Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases

Tan, Shuyin; Hang, F; Purvarshi, Gowreesunkur; Li, Min-Qing; Meng, Dahua; Huang, Lingling

doi:10.1016/j.tjog.2014.10.008

Cited by 24 publications

(28 citation statements)

References 21 publications

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“…The present study demonstrated that there are some differences in endometrial thickness, volume, VI, FI, and VFI and subendometrial VI, FI, and VFI between women with normal endometrium and those with endometrial lesions. Endometrial thickness is commonly used to estimate endometrial function, and some studies have shown that endometrial thickness, volume and VI, FI, and VFI can be used to evaluate endometrial receptivity among women undergoing assisted reproduction . However, whether endometrial volume and 3D PD characteristics can be used to evaluate endometrial function is largely unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Endometrial thickness is commonly used to estimate endometrial function, and some studies have shown that endometrial thickness, volume and VI, FI, and VFI can be used to evaluate endometrial receptivity among women undergoing assisted reproduction. [16][17][18] However, whether endometrial volume and 3D PD characteristics can be used to evaluate endometrial function is largely unknown. In the present study, endometrial thickness and volume differed between women with normal endometrium and those with endometrial lesions, but endometrial and subendometrial VI, FI, and VFI were similar between the two groups.…”

Section: Noted An 11%mentioning

confidence: 99%

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Three‐dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

Han

Liang

et al. 2019

Intl J Gynecology & Obste

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Objective To assess three‐dimensional (3D) ultrasound combined with power Doppler (PD) for the differential diagnosis of endometrial lesions among infertile women. Methods A prospective study carried out at a reproductive medicine center in Luoyang, China, between January and December 2015. The inclusion criteria were asymptomatic infertility with normal endometrium or specific endometrial lesions. Participants were subdivided by whether they had normal endometrium (group 1, n=357), or endometrial lesions including polyps, hyperplasia, intrauterine adhesions, or endometritis (group 2, n=99). 3D PD and hysteroscopy were performed in the follicular phase. Endometrial thickness, volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI), and subendometrial VI, FI, and VFI were calculated. Endometrial lesions were confirmed by pathologic analysis. Results The overall prevalence of endometrial lesions was 99/456 (21.3%). Endometrial thickness and volume were significantly larger in group 2 than in group 1 (9.96 ± 3.24 vs 8.15 ± 2.50 mm and 3.70 ± 2.54 vs 2.42 ± 1.64 cm3, respectively; both P<0.001). Endometrial thickness and volume were larger among women with endometrial polyps and hyperplasia; endometrial VI, FI, and VFI were lower among women with intrauterine adhesions. Conclusion Three‐dimensional PD has value for the differential diagnosis of endometrial lesions among infertile women. Clinical trial registration The trial is registered in the Chinese Clinical Trial Registry as ChiCTR1800015799.

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Section: Discussionmentioning

confidence: 99%

Section: Noted An 11%mentioning

confidence: 99%

Three‐dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

Han

Liang

et al. 2019

Intl J Gynecology & Obste

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“…Uterine artery is the main source of uterine blood supply and plays an important role in the maintenance of adequate uterine perfusion (Table S1). Our previous study and other studies have shown that the impedance to uterine artery blood flow is higher in RPL patients, which is detrimental to the localized vascularization of the endometrium, leading to inadequate uterine perfusion, even affects the maternal–fetal blood circulation . In addition, studies have found a significantly increased resistance to uterine artery blood flow in RPL patients with antiphospholipid syndrome (APS), Müllerian uterine anomalies or unexplained etiology in comparison to those in the control group .…”

Section: Introductionmentioning

confidence: 81%

“…Our previous study and other studies have shown that the impedance to uterine artery blood flow is higher in RPL patients, which is detrimental to the localized vascularization of the endometrium, leading to inadequate uterine perfusion, even affects the maternal-fetal blood circulation. [6][7][8][9] In addition, studies have found a significantly increased resistance to uterine artery blood flow in RPL patients with antiphospholipid syndrome (APS), Müllerian uterine anomalies or unexplained etiology in comparison to those in the control group. 7,10 And some researchers believed that inadequate uterine artery blood perfusion could play a critical role in the pathogenesis of RPL.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss

Yang

et al. 2019

J of Obstet and Gynaecol

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Aim To study the association in resistance to uterine artery blood flow and recurrent pregnancy loss (RPL) and find its potential influencing factors. Methods A retrospective study was conducted in 870 RPL and 237 non‐RPL patients visiting to the Clinic from January 2014 to February 2018. All participants underwent comprehensive examinations and were scanned by transvaginal Doppler ultrasonography during the midluteal phase to measure the pulsatility index (PI), resistance index (RI) and systolic/diastolic ratio (S/D) values of the left and right main uterine arteries. P value less than 0.05 was considered statistically significant. Results The mean PI, RI and S/D values for uterine arteries were significantly higher in RPL patients than in non‐RPL patients (P < 0.001). When subjects were grouped according to the different etiologies of RPL, significant higher indices of uterine arteries were found in RPL patients with antiphospholipid syndrome (P < 0.001), autoimmune diseases (P < 0.001), endocrinological abnormalities (P < 0.05), thrombophilia (P < 0.001), uterine anomalies (P < 0.01) and unexplained RPL (P < 0.001). No differences were found between patients with chromosomal anomalies and uterine arteries blood flow (P > 0.05). In RPL patients, mean PI, mean RI and mean S/D values shows no difference among groups (P > 0.05). The Similar results were observed in age and number of spontaneous abortion (P > 0.05). Conclusion Impaired uterine artery blood perfusion may be an underlying pathology to RPL, and it can be used as an independent risk factor for pregnancy failure.

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“…These pathological responses may dramatically increase the proportion of collagen fibers in the endometrium and, as a result, the blood flow in the endometrium reduces, the endometrium becomes thinner, and the EV reduces. Studies have shown that the endometrial thickness, EV, VFI, and other parameters in abortion patients are significantly lower than in normal pregnant subjects [23][24][25]. Most previous studies about endometrial receptivity evaluated one or some of the indicators including endometrial thickness, endometrial type, endometrial peristaltic wave, blood flow, volume, and VFI.…”

Section: Discussionmentioning

confidence: 99%

Application of ultrasound multimodal score in the assessment of endometrial receptivity in patients with artificial abortion

et al. 2020

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Background: This study aimed to evaluate the value and feasibility of ultrasound multimodal score in the evaluation of endometrial receptivity in patients with artificial abortion (AA). Methods: Sixty-eight patients with AA (AA group) and 70 women of the childbearing age without any history of abortion (control group) were recruited between January 2018 and December 2018. All subjects received the examination of endometrium in the middle luteum phase (7-9 days after ovulation) with two-dimensional grayscale ultrasound, two-dimensional color Doppler ultrasound, and three-dimensional ultrasound, and the quantitative scores were obtained and compared between two groups. Results: The quantitative score of endometrial receptivity was 10.46 ± 2.99 in the AA group and 13.49 ± 2.21 in the control group showing significant difference (p < 0.05). Conclusions: Ultrasound multimodal quantitative scores can be used to evaluate the endometrial receptivity of patients with AA.

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Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases

Abstract: The 3D-power Doppler ultrasound is a more comprehensive and sensitive method for evaluating endometrial receptivity. Endometrial volume, VI, FI, and VFI in the midluteal phase, as well as VI in early pregnancy, can be considered as predictive factors for recurrent miscarriage.

Cited by 24 publications

References 21 publications

Three‐dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

Three‐dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss

Application of ultrasound multimodal score in the assessment of endometrial receptivity in patients with artificial abortion

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