Pregnancy Success Predictive Value of Endometrial and Uterine Doppler Markers When Using Oral Ovarian Induction Medication in Subfertile Patients
Background: Most of the studies evaluating doppler use in endometrial receptivity and infertility management were in IVF cycles. None or few done to evaluate them with oral ovulation induction. We think that doppler can predict success rate with oral infertility management.
Methods: This study is a randomized prospective study. Infertile Patients with PCOS or unexplained subfertility were recruited from couples following with the infertility unit at Al-Moosa Hospital in Al-Ahsa in the Kingdom of Saudi Arabia. Randomization is done to use either clomiphene or letrozole. On the hCG trigger day and the mid-luteal day, we compared sub endometrial arteries and uterine artery doppler markers, Applebaum scoring system, endometrial thickness and blood vessels flow, the pattern between positive and negative test groups.
Results: On the trigger day, there was sufficient evidence to suggest that the endometrial width influences pregnancy success rate with a p-value of 0.0004. While, on the mid-luteal day, evidence was enough to suggest that type A endometrial pattern and zone 2 vascularity are associated with increased pregnancy success rate with a p-value of .021, 0.02, respectively. We prove that we can Predict success pregnancy rate using Applebaum Scores with a p-value of .0002. Uterine arteries PI and RI on the trigger day is associated with higher pregnancy rate with a p-value of .0005, 0.001, respectively. Finally, the pregnancy rate in our study was 18.52%.
Conclusions: On the trigger day, uterine artery PI and RI, Applebaum scoring system and endometrial thickness was predictive of pregnancy. Endometrial pattern and vascularity on the mid-luteal day are correlated with positive pregnancy success rate.