Doppler ultrasonography and implantation: A critical review

Active perifollicular angiogenesis in ovaries and endometrium is linked wit h the quality of oocytes and endometrial receptivity, and consequently with the outcome of implantation. Studies evaluating ovarian velocimetry in rel ation to implantation and pregnancy rates bring essentially into play veloc ity values or non-quantitative parameters, whose reproducibility is low and which are hardly usable in daily practice. Conversely, the assessment of u terine artery flow by Doppler examination is easy and reproducible, and hig h impedance at the end of the follicular phase is a good predictive indicat or of poor endometrial receptivity. In early pregnancy, Doppler investigati on must not be used routinely because its safety is still under discussion; however, the available data show that impedance in the uterine and spiral arteries does not show any significant difference between normal and abnorm al pregnancies (missed abortions or anembryonic pregnancies), and the signi ficance of easily detectable intervillous flow is hotly debated, raising fu ndamental points. Copyright (C) 2001 S. Karger AG, Basel.