The New Indian Journal of OBGYN. Epub Ahead of Print

A prospective study on the colour doppler indices of follicular and endometrial blood flow as a predictor of pregnancy in intrauterine insemination (IUI) cycles

Leena Wadhwa, Neelam Raj Purohit, Sanjana Wadhwa, Shivansh Jaiswal, Supreeti Kohli

ABSTRACT

Objectives: Success rates of intrauterine insemination (IUI) as first-line treatment for subfertile couples depend on various factors including follicular and endometrial blood flow and thickness. This study aimed to evaluate the color doppler indices of endometrial and follicular blood flow to predict pregnancy in IUI cycles. Methods: A prospective observational study was done on 100 infertile women (21-35 years age) who underwent IUI cycles. On the day when trigger was planned, patients underwent color doppler study of follicular and endometrial flow by 2D ultrasound. Parameters such as endometrial thickness and endometrial blood flow, follicular vascularity grading, pulsatility index (PI) and the resistance index (RI) of uterine and ovarian arteries were calculated. The association of these factors with pregnancy outcomes was evaluated. Results: Out of 100 women, 84% of women were nonpregnant, 14% got pregnant with live intrauterine pregnancy (LIUP), and 2% had poor outcome. Among the clinical characteristics, number of follicles was significantly associated with pregnancy outcomes (p<0.0001). Mean values of uterine artery PI, uterine artery RI, intraovarian artery (IOA) PI, and IOA RI were 3.27±1.63, 0.88±0.09, 1.92±1.94, and 0.74±0.69, respectively. Follicular vascularity grading was grade 1 and 2 in 50% of the total patients (mention in pregnant women). Uterine artery pulsatility index (p=0.021), follicular vascularity grading (P<.0001), and IOA PI (P<.0001) showed significant association with pregnancy outcomes. ROC curves showed that IOA PI was the best predictor of clinical pregnancy. Conclusion: Color doppler flow study of uterus and ovary at the time of trigger in IUI cycles are good predictors of successful IUI outcome.