Uterine artery blood flow and microvessel density by vaginal color Doppler ultrasonography in embryo implantation failure

Abstract

The purpose of this study was to investigate the clinical application of uterine artery blood flow parameters by vaginal color Doppler ultrasonography in patients with repeated embryo implantation failure and to examine the correlation between uterine artery blood flow parameters and microvessel density (MVD). We monitored the outcomes of in vitro fertilization and embryo transfer in eighty patients. We divided the patients into two groups: Pregnancy (successful pregnancy, n=50) and repeated implantation failure (more than two failures of in vitro fertilization-embryo transfer, n=30). The patients were subjected to vaginal color Doppler ultrasonography to measure endometrial thickness, peak systolic velocity/end diastolic velocity (S/D), pulsatility index (PI), resistance index (RI), and other uterine artery blood flow parameters. We found no significant differences in endometrial thickness (human chorionic gonadotropin endometrial thickness) and uterine artery blood flow parameters (S/D, PI) between the two groups. The RI value of endometrial blood flow was significantly higher in the repeated implantation failure group than that in pregnancy group. The endometrium MVD in the repeated implantation failure group was significantly lower than that of the pregnancy group. Spearman correlation analysis showed that S/D value of uterine artery blood flow in repeated implantation failure group was not correlated with MVD or uterine artery blood flow PI, but was positively correlated with RI. Endometrium MVD in patients with repeated implantation failure was significantly lower than that in patients with successful pregnancy during the implantation window. We also found a significant difference in uterine artery blood flow RI between the two groups. The uterine artery blood flow RI in patients with repeated implantation failure was positively correlated with MVD, which has clinical significance in predicting the outcome of embryo transfer.

Decreased ANGPTL4 impairs endometrial angiogenesis during peri‐implantation period in patients with recurrent implantation failure

“…Accordingly, we conducted uterine arterial blood flow measuring on women undergoing IVF and noted that the UAI of some RIF patients was relatively elevated. Notably, previous studies have found that the uterine artery PI and subendometrial blood flow RI were higher in RIF patients than controls, meanwhile the waveform pattern of uterine artery altered in patients reporting RIF 23 . However, in the current study, the recruited women who conceived in the control group may show some minor differences in UAI compared with fertile women due to the application of hormones and other drugs during IVF treatment.…”

“…Notably, previous studies have found that the uterine artery PI and subendometrial blood flow RI were higher in RIF patients than controls, meanwhile the waveform pattern of uterine artery altered in patients reporting RIF. 23 However, in the current study, the recruited women who conceived in the control group may show some minor differences in UAI compared with fertile women due to the application of hor- PRL mRNA levels in peri-implantation endometrial tissues, suggesting impaired decidualization in RIF patients. Insufficient endometrial angiogenesis is associated with increased resistance to endometrial blood flow from uterine artery.…”

“…It has been shown that blockade of VEGFR‐1 disrupts decidual angiogenesis during WOI, 37 while COX2‐derived prostaglandins target the VEGF system, which is important for uterine angiogenesis during implantation and decidualization 38 . In addition, endometrial angiogenesis during pregnancy facilitates embryo implantation and improves pregnancy success rate 23 . In the current study, to further explore the role of ANGPTL4 in angiogenesis, cell proliferation assay, wound‐healing assays and tube formation assay were performed on HUVECs after siRNA‐mediated knockdown of ANGPTL4.…”

Analysis of 14-bp HLA-G polymorphism in middle-eastern women with recurrent implantation failure

“…3 RIF is a form of refractory infertility with unknown aetiology, and it is defined as a failure to achieve a clinical pregnancy after transfer of four or more goodquality embryos in a minimum of two IVF cycles in a woman under the age of 40. 4 The failure of implantation may be a consequence of embryo factors (genetics, sperm contribution, and immunologic factors) or uterine factors (uterine anatomy, endometrium, and thrombophilia), whereas the causes of RIF are still poorly known. 5 It has been suggested that the abnormal maternal expression of genes associated with angiogenesis, immunity and apoptosis interferes with successful implantation.…”

Ultrasonic and dopplerometric characteristics of chronic endometritis of women with infertility and miscarriage

“…It's necessary to understand that in the case of chronic endometritis ultrasonic diagnostics allows to reveal the inflammatory process so much as its consequences, which are shown as structural and anatomical modifications of uterus. During ultrasonic diagnostics it's absolutely important to determine risk factors, as we can observe different ultrasound features in each specific situation (5,6).…”