Assessment of endometrial perfusion with Doppler ultrasound in spontaneous and stimulated menstrual cycles.

OBJECTIVE Endometrial perfusions were measured by Doppler ultrasound to evaluate the influence of spontaneous menstrual cycles and to study the effect of clomiphene citrate. METHODS Flow waveforms in right and left uterine arteries were obtained by using transvaginal color Doppler ultrasonography in infertile women with 60 spontaneous menstrual cycles and 37 clomiphene citrate stimulated cycles from the follicular to the luteal phase. RESULTS In the spontaneous menstrual cycles, the uterine arterial blood flow increased significantly from the follicular phase to the day of ovulation and then increased markedly to about 200 approximately 230% of the follicular phase after the 6th day of ovulation. In the clomiphene citrate stimulated cycles, the uterine arterial blood flow did not change during the periovulatory period and then increased significantly to about 180 approximately 220% of the follicular phase after the 6th day of ovulation. CONCLUSIONS In the present study, the clomiphene citrate stimulated cycles showed lower endometrial perfusion during the periovulatory period compared with those in the spontaneous menstrual cycles. The results suggest that the assessment of endometrial perfusion with Doppler ultrasound can be used to reveal unexplained infertility problems in induced ovarian cycles.