[en] The changes in uterine artery blood flow in women undergoing in-vitro fertilization cycles were studied throughout stimulation after gonadotrophin-releasing hormone (GnRH) desensitization. The data obtained showed that the uterine vascularity was related to hormonal changes. The GnRH agonist effect was seen only after the third week of administration, and the uterine perfusion was significantly (P = 0.002) improved by the oestradiol secretion. Human chorionic gonadotrophins increased the resistance index (RI) significantly (P = 0.0001) for a period of 48 h. Then the progesterone secretion modified the curve with a significant improvement in the uterine blood flow (P = 0.03). Comparison of the RI value 2 days before human menopausal gonadotrophin (HMG) commencement, in patients with and without pregnancy, showed a higher RI in patients who did not conceive but no difference was observed on the day of embryo transfer. The pregnancy rates were similar whatever the range of the RI observed. The data available so far suggest that haemodynamic parameters alone, detected by Doppler sonography, do not provide full information on endometrial receptivity on the day of embryo transfer. A resistance index > 0.79 before HMG commencement seems to indicate poor uterine vascularity and may necessitate an increase in the HMG doses to prevent endometrial immaturity.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Bassil, Salim
Magritte, Jean-Philippe
Roth, Jurgen
NISOLLE, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR
Donnez, Jacques
Gordts, Stéphane
Language :
English
Title :
Uterine vascularity during stimulation and its correlation with implantation in in-vitro fertilization.
Abdalla, H.I., Brooks, A.A., Johnson, M.R., Kirkland, A., Thomas, A. and Studd J.W.W. (1994) Endometrial thickness: a predictor of implantation in ovum recipient? Hum. Reprod., 9, 363-365.
Asch, R.H., Siler-Khodr, T.M., Smith, C.G. and Schally, A.V (1981) Luteolytic effect of D-Trp6-luteinizing hormone-releasing hormone in the rhesus monkey (Macaca mulata). J. Clin. Endocrinol. Metab., 52, 565-571.
Bramley, T.A., Menzies, G.S. and Baird, D.T. (1986) Specifictiy of gonadotrophin-releasing hormone binding sites of the human corpus luteum: comparison with receptors of rat pituitary gland. J. Endocrinol., 108, 323-328.
Cacciatore, B., Kurunmäki, H., Ratsula, K., Lähteenmäki, A. and Hovatta, O. (1990) Transvaginal doppler monitoring of uterine and ovarian blood flow during induction of superovulation for IVF. Hum. Reprod., 5 (Suppl.), 37.
Cohen, J., Inge, K.L., Suzman, M., Wiker, S.R. and Wright, G. (1989) Videocinematography of fresh and cryopreserved embryos: a retrospective analysis of embryogénie morphology and implantation. Fertil. Steril., 51, 820-827.
Damewood, M.D., Shen, W., Zacur, H.A., Schlaff, W.D., Rock J.A. and Wallach E.E. (1989) Disappearance of exogenously administered human chorionic gonadotrophin. Fertil. Steril., 52, 398-400.
Dickey, R.P., Olar, T.T., Taylor, S.N., Curole, D.N. and Harrigill, K. (1993) Relationship of biochemical pregnancy to pre-ovulatory endometrial thickness and pattern in patients undergoing ovulation induction. Hum. Reprod., 8, 327-330.
Fleisher, A.C., Herbert, C.M., Sacks, G.A., Wentz, A.C., Entman, S.S. and James, A.E. (1986) Sonography of the endometrium during conception and non-conception cycles in in-vitro fertilization and embryo transfer. Fertil. Steril., 46, 442-447.
Glissant, A., de Mouzon, J. and Frydman, R. (1985) Ultrasound study of the endometrium during in-vitro fertilization cycles. Fertil. Steril., 44, 786-790.
Gonen, Y., Casper, R.F, Jacobson, W. and Blankier, J. (1989) Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in-vitro fertilization. Fertil. Steril., 52, 446-450.
Goswamy, R.K. and Steptoe, RC. (1988) Doppler ultrasound studies of the uterine artery in spontaneous ovarian cycles. Hum. Reprod., 3, 721-726.
Goswamy, R.K., Williams, G. and Steptoe, P.C. (1988) Decreased uterine perfusion—a cause of infertility. Hum. Reprod., 3, 955-959.
Greiss, F., Rose, J., Kute, T., Kelly, R. and Winkler, L. (1986) Temporal and receptor correlates of the oestrogen response in sheep. Am. J. Obstet. Gynecol., 154, 831-838.
Jackson, A.E., Curtis, R, Amso, N. and Shaw, R.W. (1992) Exposure to LHRH agonists in early pregnancy following the commencement of mid-luteal buserilin for IVF stimulation. Hum. Reprod., 7, 1222-1224.
Khalifa, E., Brzyski, R.G., Olhninger, S., Acosta, A.A. and Muasher, S.J. (1992) Sonographic appearance of the endometrium: the predictive value for the outcome of in-vitro fertilization in stimulated cycles. Hum. Reprod., 6, 677-680.
Kurjak, A., Kupesic-Urek, S., Schulman, H. and Zalud, I. (1991) Transvaginal colour flow Doppler in the assessment of ovarian and uterine blood flow in infertile women. Fertil. Steril., 56, 870-873.
Medeiros, Y.S., Calixto, J.B. and Ballejo, G. (1988) Inhibitory effect of GnRH on isolated rat uterine muscle contractility. Life Sei., 42, 2055-2062.
Reddy, P.R., Rao, I.M., Raju, U.S., Rukmini, V. and Reddy, R.L. (1985) Direct inhibitory actions of GnRH on accessory reproductive organs of rat. J. Steroid Biochem., 23, 819-822.
Sandow, J. (1983) Clinical applications of LHRH and its analogues. Clin. Endocrinol., 18, 571-592.
Scholtes, M.W., Wladimiroff, J.W., Van Rijen, H.M. and Hop, W.J. (1989) Uterine and ovarian flow velocity waveforms in the normal menstrual cycle: a transvaginal Doppler study. Fertil. Steril., 52, 981-985.
Shapiro, H., Cowell, C. and Casper, R.F. (1993) The use of vaginal ultrasound for monitoring endometrial preparation in a donor oocyte program. Fertil Steril., 59, 1055-1058.
Smith, B., Porter, R., Ahuja, K. and Craft, I. (1984) Ultrasonic assessment of endometrial changes in stimulated cycles in an in- vitro fertilization and ET program. J. In Vitro Fertil. Embryo Transfer, 1, 233-238.
Smitz, J., Camus, M., Devroey, R, Bollen, N., Tournage, H. and Van Steirteghem, A.C. (1991) The influence of inadvertent intranasal buserelin administration in early pregnancy. Hum. Reprod., 6, 290-293.
Steer, C.V., Campbell, S., Pampiglione, J., Kingsland, C.R., Mason, B. and Collins, W.P (1990) Transvaginal colour flow imaging of the uterine arteries during the ovarian and menstrual cycles. Hum. Reprod., 5, 391-395.
Steer, C.V., Campbell, S., Tan, S.L., Crayford, T., Mills, C., Mason, B.A. and Collins, W.P. (1992) The use of transvaginal colour flow imaging after in vitro fertilization to identify optimum uterine conditions before embryo transfer. Fertil. Steril., 57, 372-376.
Steer, C.V., Tan, S.L., Mason, B.A. and Campbell, S. (1994) Midluteal- phase vaginal colour doppler assessment of uterine artery impedance in a subfertile population. Fertil. Steril., 61, 53-58.
Sterzik, K., Grab, D., Sasse, V, Hiitter, W., Rosenbusch, B. and Terinde, R. (1989) Doppler sonographic findings and their correlation with implantation in an in-vitro fertilization program. Fertil. Steril., 52, 825-828.
Taylor, K.J.W., Bums, P.N., Wells, P.N.T., Conway, D.I. and Hull, M.G.R. (1985) Ultrasound doppler flow studies of the ovarian and uterine arteries. Br. J. Obstet. Gynaecol., 92, 240-246.
Thaler, I., Manor, D., Brandess, J., Rottem, S. and Itskovitz, J. (1990) Basic principles and clinical applications of the transvaginal doppler duplex system in reproductive medicine. J. In Vitro Fertil. Embryo Transfer, 7, 74-85.
Van de Wiele, R.I., Bogumil, J., Dryenfurth, I., Ferin, M., Jewelwicz, R., Warren, M., Rizkallah, T. and Mikhail, G. (1970) Mechanisms regulating the menstrual cycle in women. Recent Prog. Horm. Res., 26, 63-103.