Measurement of uterine artery blood flow, sub-endometrial blood flow, endometrial thickness and pattern by 2D Doppler ultrasound on the day of HCG injection as a method of predicting pregnancy in ICSI program

Abstract

Aim of the work: To evaluate the role of endometrial thickness, pattern and sub-endometrial blood flows measured by 2D power Doppler ultrasound to predict pregnancy during IVF/ICSI treatment. Patients and methods: This was a prospective clinical study. A total of 70 infertile women were recruited from the Assisted Reproduction Technology unit of Ain Shams University Maternity Hospital during the period from September 2015 to April 2016. Women with male factor, tubal factor, ovarian factor and unexplained infertility were included in the study. Results: The mean age was 28.5 years and the mean duration of infertility is 6.1 years. Fifty eight (82.9%) patients had primary infertility and twelve (17.1%) had secondary infertility. The mean endometrial thickness was 11.9 mm. Sixty two women had triphasic pattern (88.6%), four women had isoechoiec pattern (5.7%) and four had hyperechoiec pattern (5.7%). On evaluating the sub-endometrial blood flow; the mean PI is 1.03, the mean RI is 0.63 and the mean S/D ratio is 2.51. The mean uterine a. PI is 2.18, the mean RI is 0.89, and the mean S/D ratio is 8.29. Overall, 32 (45.7%) patients conceived and in these women the endometrial pattern was triphasic and the mean sub-endometrial PI was 0.96, and those were the statistically significant parameters. Conclusion: Endometrial pattern and sub-endometrial PI measured on the day of HCG injection have value in judging endometrial receptivity and predict the final outcome of IVF/ ICSI- ET. Other ultrasound and Doppler parameters did not differ between pregnant and non-pregnant patients in IVF/ICSI cycles, so they cannot predict the likelihood of pregnancy in stimulated cycles of IVF/ICSI.