Clinical Usefulness of Uterine Artery Blood Flow by Transvaginal Color Doppler Ultrasound on the Day of Oocyte Retrieval in an In Vitro Fertilization Program / 대한산부인과학회잡지

ABSTRACT

This study was performed to assess whether measurement of uterine artery blood flow impedance(the pulsatility index[PI] and resistance index [RI]) as determined by transvaginal color Doppler ultrasound on the day of oocyte retrieval in patients undergoing in vitro fertilization (IVF) can predict successful pregnancy. From August 1995 to January 1997, ninety-two infertile women with tubal or peritoneal factor infertility who had undergone IVF during controlled ovarian hyperstimulation(COH) cycles were allocated to the study group. The COH using luteal long protocol of GnRH agonist was used in all patients. Transvaginal color Doppler assessment of uterine artery blood flow impedance(PI and RI) on the day of oocyte retrieval was done. When the patients were grouped into pregnant(n=31) and nonpregnant(n=61), the mean value of PI and RI of the nonpregnant group were significantly higher than those of the pregnant group(2.86+/-0.62 vs 2.47+/-0.35 and 0.88+/-0.05 vs 0.85+/-0.04). The patients were also grouped according to whether the PI was low(1.00 to 1.99), medium(2.00 to 2.99), or high(>or=3.00). The pregnancy rate were 33.3%, 44.8% and 10.7% for the low, medium, and high PI groups, respectively, and the pregnancy rate of the medium PI group was significantly higher than that of high PI group. The embryo implantation rates were 11.5%, 15.2% and 4.0% for the low, medium, and high PI groups, respectively, and the implantation rate of medium PI group was significantly higher than that of the high PI group, too. There was no correlation between the mean PI and RI value and serum E2 concentration on the day of hCG administration, or endometrial thickness measured on the day of oocyte retrieval. In conclusion, we fond that the measurements of uterine artery blood flow impedance(PI and RI) on the day of oocyte retrieval might predict subsequent pregnancy and implantation rates and also contribute much to effective management of infertile couples.