Color doppler study of the subendometrial area [junctional zone] of the uterus in unexplained infertility

ABSTRACT

A case control study aiming to study endometrial perfusion and receptivity in unexplained infertility as it is simple and is available in many radiological clinics. Thirty-five cases of unexplained infertility and 16 fertile females were submitted, in the midluteal phase of the menstrual cycle; to Color Doppler study of the subendometrial area which is the inner most part of the myometrium, 5 mm outside the echogenic basal layer of the endometrium. Study of vascularization of this area showed that, blood flow was detected in 51.4% of the group of unexplained and 93.8% of the control group. The difference is statistically significant. Mean pulsatility index [P1] in the subendometrial arteries, if detected by color flow mapping was 2.65 +/- 0.37 in unexplained infertility and 1.95 +/- 0.24 in control group. The difference is statistically significant. The mean peak systolic velocity [PSV] in the subendometrial arteries in unexplained infertility was 0.29 +/- 0.0, 02 m/second and in the control group was 0.42 +/- 0.03 m/second. The difference is statisically significant. Our color Doppler study of the uterine arteries showed also that P1, resistance index [RI] are higher and PSV was lower in unexplained infertility than in control ferile group. Our study showed that in midluteal phase of the menstrual cycle in patients with unexplained infertility blood perfusion of the subendometrial area was impaired. Blood perfusion of the endometrium was also impaired as the blood supply to it passes through the subendometrium area. A possible treatment of these patients is uterine perfusion enhancers as sildenafil [Viagra], low dose aspirin and glyceryl trinitrate