Transvaginal Sonographic Evaluation of Doppler Indices of Ovarian Artery and Uterine Artery in Infertile Females

Objective: The objective of this study was to assess the transvaginal Doppler indices of ovarian artery and uterine artery in infertile females in comparison with fertile females. Methods: The research strategy comprised search items identifying all synonyms of transvaginal Doppler indices in infertile females compared with fertile females. The databases searched were Google Scholar, Pubmed and Science direct. Only the studies comprising of Doppler indices in infertile females on transvaginal sonography were nominated. The studies were screened and data analysis performed by using content analysis. Data reduction was performed through systematic coding and the generation of themes. We identified 12 studies comprising of Doppler indices to evaluate the blood flow in uterine and ovarian artery in mid-luteal phase in infertile and fertile females by using transvaginal ultrasound. Results: In this systematic review, 12 studies included 1408 women, out of which 610 (43.3%) women got pregnant within one year of marriage and 798 (56.68%) presented with infertility. In the analysis of these studies, Doppler indices (PI & RI) were higher in infertile group than in fertile group. Out of 798 (56.68%) cases of infertility, 443 (55.5%) presented with increased Doppler indices (PI & RI) and 265 (33.2%) with very low pulsatility index of uterine and ovarian artery and remaining 102(12.78%) cases had other causes of infertility (5% cases of endometrioma with endometriosis, 4%cases of endometrioma without endometriosis, 2% cases are of ovarian cysts, tubal factor infertility and thin endometrial thickness). Transvaginal Doppler ultrasonography is significantly better in defining the resistivity index and pulsatility index in uterine and ovarian artery and for the detection of other intrauterine abnormalities. Conclusion: In the view of the results obtained from 12 studies included in this systematic review, we concluded that transvaginal Doppler ultrasound is an appropriate diagnostic tool in the evaluation of blood flow indices in uterine and ovarian artery in mid luteal phase. Unexplained infertility is associated with decreased or increased uterine and ovarian arteries blood flow during the luteal phase. Optimum uterine receptivity seems to occur when the mean pulsatility index of both arteries is between 2 and 3. The implantation and pregnancy rate decreased significantly when pulsatility is over 3 or 4 and there was no significant difference as regards the resistivity index.