Application Of Monitoring Ovarian And Uterine Blood Flow By Transvaginal Color Doppler Sonsography In Reproductive Technology

Objective: To apply transvaginal color Doppler sonography (TV-CDS) monitoring ovarian and uterine arteries blood flow and endometrial changes in women undergoing controlled ovarian hyperstimulation for in –vitro fertilization-embryo transfer(IVF-ET) to predict the reaction of ovary and uterine endometrium. Methods: 174 infertile women were received TV-CDS monitoring ovarian and uterine arteries blood flow and endometrial changes for detection of the development of follicles and endometrial morphological changes undergoing in vitro fertilization procedure in Nov 2002-Nov.2003. The pulsative index(PI) and resistance index(RI) of the ovarian and uterine arteries blood flow and endometrial pattern and thickness were measured by transvaginal color Doppler imaging on the day ofHCG administration. Results: 174 cases were divided into two groups, the conception (55 cases) and nonconception(119 cases) groups. There were no significant differences in the causes of infertility, age, dose of drug, period of using drug, retrieved mature ova and number of embryos between two groups. But the ovarian and uterine arteries RI and PI of the conception group were significantly lower thanthe nonconception group, P<0.05. The endometrial thickness of both groups had no differences. But the endometrial pattern had significance to the endometrial receptivity. The highest pregnant rate 46.25%(37/80) was in pattern A cases, it higher than pattern B 20% and pattern C 17.9%.Conclusions: The lower ovarian and uterine arteries RI and PI revealed the increasing of blood supply in ovaries and uterus. Thus it could cause growth of good ova and better embryos development. Therefore the pregnant rate will be increased.The uterine endometrial pattern was related to the success of pregnancy. We suggested that why the pattern A had higher pregnant rate because of the pattern A endometriam had more blood vascular supply and could improve endometrial development becoming more soft, velvety and spongy like. Thus the endometrium might increase the receptivity and also the pregnant rate.