INFLUENCE OF OVULATION INDUCTION WITH HUMAN MENOPAUSAL GONADOTROPIN ON UTERINE BLOOD-FLOW - COMPARISON OF UNEXPLAINED AND MECHANICAL INFERTILITY

A prospective study in patients undergoing in vitro fertilization trea tment was conducted to assess whether any difference may be present in uterine blood flow between unexplained and mechanical infertility, be fore and during ovulation induction. The ascending branch of the uteri ne artery, the arcuate arteries, and the radial arteries were examined by transvaginal, color pulsed Doppler sonography on day 3 and on the day of human chorionic gonadotropin administration. Patients with mech anical factor demonstrated a decrease in resistance to blood flow in a ll the examined vessels during ovulation induction. Patients with unex plained infertility showed a contrasting trend in changes of uterine b lood flow (e.g., as the cycle progressed, the resistance index increas ed). Moreover, the resistive index values on the day of human chorioni c gonadotropin administration were significantly higher in patients wi th unexplained infertility. It is quite possible that the rise in impe dance to uterine blood flow during ovulation induction and the higher impedance on the day of human chorionic gonadotropin administration in patients with unexplained infertility may be one of the factors respo nsible for the lower conception rate in these patients.