EP11.02: Ultrasound of spiral arteries in assessing endometrial receptivity in infertile women with adenomyosis taking low‐dose acetylsalicylic acid

The aim of this study was to evaluate the effect of acetylsalicylic acid (ASA) on subendometrial blood flow in infertile women with adenomyosis. Adenomyosis is a benign uterine pathology of the uterus in which the endometrium cells grow into the myometrium, often associated with infertility. Vascularisation of the female reproductive system seems to play an important role in the uterine receptivity. In the uterus, angiogenesis is essential for endometrial growth and maturation. 25 infertile patients with adenomyosis and 19 infertile patients with adenomyosis receiving low-dose ASA (75 mg/d) were included in the study. All patients were less than 32 years old, had body mass indices between 19 and 32 and serum FSH and LH levels below 10 IU/l in the early proliferative phase. The following sonographic criteria for diagnosing adenomyosis were used: heterogeneous myometrial structure with hypoechoic areas, small anechoic lakes, asymmetrical uterine enlargement, indistinct endometrial-myometrial border. Both groups received identical clomifene citrate regimen for ovarian stimulation. The mean spiral artery pulsatility index values (PI), resistance index values (RI) and peak systolic velocity (PSV) were estimated in the mid-luteal phase of the menstrual cycle. The area of interest was defined as the subendometrial area within 5 mm of the endometrial borders. The obtained values were compared using one-way ANOVA. Mean spiral artery PI values were significantly decreased (subendometrial blood flow was increased) in infertile patients with adenomyosis receiving ASA in comparison to the patients not treated with ASA: 0.96 (0.93–1.21) vs. 1.22 (1.01–1.38); p < 0.01. No significant differences were found in spiral artery RI and PSV between the groups. Low-dose acetylsalicylic acid significantly improves subendometrial blood flow in infertile women with adenomyosis.