الفهرس 
Measurement of endometrial and subendometrial blood flowOnly 14 pages are availabe for public view
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Abstract
The term ”uterine receptivity” refers to a state when endometrium allows a blastocyst to attach, penetrate and induce changes in the stroma, which results in the so-called process of implantation. It appears that a favourable endometrial milieu is necessary for successful implantation (Horcajadas et al., 2009).
With the advent of three-dimensional power Doppler ultrasound, it became possible to perform a reliable and reproducible sonographic evaluation to the role of endometrial and subendometrial vascularization for predicting uterine receptivity. Power Doppler ultrasound is better suited to the study of endometrial and subendometrial perfusion as it is more sensitive to low flow and thus overcomes the problems of angle dependence and background noise associated with both color and pulsed wave Doppler. In addition, the power Doppler signal can be subsequently analysed to produce quantitative information through one of several computer software packages. In combination with three-dimensional ultrasound, power Doppler offers a tool with which one may not only demonstrate but also quantify total endometrial, subendometrial and regional uterine blood flow (Raine-Fenning et al., 2004).
The current study was conducted on anovulatory patients who attended the infertility clinic at Ain Shams Maternity University Hospital between October 2009 and March 2010. It was conducted on eighty six (86) patients undergoing induction of ovulation in the form of clomiphene citrate (Clomid) 50 mg tablet twice daily from third day of menstrual cycle for five days. Then HCG (Pregnyl) 10000 I.U. intramuscular administration when the size of leading follicle reached or exceeded 18 mm. These patients were between 20-35 years old, with normal uterine cavity and with no previous uterine surgery.
On the day of HCG administration, trans-vaginal 3D power Doppler ultrasound was performed at Ultrasound Unit in Ain Shams Maternity University Hospital by the same operator after the patients had emptied their bladders. Measurements included: pulsatility index (PI) and resistance index (RI) of the uterine arteries. It also included endometrial / subendometrial vascularization index (VI), flow index (FI), vascularization flow index (VFI). Subendometrial region was defined as 5mm outer from endometrial defined borders.
Two weeks after HCG administration, serum B-HCG was estimated.
Overall 63 of 86 patients responded to clomiphene citrate and ovulation occurred (73.25%). Pregnancy occurred in 12 of 63 patients (pregnancy rate 19.05%).
The results of the study showed that there were no statistically significant differences in pulsatility index (PI) and resistance index (RI) of the uterine arteries between pregnant and non pregnant groups.
As regards endometrial vascular indices (VI, FI and VFI), there were statistically significantly increase in pregnant group than in non pregnant group. There were also statistically significant increase in subendometrial vascular indices (VI, FI and VFI) between pregnant group than in non pregnant group.