Quantitative assessment of subendometrial blood flow by three-dimensional-ultrasound is an important predictive factor of implantation in an in-vitrofertilization programme

This study was designed to investigate the role of three-dimensional (3D) p ower Doppler sonography of the (sub-) endometrial area on the first day of ovarian stimulation in predicting the outcome of an in-vitro fertilization (IVF) programme. Among the 75 cycles analysed, the overall pregnancy rate w as 20% (15/75) per cycle and 23.8% (15/63) per embryo transfer. Intra-obser ver variability of the colour histogram was checked in 14 patients with the results demonstrating a high level of agreement. Neither endometrial measu rements nor uterine blood flow were correlated with the pregnancy rate. In contrast, all 3D indices were significantly lower in conception compared wi th non-conception cycles (P < 0.05). Logistic regression analysis found the subendometrial flow index to be the strongest predictive factor of IVF suc cess among the tested sonographic parameters (P = 0.04). In conclusion, qua ntitative assessment of spiral artery blood flow may be of predictive value for implantation in IVF cycles even before ovarian stimulation therapy is started.