claude@2026-06+body, 2026-06-08

Ovarian stimulation for IVF significantly reduced uterine artery pulsatility index compared to natural cycles, with the reduction correlating with patient age and stimulation effectiveness.

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This study evaluated whether induction of ovulation alters uterine perfusion by measuring uterine artery pulsatility index with transvaginal color Doppler in 42 infertile women during days 16–21 of a spontaneous ovulatory cycle and again prior to embryo transfer in an IVF cycle. The uterine artery pulsatility index was significantly lower in IVF than in natural cycles, with an average reduction of about 18%, and the magnitude of reduction correlated with patient age and estradiol concentration, as well as the number of follicles and oocytes recruited. The reduction was numerically greater among women who conceived than those who did not, but these subgroup differences were not statistically significant, and most participants had tubal or unexplained infertility. Relevance to endometriosis: the paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Purpose: We evaluated the effect of induction of ovulation on uterine perfusion.

Methods

In 42 infertile women transvaginal color Doppler was performed at days 16–21 of a spontaneous ovulatory cycle and prior to embryo transfer in an in vitro fertilization (IVF) cycle. Indication for treatment was mainly tubal or unexplained infertility.

Results

Uterine artery pulsatility index was significantly (P<0.001) lower in IVF than in natural cycles, 3.24±0.72 2.64±0.53 (mean ± SD), with a mean reduction of 18%. The reduction was higher, although not significantly, in the women who conceived (20%) than in those who did not (15%), and in those with a basal PI>3.0 (20%) as opposed to those with normal values (16%). The percentage reduction correlated with patient age and with estradiol concentration, number of follicles, and oocytes recruited.

Conclusions

Induction of superovulation reduces impedance to flow in the uterine circulation. The amplitude of this effect appears to be regulated partially by patient age and by effectiveness of ovarian stimulation. Similar content being viewed by others

References

Goswamy RK, Steptoe PC: Doppler ultrasound studies of the uterine arteries in spontaneous ovarian cycles. Hum Reprod 1988;3:721–726 Scholtes MC, Wladimiroff JW, van Rijen HJM, Hop WCJ: Uterine and ovarian flow velocity waveforms in the normal menstrual cycle: A transvaginal study. Fertil Steril 1989;52:981–985 Steer CV, Campbell S, Pompiglione JS, Kingsland CRC, Mason BA, Collins WP: Transvaginal colour flow imaging of the uterine arteries during the ovarian and menstrual cycles. Hum Reprod 1990;5:391–395 Goswamy RK, Williams G, Steptoe PC: Decreased uterine perfusion—a cause of infertility. Hum Reprod 1988;3:955–959 Kurjak A, Kupesic-Urek S, Schulman H, Zalud I: Transvaginal color Doppler flow in the assessment of ovarian and uterine blood flow in infertile women. Fertil Steril 1991;56:870–873 Steer CV, Tan SL, Mason BA, Campbell S: Midluteal-phase vaginal color Doppler assessment of uterine artery impedence in a subfertile population. Fertil Steril 1994;61:53–58 Sterzik K, Grab D, Sasse V, Hütter W, Rosenbusch B, Terinde R: Doppler sonographic findings and their correlation with implantation in an in vitro fertilization program. Fertil Steril 1989;52:825–828 Steer CV, Campbell S, Tan SL, Crayford T, Mills C, Mason BA, Collins WP: The use of transvaginal color flow imaging after in vitro fertilization to identify optimum uterine conditions before embryo transfer. Fertil Steril 1992;57:72–76 Serafini P, Batzofin J, Nelson J, Olive D: Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril 1994;62:815–822 Maulik D: Hemodynamic interpretation of the arterial Doppler waveform. Ultrasound Obstet Gynecol 1993;3:219–227 de Ziegler D, Bessis R, Frydman R: Vascular resistance of uterine arteries: Physiological effects of estradiol and progesterone. Fertil Steril 1991;55:775–779 Magness RR, Parker CC, Rosenfeld CR: Systemic and uterine responses to chronic infusion of estradiol-17B. Am J Physiol 1993;265:E690-E698 Weiner Z, Thaler I, Levron J, Lewit N, Itskovitz-Eldor J: Assessment of ovarian and uterine blood flow by transvaginal color Doppler in ovarian-stimulated women: Correlation with the number of follicles and steriod hormone levels. Fertil Steril 1993;59:743–749 Toth P, Li X, Rao ChV, Lincoln SR, Sanfilippo JS, Spinnato JA, Yussman MA: Expression of functional human chorionic gonadotropin/human luteinizing hormone receptor gene in human uterine arteries. J Clin Endocrinol Metab 1994;79:307–315 Author information Authors and Affiliations Rights and permissions About this article Cite this article Cacciatore, B., Tiitinen, A. Does ovarian stimulation affect uterine artery impedance?. J Assist Reprod Genet 13, 15–18 (1996). https://doi.org/10.1007/BF02068863 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF02068863

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