COLOR-DOPPLER VELOCIMETRY OF UTERINE ARTERIES IN PREGNANT AND NONPREGNANT PATIENTS DURING MULTIOVULATION INDUCTION FOR IVF

Objectives: To evaluate uterine artery resistance during multiovulatio n induction in relation to the implantation rate in patients attending in vitro fertilization (IVF) cycles. Patients: Multiovulation inducti on for IVF was monitored by daily determination of the pulsatility ind ex (PI) of the uterine arteries, obtained by a transvaginal probe (6.5 MHz) implemented with color-flow imaging. Doppler data were obtained from 5 days before hCG administration to the day of follicular aspirat ion. One IVF cycle was monitored in 70 patients. In 17 patients, 41 IV F cycles were monitored until a successful attempt occurred. Results: In the 70 patients studied during one IVF attempt, the PI of the uteri ne arteries significantly varied (P < 0.001) in the different phases o f the cycle. In the 24 patients who conceived, a significantly lower P I (P < 0.03) was found throughout the cycle. This result was mainly du e to a highly significant difference of PI values observed the day aft er hCG administration (P < 0.005), In the 17 patients who conceived af ter 1 to 4 negative in vitro fertilizations, no significant difference in PI was observed in the uterine artery resistance in cycles in whic h implantation was or was nor successful. Conclusions: Uterine artery resistance varies significantly during phases of the induction therapy . Uterine artery resistance is lower throughout the course of multiovu lation induction in patients with higher pregnancy rates. The PI on th e day after hCG administration was the best index of pregnancy rate. L ow uterine artery resistance was present even in negative attempts in patients who eventually achieved a successful implantation, PI values less than or equal to 3 can be considered a favorable prognostic facto r for future IVF cycles.