Endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in patients with small intramural uterine fibroids during IVF treatment

Background: The impact of intramural fibroids on the success of IVF treatment is controversial and the mechanisms leading to poor treatment outcomes remain unknown. We compared endometrial and subendometrial blood flow between women with and without intramural fibroids during IVF treatment. Methods: Three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval in 50 patients with intramural fibroids not distorting the uterine cavity and in 50 matched controls to measure endometrial thickness, uterine pulsatility index (PI)/resistance index (RI), endometrial volume and vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions. Smokers, patients with serum estradiol concentrations greater than or equal to20 000 pmol/l on the day of HCG and previous history of myomectomy were excluded. Results: Endometrial thickness and pattern, averaged uterine PI and RI and endometrial and subendometrial VI/FI/VFI were similar between the fibroid group and the control group. There was no correlation between the total volume of fibroids and endometrial and subendometrial 3D power Doppler flow indices in the fibroid group. Conclusion: Endometrial and subendometrial 3D power Doppler flow indices were similar in patients with and without small intramural fibroids.