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Hum. Reprod. Advance Access originally published online on December 5, 2006
Human Reproduction 2007 22(4):1134-1141; doi:10.1093/humrep/del458
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Endometrial and subendometrial vascularity is higher in pregnant patients with livebirth following ART than in those who suffer a miscarriage

Ernest Hung Yu Ng1, Carina Chi Wai Chan, Oi Shan Tang, William Shu Biu Yeung and Pak Chung Ho

Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China

1 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong. Tel: + 86 852 28553400; Fax: + 86 852-28175374; E-mail: nghye{at}hkucc.hku.hk

BACKGROUND: Blood flow towards the peri-implantation endometrium may have effects on miscarriage and live birth following assisted reproduction treatment, in addition to its role in implantation.

METHODS: Three-dimensional ultrasound examination with power Doppler was performed on the day of oocyte retrieval in stimulated IVF cycles and on LH + 1 day in frozen thawed-embryo transfer (FET) cycles to measure endometrial thickness, endometrial pattern, uterine artery Doppler flow indices, endometrial volume, vascularization index (VI), flow index (FI), vascularization flow index (VFI) of endometrial and subendometrial regions.

RESULTS: In stimulated IVF cycles, 45 (28.0%) out of 161 pregnant patients subsequently miscarried. Patients in the live birth group had significantly higher endometrial VI and VFI and subendometrial VI, FI and VFI, when compared with those in the miscarriage group. In a multiple logistic regression analysis, only endometrial VI was significantly associated with the chance of live birth with an odds ratio of 1.384 [95% confidence interval (CI) 1.025–1.869, P = 0.034]. For FET cycles, patients in the live birth group had significantly higher endometrial VFI, subendometrial VI and VFI than those in the miscarriage group.

CONCLUSIONS: Endometrial and subendometrial vascularity was significantly higher in pregnant patients with live birth following stimulated IVF and FET treatment than in those who suffered a miscarriage.

Key words: endometrial and subendometrial vascularity/live birth/miscarriage/3D power Doppler

Submitted on July 24, 2006; resubmitted on October 25, 2006; accepted on October 31, 2006.


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