Doppler evaluation of the uterine and spiral arteries from different sampling sites and phases of the menstrual cycle during controlled ovarian hyperstimulation

Objective To compare the pulsatility index (PI) and resistance index (RI) a t different sampling sites of the uterine and spiral arteries in the early and mid-menstrual phases. Materials and methods The uterine and spiral arteries of 110 women undergoi ng similar ovarian hyperstimulation and intra-uterine insemination regimes were examined using transvaginal color Doppler ultrasound. The uterine arte ry was sampled at five sites: (1) ascending branch; (2) descending branch; (3) proximal, near branch division; (4) mid, 0.5 cm distal to the division; (5) lateral location, 2 cm distal to the division. The spiral artery was s ampled at three sites: (a) anterior; (b) fundal; (c) posterior. The uterine and spiral arteries were examined twice, on days 2-3 and 14-16, respective ly, of the menstrual cycle. The women were also grouped according to age at examination, less than or equal to 30 years and > 30 years. The PI and RI values for different sites, menstrual phase, and age were compared. Results The mean PI and RI values of the uterine artery were: (1) 2.86 +/- 1.20 and 0.92 +/- 0.13; (2) 2.66 +/- 1.15 and 0.89 +/- 0.12; (3) 2.88 +/- 1 .26 and 0.90 +/- 0.15; (4) 3.03 +/- 1.02 and 0.91 +/- 0.07; (5) 3.23 +/- 1. 38 and 0.89 +/- 0.12; and of the spiral artery were (a) 1.61 +/- 1.01 and 0 .69 +/- 0.17; (b) 1.69 +/- 0.74 and 0.74 +/- 0.17; (c) 2.73 +/- 0.86 and 0. 68 +/- 0.17 The PI values for uterine and spiral arteries at two phases of the menstrual cycle were 2.92 +/- 1.18 and 1.55 +/- 0.72 (days 2-3); 3.21 /- 1.15 and 1.80 +/- 2.02 (days 14-16), respectively; for younger women (ag e less than or equal to 30 years) these values were 2.83 +/- 1.22 and 1.6 0.85 and for older women (age > 30 years) 3.0 +/- 1.34 and 1.72 +/- 0.96, respectively. Conclusions There were no significant differences in PI and RT values of th e uterine and spiral arteries at different sampling sites, phase of the men strual cycle or age. The higher PI values tended to occur in the lateral ut erine artery and posterior spiral artery, during the mid-menstrual phase an d in the older age group. The PI and RI values of the mid-uterine and funda l spiral artery sampling sites are representative of the whole uterine arte ry and spiral artery, respectively.