Human Reproduction, Vol. 17, No. 1, 190-194,
January 2002
© 2002 European Society of Human Reproduction and Embryology
Elevated blood flow resistance in uterine arteries of women with unexplained recurrent pregnancy loss
Department of Obstetrics and Gynaecology, Okayama University Medical School, Okayama City, Okayama, Japan
BACKGROUND: Uterine perfusion appears to regulate uterine receptivity. However, vascular changes in recurrent pregnancy loss (RPL) remain poorly studied. METHODS: One hundred and twentyone women were enrolled into this study: normal women with sterility caused by male factor (control group: n = 72) and women with RPL (n = 49). Women with uterine anomaly, impaired glucose tolerance, abnormal thyroid function, or anti-phospholipid antibodies were excluded from the study. In the mid-luteal phase of a non-pregnant cycle, transvaginal pulsed Doppler ultrasonography of the uterine artery was performed. Uterine arterial pulsatility index (PI), endometrial thickness, serum estradiol, progesterone, and nitrite/nitrate concentrations were determined. RESULTS: In the RPL group, the PI in the uterine artery of women with antinuclear antibodies was significantly higher than that of women without antinuclear antibodies (P < 0.05). Among women without antinuclear antibodies, the mean (±SD) uterine artery PI in the RPL group (2.44 ± 0.41) was also significantly higher than in the control group (2.19 ± 0.40; P < 0.01). The PI was inversely correlated with serum progesterone levels (r = -0.47, P < 0.01). CONCLUSIONS: Elevated uterine arterial impedance is associated with RPL. Pulsed Doppler ultrasonography is useful in identifying women with unexplained RPL who have impaired uterine circulation.
Key words: progesterone/pulsed Doppler ultrasonography/recurrent pregnancy loss/uterine artery/uterine receptivity
1 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Okayama University Medical School, 2–5–1 Shikata, Okayama City, Okayama, 700-8558, Japan. E-mail: mikiya{at}cc.okayama-u.ac.jp
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