COLOR DOPPLER CHANGES AND THROMBOXANE PRODUCTION AFTER OVARIAN STIMULATION WITH GONADOTROPIN-RELEASING-HORMONE AGONIST

The objective of this study was to evaluate the Doppler how variations which occur following the use of different protocols of ovarian stimu lation in an IVF programme, and to investigate the thromboxane product ion by cultured endometrial cells and its influence on embryo implanta tion. A total of 60 patients underwent three different ovarian stimula tion protocols: long gonadotrophin-releasing hormone agonist (GnRH-a), short GnRH-a and no GnRH-a. Transvaginal ultrasonography and colour D oppler analysis were performed before and during the treatment. On the day that the Doppler examination took place, luteinizing hormone, fol licle stimulating hormone, plasma oestradiol and thromboxane concentra tions were assayed. On the day of oocyte retrieval, endometrial cells were collected and cultured, and their thromboxane production evaluate d. No significant differences in hormonal, ultrasonographic or Doppler parameters were observed between the three groups. Ten out of 56 pati ents who had a successful embryo transfer became pregnant. In the grou p of pregnant women the pulsatility index values of both uterine and s piral arteries was lower than in non-pregnant patients, and was associ ated with significantly lower thromboxane concentrations from cultured endometrial cells. It is concluded that thromboxane plays a role in e mbryo implantation, and that Doppler flow analysis of uterine and spir al arteries in infertile patients may be important in the management o f ovarian stimulation.