Comparison of Uterine Receptivity between Fertile and Unexplained Infertile Women by Assessment of Endometrial and Subendometrial Perfusion Using Contrast-Enhanced Ultrasound: Which Index is Better—Peak Intensity or Area under the Curve?

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• 作者：Minxia Chen^&lowast ; ; Yanni He^&lowast ; ; ^{519324096@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Pengjie Zhang^&lowast ; ; Qiang Geng^&dagger ; ; Qiuxiang Liu^&Dagger ; ; Linghong Kong^&Dagger ; ; Yihan Chen^&lowast ; ; Qingzhu Wei^§ ; ; Jianghuan Liu^§ ; ; Suiqun Guo^&Dagger ; ; ^{1014539690@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Hongmei Liu^&lowast ; ; ^{hongmeiliu3@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Infertility ; Endometrium ; Subendometrium ; Perfusion ; Contrast-enhanced ultrasound
• 刊名：Ultrasound in Medicine & Biology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：42
• 期：3
• 页码：654-663
• 全文大小：1951 K

文摘

The goal of this study was to compare uterine receptivity between women with normal fertility and those with unexplained infertility during natural cycles by assessment of endometrial and subendometrial perfusion using contrast-enhanced ultrasound (CEUS). We wanted to determine the better index: peak intensity (PI) or area under the curve (AUC). Thirty women with unexplained infertility were recruited into the study group, and 30 women with normal fertility were recruited into the control group. All women underwent CEUS during the late proliferative phase, ovulation phase, and implantation window of a menstrual cycle. Endometrial PI, endometrial AUC, subendometrial PI and subendometrial AUC were analyzed. In the late proliferative phase, the control group had a significantly higher endometrial PI (p < 0.001) as well as subendometrial PI (p < 0.001) and AUC (p = 0.004) than the study group. In the ovulation phase, the control group had a significantly higher endometrial PI (p < 0.001) and AUC (p = 0.021), as well as subendometrial PI (p < 0.001) and AUC (p = 0.003). During the implantation window, there were no significant differences between the two groups. Only subendometrial PI underwent a significant periodic change during the menstrual cycle in both groups. This finding was further confirmed by evaluation of the microvessel density of endometria. In conclusion, CEUS can be used to assess endometrial and subendometrial perfusion to evaluate uterine receptivity. Subendometrial PI was the most sensitive index compared with endometrial PI, endometrial AUC and subendometrial AUC.