ABSTRACT
The aim of this study was to determine the correlation between three-dimensional power Doppler sonography (3D-PDS) of the (sub)endometrium and concentrations of angiogenic cytokines in patients attending an IVF programme. A total of 42 patients was included in a prospective, non-randomized clinical study. 3D-PDS of the (sub)endometrium was performed on the day of oocyte aspiration, with and without contrast agent. Quantitative assessment included the following 3D Doppler parameters: vascularization index, flow intensity, and vascularization flow index. On the same day, concentrations of oestradiol (serum only), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF) 1, IGF-binding protein 3 (IGFBP-3) and leptin were determined in the serum and in the follicular fluid. All 3D-PDS indices were significantly higher with contrast enhancement (P < 0.05). Follicular fluid concentrations of VEGF and IGFBP-3, as well as serum concentrations of leptin, showed significant P-values when correlated with (sub)endometrial Doppler indices. A weak linear dependency appeared between flow intensity and VEGF and leptin. Furthermore, weak dependencies were apparent between 3D Doppler parameters and high follicular fluid concentrations of VEGF and IGFBP-3. It is concluded that there is only little evidence for an association between (sub)endometrial Doppler indices as assessed by 3D-PDS and concentrations of angiogenic cytokines.
Subject(s)
Angiogenic Proteins/analysis , Cytokines/analysis , Endometrium/diagnostic imaging , Imaging, Three-Dimensional , Ultrasonography, Doppler/methods , Adolescent , Adult , Cytokines/blood , Endometrium/blood supply , Estradiol/blood , Female , Fertilization in Vitro/methods , Follicular Fluid/chemistry , Humans , Imaging, Three-Dimensional/methods , Insulin-Like Growth Factor Binding Protein 3 , Insulin-Like Growth Factor Binding Proteins/blood , Insulin-Like Growth Factor I/analysis , Leptin/blood , Pilot Projects , Pregnancy , Vascular Endothelial Growth Factor A/bloodABSTRACT
METHODS: Based on the results from 42 IVF patients on the day of oocyte aspiration, our study tested the hypothesis that 3-D Doppler ultrasound of the endometrium supported by a contrast agent possesses advantages over a conventional 3-D Doppler ultrasound examination. We also determined whether the subendometrial blood flow indices measured under continuous infusion of Levovist (Schering, Berlin, Germany) were an indicator of a successful implantation. RESULTS: It was demonstrated that, after the administration of Levovist, all subendometrial blood flow parameters (e.g., vascularization index [VI: 8.82+/-16.64], flow index [FI: 35.67+/-9.33], and vascularization flow index [VFI: 3.99+/-8.80]) were significantly higher than without the contrast agent ( p<0.001; VI: 3.09+/-7.11; FI: 29.13+/-14.26; VFI: 1.35+/-3.31). However, no significant differences between blood flow with contrast agent and pregnancy rate were found. CONCLUSION: In summary, quantitative 3-D Doppler ultrasound employing Levovist (Schering, Berlin, Germany) is significantly more sensitive when compared to conventional 3-D Doppler examination. For the first time this was demonstrated on 42 IVF patients on the day of oocyte aspiration. However, no correlation with outcome of the IVF-treatment could be found.