ABSTRACT
Background: infertility is customarily defined as the inability to conceive after 1 year of regular unprotected intercourse. The infertility evaluation is typically initiated after 1 year of trying to conceive, but in couples with advanced female age [> 35 years], most practitioners initiate diagnostic evaluation after an inability to conceive for 6 months
Aim of the Work: to assess endometrial receptivity in women with unexplained infertility using sub-endometrial vascular flow resistant index and endometrial leukemia inhibitory factor [LIF]
Patients and Methods: this clinical controlled trial was conducted at Ain Shams University Maternity Hospital during the period from August 2014 to September 2017 on 140 patients divided into two equal groups: Group I [study group]: women with unexplained infertility defined as inability to conceive inspite of regular marital life for at least 12 months. Group II [control group]: matched women with infertility due to tubal factor, recruited from outpatient gynecology or infertility clinic at Ain Shams University Maternity Hospital
Results: a cutoff value for LIF staining score of 0.71 for subendometrial blood flow RI predicted unexplained infertility with a sensitivity of 70.67% and specificity of 86.67%. A cutoff of
Conclusion: leukemia inhibitory factor may be a predictor for unreceptive endometrium in cases of unexplained infertility. Subendometrial blood flow RI and endometrial thickness may be used rather than LIF IHC [due to its invasive nature]for the prediction of endometrial factor status in cases of unexplained infertility because of the statistically significant negative correlation between the above parameters
Recommendations: further studies are needed to evaluate the predictive value of the multiple logistic model including [endometrial thickness, subendometrial blood flow color Doppler and LIF IHC score and even other proposed cytokines as VEGF, IL6 and integrins] in unexplained infertility