Doppler of the uterine arteries combined with endometrial thickness correlate well with the degree of pituitary suppression in women treated with long-acting GnRH agonists

作者：Geber Selmo^*; Vaintraub Marco Tulio; Rotschild Gisele; Sampaio Marcos

来源：Archives of Gynecology and Obstetrics, 2013, 287(2): 369-373.

DOI：10.1007/s00404-012-2554-5

• Doppler
• Assisted reproduction
• Pituitary suppression
• Uterine artery

The aim of this study was to evaluate the use of Doppler velocimetry of the uterine arteries and its association to endometrial thickness as a method to confirm pituitary suppression after administration of gonadotropin-releasing hormone analogues in assisted reproduction treatment cycles. %26lt;br%26gt;A total of 70 patients using gonadotropin-releasing hormone analogues for pituitary suppression for in vitro fertilization treatment were studied. To confirm down-regulation, serum estradiol levels and endometrial thickness were evaluated 10 days after gonadotropin-releasing hormone analogues administration. When estradiol was %26lt; 30 pg/ml and endometrial thickness was %26lt; 3 mm, pituitary suppression was confirmed. Doppler velocimetric measurements were performed at the same day to study the pulsatility index of the uterine arteries, until pituitary suppression was confirmed. %26lt;br%26gt;All 70 patients had normal ovarian morphology. For the patients who had estradiol levels a parts per thousand currency sign30 pg/ml, the mean pulsatility index of the uterine arteries was 2.95 +/- A 0.79 and for those who had levels %26gt; 30 pg/ml the mean PI was 2.22 +/- A 0.8 (p = 0.005). For the patients who had endometrial thickness a parts per thousand currency sign5 mm the mean PI was 2.86 +/- A 0.82 and for those with endometrial thickness %26gt; 5 mm the mean PI was 2.17 +/- A 0.79 (p = 0.004). Using a cut-off point of 2.51 for the pulsatility index, to compare to estradiol levels, we observed a sensitivity of 72.7 % and specificity of 71 %. The combination of Doppler velocimetric and endometrial thickness showed a sensitivity of 94 % and specificity of 82.3 %. %26lt;br%26gt;Doppler velocimetric analysis of the uterine arteries can be an important tool in the diagnosis of the down-regulation after the use of gonadotropin-releasing hormone analogues and might help simplify assisted reproduction programmes.

• 出版日期2013-2