Perifollicular and subendometrial blood flow and ICSI cycle outcome

Background: There is a fundamental correlation between follicles and endometrium in intracytoplasmic sperm injection (ICSI) cycles. Objective: To assess the relation between perifollicular perfusion and sub endometrial parameters in Doppler ultrasonography and outcome of in ICSI cycles. Materials and Methods: In this prospective descriptive pilot study, 10 patients were enrolled. Strict inclusion criteria were considered. Routine long protocol was used for ICSI. On the day of follicle retrieval, colour Doppler indices were determined. Sub endometrial pulsatility index (PI) and resistance index (RI) and perifollicular perfusion were assessed. After oocyte retrieval the count of metaphase 2 (M2) oocytes, emberyo with grade A quality and the result of cycle were evaluated also. Results: RI and PI indices had a positive correlation. Follicles with ≥18 mm diameter and follicles with >75% perfusion had a direct relation. Also, subendometrial RI had a significant relation with follicular status (p-value= 0.04), But there was not a significant triple correlation (between endometrium, follicles and outcome). Conclusion: The mutual effects of vascularization status in two fundamental parts in ART, is still unclear. The evaluation with Doppler ultrasonography should focus on two compartments together as one functional part at the same time. It means even in presence of good markers in each part, the final decision must be taken by co-evaluation of follicles and endometrium.