Two-Dimensional and Three-Dimensional Doppler in Reproductive Medicine

Ultrasound examination of the endometrium is a noninvasive method to evaluate the endometrium during in vitro fertilization (IVF). A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation, and assessment of endometrial blood flow may therefore predict the IVF outcomes. Doppler flow of uterine vessels measured by two-dimensional (2D) ultrasound has a high negative predictive value and sensitivity (in the ranges of 88–100% and 96–100%, respectively) and a relatively higher range of positive predictive value and specificity (44–56% and 13–35%, respectively) when compared with endometrial thickness and pattern. Doppler study of uterine arteries measured by 2D ultrasound does not reflect the blood flow to the endometrium measured by three-dimensional (3D) ultrasound with power Doppler. Conflicting results are reported with regard to their role in the prediction of pregnancy in IVF. Furthermore, endometrial and subendometrial blood flow measured by 3D ultrasound on the days of hCG and embryo transfer and the percentage change in these parameters between these 2 days were not predictive of pregnancy in IVF. On the other hand, the endometrial blood flow may give insight into a potential novel screening tool for assessing the risk of pregnancy induced hypertension or small for gestational age in women undergoing IVF. Ovarian stromal blood flow measured by 2D and 3D power Doppler ultrasound had no predictive value for the ovarian response during IVF. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Abulafia O, Sherer DM. Angiogenesis of the ovary. Am J Obstet Gynecol. 2000;182:240–6. Smith SK. Regulation of angiogenesis in the endometrium. Trends Endocrinol Metab. 2001;12:147–51. Ng EHY, Ho PC. The role of ultrasound parameters in the prediction of pregnancy during in vitro fertilization treatment. Expert Rev Obstet Gynaecol. 2008;3:503–14. Turnbull LW, Lesny P, Killick SR. Assessment of uterine receptivity prior to embryo transfer: a review of currently available imaging modalities. Hum Reprod Update. 1995;1:505–14. Friedler S, Schenker JG, Herman A, Lewin A. The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum Reprod Update. 1996;2:323–35. Raga R, Bonilla-Musoles F, Casan EM, Klein O, Bonilla F. Assessment of endometrial volume by three-dimensional ultrasound prior to embryo transfer: clues to endometrial receptivity. Hum Reprod. 1999;14:2851–4. Yaman C, Ebner T, Sommergruber M, Polz W, Tews G. Role of three-dimensional ultrasonographic measurement of endometrium volume as a predictor of pregnancy outcome in an IVF-ET program. A preliminary study. Fertil Steril. 2000;74:797–801. Schild RL, Knoblock C, Dorn C, Fimmers R, van der Ven H, Hansmann M. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril. 2001;75:361–6. Ng EHY, Yeung WSB, Ho PC. Endometrial and subendometrial vascularity significantly lower in patients with endometrial volume ≤2.5ml. Reprod Biomed Online. 2009;18:262–8. Jinno M, Ozaki T, Iwashita M, Nakamura Y, Kudo A, Hirano H. Measurement of endometrial tissue blood flow: a novel way to assess uterine receptivity for implantation. Fertil Steril. 2001;76:1168–74. Guerriero S, Ajossa S, Lai MP, Risalvato A, Paoletti AM, Melis GB. Clinical applications of colour Doppler energy imaging in the female reproductive tract and pregnancy. Hum Reprod Update. 1999;5:515–29. 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;57:372–6. Coulam CB, Bustillo M, Soenksen DM, Britten S. Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril. 1994;62:1004–10. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. Relationship between uterine blood flow and endometrial and subendometrial blood flow during stimulated and natural cycles. Fertil Steril. 2006;85:721–7. Zaidi J, Campbell S, Pittrof FR, Tan SL. Endometrial thickness morphology, vascular penetration and velocimetry in predicting implantation in an IVF program. Ultrasound Obstet Gynecol. 1995;6:191–8. Yuval Y, Lipitz S, Dor J, Achiron R. The relationship between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization. Hum Reprod. 1999;14:1067–71. Battaglia C, Artini PG, Giulini S, Salvatori M, Maxia N, Petraglia F, Volpe A. Colour Doppler changes and thromboxane production after ovarian stimulation with gonadotrophin-releasing hormone agonist. Hum Reprod. 1997;12:2477–82. Kupesic S, Bekavac I, Bjelos D, Kurjak A. Assessment of endometrial receptivity by transvaginal color Doppler and three-dimensional power Doppler ultrasonography in patients undergoing in vitro fertilization procedures. J Ultrasound Med. 2001;20:125–34. Yang JH, Wu MY, Chen CD, Jiang MC, Ho HN, Yang YS. Association of endometrial blood flow as determined by a modified colour Doppler technique with subsequent outcome of in-vitro fertilization. Hum Reprod. 1999;14:1606–10. Contart P, Baruffi RL, Coelho J, Mauri AL, Petersen C, Franco Junior JG. Power Doppler endometrial evaluation as a method for the prognosis of embryo implantation in an ICSI program. J Assist Reprod Genet. 2000;17:329–34. Chien LW, Au HK, Chen PL, Xiao J, Tseng CR. Assessment of uterine receptivity by the endometrial-subendometrial blood flow distribution pattern in women undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2002;78:245–51. Maugey-Laulon B, Commenges-Ducos M, Jullien V, Papaxanthos-Roche A, Scotet V, Commenges D. Endometrial vascularity and ongoing pregnancy after IVF. Eur J Obstet Gynecol Reprod Biol. 2002;104:137–43. Pairleitner H, Steiner H, Hasenoehrl G, Staudach A. Three-dimensional power Doppler sonography: imaging and quantifying blood flow and vascularization. Ultrasound Obstet Gynecol. 1999;14:139–43. Raine-Fenning NJ, Campbell BK, Clewes JS, Kendall NR, Johnson IR. The reliability of virtual organ computer-aided analysis (VOCAL) for the semiquantification of ovarian, endometrial and subendometrial perfusion. Ultrasound Obstet Gynecol. 2003;22:633–9. Raine-Fenning NJ, Campbell BK, Clewes JS, Kendall NR, Johnson IR. The interobserver reliability of three-dimensional power Doppler data acquisition within the female pelvis. Ultrasound Obstet Gynecol. 2004;23:501–8. Schild RL, Holthanus S, Alquen JD, Fimmers R, Dorn C, van der Ven H, Hansmann M. Quantitative assessment of subendometrial blood flow by three-dimensional-ultrasound is an important predictive factor of implantation in an in-vitro fertilization programme. Hum Reprod. 2000;15:89–94. Wu HM, Chiang CH, Huang HY, Chao AS, Wang HS, Soong YK. Detection of the subendometrial vascularization flow index by three-dimensional ultrasound may be useful for predicting the pregnancy rate for patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2003;79:507–11. Dorn C, Reinsberg J, Willeke C, Wendt A, van der Ven H, Schild RL. Three-dimensional power Doppler ultrasound of the subendometrial blood flow under the administration of a contrast agent (Levovist). Arch Gynecol Obstet. 2004;270:94–8. Järvelä IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol. 2005;26:765–9. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. The role of endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during in vitro fertilization treatment. Hum Reprod. 2006;21:164–70. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. Factors affecting endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound during in vitro fertilization treatment. Hum Reprod. 2006;21:1062–9. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. Comparison of endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound between stimulated and natural cycles in the same patients. Hum Reprod. 2004;19:2385–90. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. The role of endometrial and subendometrial vascularity measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during frozen-thawed embryo transfer cycles. Hum Reprod. 2006;21:1612–7. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. Endometrial and subendometrial vascularity is higher in pregnant patients with live birth following ART than in those who suffer a miscarriage. Hum Reprod. 2007;22:134–1141. Mercè LT, Barco MJ, Bau S, Troyano J. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome? Fertil Steril. 2008;1:111–7. Lai CW, Yung SS, Ng EH. Endometrial vascularity is lower in pregnancies with pregnancy-induced hypertension or small-for-gestational age in live birth after IVF. Ultrasound Obstet Gynecol. 2014;44:455–60. Raine-Fenning NJ, Campbell BK, Kendall NR, Clewes JS, Johnson IR. Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensional power Doppler angiography. Hum Reprod. 2004;19:330–8. Sharkey AM, Day K, McPherson A, Malik S, Licence D, Smith SK, Charnock-Jones DS. Vascular endothelial growth factor expression in human endometrium is regulated by hypoxia. J Clin Endocrinol Metab. 2000;85:402–9. Graham CH, Postovit LM, Park H, Canning MT, Fitzpatrick TE. Adriana and Luisa Castellucci award lecture 1999: role of oxygen in the regulation of trophoblast gene expression and invasion. Placenta. 2000;21:443–50. Ng EHY, Chan CCW, Tang OS, Yeung WSB, Ho PC. Changes in endometrial and subendometrial blood flows in IVF. Reprod Biomed Online. 2009;18:269–75. Engmann L, Sladkevicius P, Agrawal R, Bekir JS, Campbell S, Tan SL. Value of ovarian stromal blood flow velocity measurement after pituitary suppression in the prediction of ovarian responsiveness and outcome of in vitro fertilization treatment. Fertil Steril. 1999;71:22–9. Kupesic S, Kurjak A. Predictors of IVF outcome by three-dimensional ultrasound. Hum Reprod. 2002;17:950–5. Kupesic S, Kurjak A, Bjelos D, Vujisic S. Three-dimensional ultrasonographic ovarian measurements and in vitro fertilization outcome are related to age. Fertil Steril. 2003;79:190–7. Popovic-Todorovic B, Loft A, Lindhard A, Bangsboll S, Andersson AM, Andersen AN. A prospective study of predictive factors of ovarian response in ‘standard’ IVF/ICSI patients treated with recombinant FSH. A suggestion for a recombinant FSH dosage normogram. Hum Reprod. 2003;18:781–7. McGee EA, Hsueh AJ. Initial and cyclic recruitment of ovarian follicles. Endocr Rev. 2000;21:200–14. Redmer D, Reynolds L. Angiogenesis in the ovary. Rev Reprod. 1996;1:182–92. Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS. Power Doppler US: a potentially useful alternative to mean frequency-based color Doppler US. Radiology. 1994;190:853–6. Zaidi J, Barber J, Kyei-mensah A, Bekir J, Campbell S, Tan SL. Relationship of ovarian stromal blood flow at the baseline ultrasound scan to subsequent follicular response in an in vitro fertilization program. Obstet Gynecol. 1996;88:779–84. Bassil S, Wyns C, Toussaint-Demylle D, Nisolle M, Gordts S, Donnez J. The relationship between ovarian vascularity and the duration of stimulation in in-vitro fertilization. Hum Reprod. 1997;12:1240–5. Ng EHY, Tang OS, Chan CCW, Ho PC. Ovarian stromal blood flow in the prediction of ovarian response during in vitro fertilization treatment. Hum Reprod. 2005;20:3147–51. Ng EHY, Chan CCW, Tang OS, Ho PC. Ovarian stromal vascularity is not predictive of ovarian response and pregnancy. Reprod BioMed Online. 2006;12:43–9. Ng EHY, Fong DYT, Yeung WSB, Ho PC. Effects of age on hormonal and ultrasound markers of ovarian reserve in Chinese women with proven fertility. Hum Reprod. 2003;18:2169–74. Ng EHY, Chan CCW, Yeung WSB, Ho PC. Effect of age on ovarian stromal flow measured by three-dimensional ultrasound with power Doppler in Chinese women with proven fertility. Hum Reprod. 2004;19:2132–7. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2019 Springer Nature Switzerland AG About this chapter Cite this chapter Ng, E.H.Y. (2019). Two-Dimensional and Three-Dimensional Doppler in Reproductive Medicine. In: Stadtmauer, L., Tur-Kaspa, I. (eds) Ultrasound Imaging in Reproductive Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-16699-1_3 Download citation DOI: https://doi.org/10.1007/978-3-030-16699-1_3 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-16698-4 Online ISBN: 978-3-030-16699-1 eBook Packages: MedicineMedicine (R0)