Zeitschrift für Frauengesundheit
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Endometrium Blood Flow Doppler Evaluation in Infertility

Mehboob Hassan Bhatti

Introduction: In the recent past, the cornerstone for the assessment of uterine vasculature was two-dimensional (2D) ultrasound. However it does not detect flow in small endometrial and sub-endometrial vessels, an important feature to be assessed in infertile patients. Nowadays in reproductive medicine, three-dimensional (3D) ultrasound is gradually replacing 2D ultrasound. 3D Ultrasound has many benefits over traditional 2D ultrasound in general and in the area of endometrial and subendometrial blood flow evaluation in particular. The 3D Ultrasound generates detailed, reliable data for a preselected area and stores it. For better reproducibility and precision, new techniques were implemented in 3D Ultrasound. In this paper, we have reviewed the indices of 3D power Doppler in endometrial and subendometrial blood flow in infertile and pregnant women. Objective: To evaluate endometrial and subendometrial 3D Power Doppler blood flow indices in infertile and pregnant women. Methodology: The data bases PubMed, Proquest, Google scholar and research gate were searched by two reviewers with the key words: Endometrium, endometrial, blood flow, Doppler evaluation, Doppler flow, infertile and infertility from 1991 to 2019. For inclusion and exclusion of studies two reviewers (M.H and M.Y) independently screened the titles and abstracts of full and related articles. The disparity of the reviewers was fixed by consensus. Studies having information of endometrial and sub-endometrial blood flow in infertile women were included. All the studies , 3D US acquisition of an entire uterine volume has allowed the estimation of the endometrial volume through computer aided software, the most well-known being VOCAL (Virtual Organ Computer aided AnaLysis). The analysis was done on eligible studies. Results and conclusion: The pooled mean of 3D power Doppler indices of endometrial and subendometrial blood flow are low in infertile women as compared to pregnant women. However there is extreme variation in approximately 20% of the reported studies. Therefore larger studies should be don. The pooled mean of 3D power Doppler indices of endometrial and subendometrial blood flow are low in infertile women as compared to pregnant women. However there is extreme variation in approximately 20% of the reported studies.