Uterine blood flow. Assessment in an intrauterine insemination program for unexplained infertility

To evaluate the diagnostic usefulness of color Doppler velocimetry for infertility treatment.

Sixty-one women undergoing controlled ovarian hyperstimulation and intrauterine insemination with their husbands' semen due to unexplained infertility were enrolled in the study. The Doppler waveforms of the uterine artery, subendome-trial radial artery and intraovarian artery were analyzed around ovulation, and the calculated pulsatility indices (PIs) were correlated with subsequent pregnancy results.

Those women who conceived exhibited a significantly lower uterine artery PI and higher frequency of positive diastolic blood flow in the subendometrial arteries shortly after ovulation. The PI of the intraovarian arteries prior to ovulation was also significantly lower in conception cycles than in nonconception cycles. Uterine artery PIs between different cycles correlated well in the same individual. Lower uterine artery impedance was noted in women receiving supplementation with human menopausal gonadotropins as compared to clomiphene citrate alone.

Doppler velocimetry is a useful tool for evaluating uterine receptiveness in infertility treatment. Intrinsically poor uterine perfusion should be investigated in cases of unexplained infertility.