Uterine Artery and Endometrial Vascularity Doppler Indices and Pregnancy Outcome in ICSI

Abstract

Background: Good blood flow within uterine arteries and endometrium is important for implantation this
study was conducted to determine the role of Doppler indices in prediction of pregnancy outcome during
evaluation of ICSI women .Material and Method: It was case control study. 60 infertile women were included
in the study and prepared for IVF-ET/ICSI, . All the patients underwent controlled ovarian stimulation, and
evaluated by Transvaginal ultrasound and measurements performed on day oocyte retrieval and on day
embryo transfer. Assessment of endometrial thickness, pattern and grade of vascularity zones, peak systolic
velocity (PSV), end diastolic velocity (EDV), systolic/diastolic ratio, resistance index (RI), and pulsatility
index for both uterine arteries and endometrial vessles.
Result: 30 women are pregnant and 30 women, there was significant differences at a cut value of endometrial
thickness of > 8 mm between pregnant and non pregnant groups(27 (90 %) versus 20 (66.7 %) with 0.015
p value at day of oocyte retrieval and (27 (90 %) versus 20 (66.7 %) with P value of 0.28 at day of embryo
transfer), pregnant women are limited to zone II and III with mainly zone III while non pregnant are mainly
zone II. four cases has absent endometrial vascularity at day of embryo transfer, no one of them get pregnancy,
there is significant difference in day of embryo transfer regarding endometrial RI being lower in pregnant.
Significant differences in uterine PSV and high significant difference in uterine EDV at embryo transfer day.
Conclusion: Endometrial thickness of 8 mm., with vascularity zone III at day of oocyte retrieval and embryo
transfer are significant for positive pregnancy outcome, absent endometrial and sub endometrial vascularity
at day of embryo transfer predict poor outcome of pregnancy .