Relationship between temporal changes of endometrial blood flow impedance during natural and hormone replacement cycles and prediction of pregnancy during vitrified‐warmed embryo transfer

2021 ◽  
Author(s):  
Kuniaki Ota ◽  
Satoru Shiraishi ◽  
Toshifumi Takahashi
Keyword(s):  
Blood Flow ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Temporal Changes ◽  
Flow Impedance ◽  
Endometrial Blood Flow

scholarly journals The role of temporal changes in endometrial blood flow in natural and hormone replacement cycles with vitrified-warmed embryo transfer

2019 ◽  
Author(s):  
Kuniaki Ota ◽  
Toshifumi Takahashi ◽  
Satoru Shiraishi ◽  
Hideki Mizunuma
Keyword(s):  
Blood Flow ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Follicular Phase ◽  
Natural Cycle ◽  
Uterine Blood Flow ◽  
Early Follicular Phase ◽  
Endometrial Blood Flow ◽  
Hcg Trigger ◽  
Natural Cycles

Abstract Background Uterine blood flow promotes endometrial development and subsequent implantation of fertilized eggs. We examined the temporal changes in uterine blood flow during natural and hormone replacement (HRT) cycles and clarified the relationship between uterine blood flow and assisted reproductive technology outcomes for vitrified-warmed embryo transfer (ET). Methods This was a retrospective cohort study. A total of 60 patients with vitrified-warmed ET were assigned to two groups according to the endometrial preparation: natural cycle (28 patients) or HRT cycle (32 patients). The uterine endometrial blood flow was evaluated using measurements of the radial artery resistance index (RA-RI) during the early follicular phase, the days of the human chorionic gonadotropin (hCG) trigger during a natural cycle or the start of progesterone administration during the HRT cycle, and the day of ET. We statistically and longitudinally measured and evaluated the RA-RI values of all individual patients. Results During natural cycles, the RA-RI on the day of ET was significantly higher than that during the early follicular phase. During HRT cycles, the RA-RI on the day of ET was also significantly increased compared to that during the early follicular phase. We validated the efficacy of the RA-RI values for predicting the possibility of pregnancy with vitrified-warmed ET. During natural cycles, the area under the receiver-operating characteristic curves (AUCs) for the early follicular phase, the day of hCG trigger, and the day of ET were 0.75 (95% confidence interval [CI], 0.57–0.93), 0.69 (95% CI, 0.49–0.88), and 0.60 (95% CI, 0.36–0.84), respectively. During HRT cycles, AUCs for the early follicular phase, the day of starting progesterone administration, and the day of ET were 0.60 (95% CI, 0.40–0.81), 0.60 (95% CI, 0.39–0.87), and 0.58 (95% CI, 0.37–0.79), respectively. Conclusions The uterine RA-RI increased at approximately the time of the implantation window compared to that of the early follicular phase during both natural and HRT cycles with vitrified-warmed ET. Our findings suggest that RA-RI during the early follicular phase might be effective and useful for deciding whether to choose the natural or HRT cycle for vitrified-warmed ET.

Temporal changes in cardiac function and cerebral blood flow during sequential postmenopausal hormone replacement

2001 ◽  
Vol 184 (2) ◽  
pp. 41-47 ◽  
Author(s):  
Morten B. Sørensen ◽  
Thomas Fritz-Hansen ◽  
Henrik H. Jensen ◽  
Anette T. Pedersen ◽  
Liselotte Højgaard ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cardiac Function ◽  
Hormone Replacement ◽  
Temporal Changes ◽  
Postmenopausal Hormone

O-031 Importance of blood flow to human implantation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Pierzynski
Keyword(s):  
Blood Flow ◽  
Embryo Transfer ◽  
Assisted Reproduction ◽  
Embryo Implantation ◽  
Power Doppler ◽  
Oxytocin Receptor ◽  
Endometrial Receptivity ◽  
Flow Index ◽  
Uterine Contractions ◽  
Endometrial Blood Flow

Abstract text The success of embryo implantation depends on a plethora of factors, with embryo quality and endometrial receptivity belonging to the most important ones. The receptive phenotype of endometrium develops in reaction to appropriate estrogen stimulation in the proliferative phase and embryo-synchronized maturation warranted by the action of progesterone. Uterine blood supply, myometrial contractions and the activity of local immune cells also belong to important factors affecting the outcome of both natural and assisted reproduction. Endometrial perfusion was shown to be an independent receptivity parameter, showing a direct association with pregnancy outcomes. Historically, the use of Doppler parameters of uterine vessels was studied as a reflection of blood flow to the endometrium. Although some authors showed a correlation between blood flow in uterine arteries and success rates in IVF cycles, it might not reflect the actual endometrial flow as most of the blood volume goes through myometrium, not endometrium. Currently, using available ultrasound tools – 2D/3D Power Doppler with VOCAL (Virtual Organ Computer-Aided Analysis) software enables clinicians to evaluate parameters of endometrial perfusion in a matter of minutes. In this method, ultrasound system can calculate indices reflecting endometrial blood flow - vascularity index (VI), endometrial flow index (FI), and endometrial vascularity flow index (VFI) which are based on the total and relative amounts of Power Doppler signal (corresponding to the blood flow) within the volume of interest. Endometrial blood flow parameters can be altered in implantation limiting conditions such as endometriosis or chronic intrauterine inflammation. It was also shown to be influenced by implantation-related hormones such as oxytocin. Oxytocin receptor antagonists were shown to decrease uterine contractions in non-pregnant uteri of women being prepared for embryo transfer procedure. This class of medications has been extensively studied as potential candidates for medications promoting embryo implantation in IVF-ET treatments. In several studies, it was shown that mixed oxytocin/vasopressin V1A receptor antagonist atosiban, which is currently registered in Europe for the tocolysis in preterm labour, had the potential of improving implantation rates. Interestingly, this effect was confirmed also in women without pronounced contractions. Additionally, it has been demonstrated that oxytocin antagonism enhances endometrial decidualization and influences other parameters necessary for the acquisition of the endometrial receptivity phenotype. Considering that atosiban and other oxytocin antagonists relax uterine blood vessels and increase endometrial blood flow, it was hypothesized that improvement in endometrial perfusion could be an additional mechanism for observed support of embryo implantation. A similar finding was confirmed in our study on nolasiban – a non-peptide, orally active, oxytocin receptor-specific antagonist. In the 1st phase study on volunteers undergoing estrogen/progesterone endometrial preparation reflecting the synchronization for embryo transfer, it was confirmed that application of nolasiban decreased uterine contractions and improved FI and VFI parameters of endometrial perfusion. Such an effect lasted for more than 24 hours after dosing. The study results suggested that oxytocin antagonism could have an effect on endometrial perfusion, and its potential clinical significance requires further investigation. In a longer perspective, once confirmed it would mean that, apart from the possibility of observation of endometrial blood flow, we could have a tool for improving it, which would hopefully lead to improved outcomes of assisted reproduction treatments.

scholarly journals Assessment of Uterine Receptivity by the Subendometrial-Endometrial Blood Flow Distribution Pattern in Frozenthawed Embryo Transfer Cycles

2015 ◽  
Vol 6 (1) ◽  
pp. 35-39
Author(s):  
Divya Sardana
Keyword(s):  
Blood Flow ◽  
Distribution Pattern ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Flow Distribution ◽  
Blood Flow Distribution ◽  
Uterine Receptivity ◽  
Endometrial Blood Flow ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

ABSTRACT Objective To investigate the correlation of blood flow detected by 2-Dimensional Power Doppler (2D-PD) sonography in the subendometrial-endometrial unit with the pregnancy outcome in frozen-thawed embryo transfer (FET) cycles. Study design Prospective non-randomized observational study. Materials and methods A total of 127 patients undergoing their first FET cycle were recruited and prepared using hormone replacement therapy. All patients were evaluated for subendometrial-endometrial blood flow by 2D-PD once the endometrium was ≥7 mm thick. Progesterone supplement was added and transfer of 2 to 3 cleavage stage good quality embryos was done after 3 days. Results The difference in the BMI, FSH, LH and endometrial thickness of women in the three zones was not statistically significant (p > 0.05). However, women with blood flow in zone 1 were of older age as compared to women in zone 3 with a statistically significant difference (p = 0.0001). In the present study, the overall pregnancy rate was 35.43% (45/127). Women having blood flow in zone 3 or 4 showed a rising trend of pregnancy rate as compared to those in zone 1 and 2 although it was not statistically significant (p = 0.15). But, clinical pregnancy and implantation rates were significantly higher in women with zone 3 or 4 penetration compared with zone 1 or 2 penetration (p = 0.03 and 0.01, respectively). Conclusion The subendometrial-endometrial vascularity has a useful predictive value for pregnancy outcome in FET cycles. However, larger studies are needed to reach definite conclusion. How to cite this article Sardana D. Assessment of Uterine Receptivity by the Subendometrial-Endometrial Blood Flow Distribution Pattern in Frozen-Thawed Embryo Transfer Cycles. Int J Infertil Fetal Med 2015;6(1):35-39.

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