Characteristics of uterine blood supply in women with chronic endometritis depending on the duration of infertility


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To assess the hemodynamics of the uterus, including the endometrium, in women with chronic endometritis depending on the duration of infertility. Materials and methods. This was a retrospective analysis of an ultrasound study of 581 reproductive-aged women suffering from infertility and diagnosed with endometritis. All women were divided into groups according to the duration of infertility: less than 2years, from 2 to 5 years and more than 5 years. In the uterus and endometrium, the vascularization index (VI), the flow index (FI), and the vascular-flow index (VFI) were evaluated. Dopplerography of the uterine artery showed the arterial perfusion index (API), which reflects perfusion of 1 cm3 of the uterus. Results. According to the data of VI, FI and VFI, vascularization of the uterus and endometrium decreased not only in phase I, but also in phase II along with the increase in the duration of infertility. Arterial perfusion of the uterus decreased in phase I. There were no significant changes in the maximum blood flow rate (Vmax), pulsation index (PI), and resistance index (RI) in the groups. Conclusion. The increase in the duration of infertility is accompanied by a decrease in vascularization not only of the endometrium, but also of the myometrium, as well as a decrease in arterial blood flow.

Full Text

Restricted Access

About the authors

Irina A. Ozerskaya

Peoples' Friendship University of Russia

Email: ozerskaya_usd@mail.ru
M.D., Ph.D., Professor, Ultrasound Diagnostics and Surgery Department

Vladimir A. Ivanov

Peoples' Friendship University of Russia

Email: ivanov.rudn@mail.ru
M.D., Ph.D., Full Professor, Head of the Department of Ultrasound Diagnostics and Surgery

Sergey Ya. Porkhovaty

Asklepion Medical Center

Email: oracul2003@gmail.com
Ph.D., ultrasound diagnostician

Gayane G. Kazaryan

Scientific and Practical Center for Minimally Invasive Surgery and Gynecology

Email: 79165521271@yandex.ru
ultrasound diagnostician

References

  1. Менге К., Опитц Е., ред. Руководство по гинекологии. Пер. с нем. Петроград: Практическая медицина; 1914: 321-8. [Menge C., Opitz E., ed. Guide to gynecology. Transl. from German. Petrograd: Publishing House "Practical Medicine" (V.S. Ettinger). 1914; 321-8. (in Russian)].
  2. Радзинский В.Е., ред. Бесплодный брак: версии и контраверсии. М.: ГЭОТАР-Медиа; 2019: 40-9. [Radzinsky V.E., ed. Infertile marriage: versions and contraverses. M.: GEOTAR-Media; 2019: 40-9 (in Russian)].
  3. Кулаков В.И., Манухин И.Б., Савельева Г.М., ред. Гинекология. Национальное руководство. М.: ГЭОТАР-Медиа; 2007: 576-607. [Kulakov V.I., Manukhin I.B., Savelyeva G.M., ed. Gynecology: national leadership. M.: GEOTAR-Media; 2007: 576-607. (in Russian)].
  4. Цаллагова Л.В., Кабулова И.В., Золоева И.А. Роль хронического эндометрита в генезе бесплодия. Кубанский научный медицинский вестник. 2014; 4: 131-6. [Tsallagova L.V., Kabulova I.V., Zoloeva I.A Role in the genesis of chronic endometritis infertility. Kubanskiy nauchnyy meditsinkiy vestnik/ Kuban Scientific Medical Bulletin. 2014; 4 (146): 131-6. (in Russian)].
  5. Базина М.И., Егорова А.Т., Ходорович Н.А., Сыромятникова С.А., Кириченко А.К., Хоржевский В.А. Хронический эндометрит: скрытая угроза репродукции. Доктор.Ру. 2015; 14: 20-7. [Bazina M.I., Egorova A.T., Khodorovich N.A., Syromyatnikova S.A., Kirichenko A.K., Khorzhevsky V.A. Chronic endometritis: a hidden threat of reproduction. Doctor.Ru. Ginekologiya Endokrinologiya/Gynecology Endocrinology. 2015; 14 (115): 20-7. (in Russian)].
  6. Шалина Р.И., Михалева М.В., Кирющенков А.П., Шаманова М.Б., Гаврилина Е.Н. Дифференцированный подход к прегравидарной подготовке у пациенток с привычным невынашиванием беременности в анамнезе. Российский вестник акушера-гинеколога. 2015; 15(5): 36-40. https://dx.doi.org/10.17116/rosakush201515436-40.
  7. Радзинский В.Е., Ордиянц И.М., Добрецова Т.А. Эндометрий в огне. Острое и хроническое воспаление эндометрия: от новых взглядов к новым стратегиям. StatusPraesens. Гинекология, акушерство, бесплодный брак. 2016; 2: 126-32. [Radzinsky V.E., Ordiyants I.M., Dobretsova T.A. Endometrium on fire. Acute and chronic inflammation of the endometrium: from new perspectives to new strategies. StatusPraesens. Ginekologiya, akusherstvo, besplodnyy brak/Gynecology, obstetrics, barren marriage. 2016; 2: 126-32. (in Russian)].
  8. Малева Т.А. Современные методы диагностики хронического эндометрита (обзор литературы). Международный журнал прикладных и фундаментальных исследований. 2016; 4: 566-8. [Maleva T.A. Modern methods of diagnosis of chronic endometritis (review of literature). Mezhdunarodny zhurnal prikladnykh i fundamentalnykh issledovany/International Journal of Applied and Fundamental Research. 2016; 4: 566-8. (in Russian)].
  9. Доброхотова Ю.Э., Боровкова Е.И., Скальная В.С., Ильязов Т.К., Рассохина О.В. Клинико-иммунологические параллели у пациенток с бесплодием и хроническим эндометритом до и после экзогенной цитокинотерапии. Акушерство и гинекология. 2019; 12: 154-60.
  10. Klenov V., van Voorhis B. Ultrasound in infertility treatment. Clin. Obstet. Gynecol. 2017; 60(1): 108-20. https://dx.doi.org/10.1097/GRF.0000000000000263.
  11. Ni J., Han B., Liang J., Wang F. Three-dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women. Int. J. Gynaecol. Obstet. 2019; 145(2): 212-8. https://dx.doi. org/10.1002 / ijgo.12787.
  12. Campbell S. Ultrasound evaluation in female infertility: Part 2, the uterus and implantation of the embryo. Obstet. Gynecol. Clin. North Am. 2019; 46(4): 697-713. https://dx.doi.org/10.1016/j.ogc.2019.08.002.
  13. Puente E., Alonso L., Lagand A.S., Ghezzi F., Casarin J., Carugno J. Chronic endometritis: old problem, novel insights and future challenges. Int. J. Fertil. Steril. 2020; 13(4): 250-6. https://dx.doi.org/10.22074/ijfs.2020.5779.
  14. Демидов В.Н., Гус А.И. Эхография органов малого таза у женщин. Выпуск IV. Патология полости матки и эндометрия. ВМК: Практическое пособие. М.: Издательский дом БИНОМ; 2016. 160с. [Demidov V.N., Gus A.I. Echography of pelvic organs in women. Issue IV. Pathology of the uterine cavity and endometrium. IUC: Practical manual. Moscow: Publishing house BINOM; 2016: 160 p. (in Russian)].
  15. Буланов М.Н. Ультразвуковая гинекология: курс лекций. ч. 1. 4-е изд. М.: Издательский дом Видар-М; 2017. 560с. [Bulanov M.N. Ultrasonic gynecologists: a course of lectures: in two parts. Part 1, Ch. 1-13. 4th ed. Moscow: Vidar-M Publishing House; 2017. 560 p. (in Russian)].
  16. Маринкин И.О., Трунченко Н.В., Серяпина Ю.В., Никитенко Е.В., Макаров К.Ю., Кулешов В.М., Айдагулова С.В. Хронический эндометрит с нормальным и тонким эндометрием в динамике реабилитации пациенток репродуктивного возраста: ультразвуковые и гистологические корреляции. Проблемы репродукции. 2017; 23(1): 29-36. [Marinkin I.O., Trunchenko N.V., Seryapina Yu.V., Nikiteno E.V., Makarov K.Yu., Kuleshov V.M. et al. Chronic endometritis with normal and fine endometrium in the dynamics of rehabilitation of patients of reproductive age: ultrasound and histological correlations. Problemy reproduktsii/Reproduction problems. 2017; 1: 29-36. (in Russian)]. https://dx.doi.org/10.17116/repro201723129-36.
  17. Шанин В.Ю. Воспаление. В кн.: Шевченко Ю.Л., ред. Клиническая патофизиология. СПб.: Специальная литература; 1998: 170-97. [Shanin V.Yu. Inflammation In: Shevchenko Yu.L., ed. Clinical pathophysiology. S.-Pb: Special Literature; 1998: 170-97. (in Russian)].
  18. Качалина Т.С., ред. Хронический эндометрит в репродуктивном возрасте. Современные представления об этиопатогенезе, диагностике и принципах лечения. Новые подходы к терапии. Учебное пособие. 2-е изд. Н-Новгород: Издательство Приволжского исследовательского медицинского университета; 2018. 88с. [Kachalina T.S., ed. Chronic endometritis in reproductive age. Modern ideas about etiopathogenesis, diagnosis and treatment principles. New approaches to therapy: a training manual. 2nd ed. N-Novgorod: Publishing House of the Volga Research Medical University; 2018. 88 p. (in Russian)].
  19. Ящук А.Г., Масленников А.В., Фаткуллина И.Б., Рахматуллина И.Р., Берг Э.А., Берг П.А. Применение сулодексида для улучшения внутри-маточной гемодинамики у пациенток с невынашиванием беременности. Акушерство и гинекология. 2019; 10: 172-8. [Yashchuk A.G., Maslennikov A.V., Fatkullina I.B., Rakhmatullina I.R., Berg E.A., Berg P.A. The use of sulodexide to improve intrauterine hemodynamics in patients with miscarriage. Akusherstvo i ginekologiya/Obstetrics and gynecology. 2019; 10: 172-8. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.10.172-178.
  20. Leone F.P., Timmerman D., Bourne T., Valentin L., Epstein E., Goldstein S.R. et al. Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group. Ultrasound Obstet. Gynecol. 2010; 35(1): 103-12. https://dx.doi.org/10.1002/uog.7487.
  21. Alcazar J.L., Kudla M.J. Three-dimensional vascular indices calculated using conventional power Doppler and high-definition flow imaging: are there differences? J. Ultrasound Med. 2010; 29(5): 761-6. https://dx.doi.org/10.7863/ jum.2010.29.5.761.
  22. Raine-Fenning N.J., Campbell B.K., Kendall N.R., Clewes J.S., Johnson I.R. Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensional power Doppler angiography. Hum. Reprod. 2004; 19(2): 330-8.
  23. Kim A., Han J.E., Yoon T.K., Lyu S.W., Seok H.H., Won H.J. Relationship between endometrial and subendometrial blood flow measured by threedimensional power Doppler ultrasound and pregnancy after intrauterine insemination. Fertil. Steril. 2010; 94(2): 747-52. https://dx.doi.org/10.1016/j. fertnstert.2009.03.084.
  24. Wang J., Xia F., Zhou Y., Wei X., Zhuang Y., Huang Y. Association between endometrial/subendometrial vasculature and embryo transfer outcome: a metaanalysis and subgroup analysis. J. Ultrasound Med. 2018; 37(1): 149-63. https:// dx.doi.org/10.1002/jum.14319.
  25. Wang L., Lv S., Mao W., Pei M., Yang X. Assessment of endometrial receptivity during implantation window in women with unexplained infertility. Gynecol. Endocrinol. 2020; 36(10): 917-21.https://dx.doi.org/10.1080/09513590.2020. 1727433.
  26. Титченко Ю.П., Зароченцева Н.В., Аршакян А.К., Меньшикова Н.С. Применение ультразвуковых методов исследования в оценке состояния эндометрия у пациенток с хроническим эндометритом и невынашиванием беременности. Российский вестник акушера-гинеколога. 2014; 14(1): 55-8. [Titchenko Yu. P., Zarochentseva N.V., Arshakyan A.K., Menshikova N.S. Use of ultrasound techniques in the evaluation of the endometrium in patients with chronic endometritis and miscarriage. Rossiyskiy vestnik akushera-ginekologa/Russian Bulletin of the Obstetrician-Gynecologist. 2014; 1: 55-8. (in Russian)].
  27. Cicinelli E., Matteo М., Tinelli R., Lepera A., Alfonso R., Indraccolo U. et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum. Reprod. 2015; 30(2): 323-30. https://dx.doi.org/10.1093/humrep/ deu292.
  28. Engels V., Sanfrutos L., Perez-Medina T., Alvarez P., Zapardiel I., Bueno B. et al. Evaluation of endometrial and subendometrial vascularization and endometrial volume by 3-D power Doppler ultrasound and its relationship with age and pregnancy in intrauterine insemination cycles. Gynecol. Obstet. Invest. 2011; 72(2): 117-22. https://dx.doi.org/10.1159/000323777.
  29. Alcazar J.L., Pascual M.A., Ajossa S., de Lorenzo C., Piras A., Hereter L. et al. Reproducibility of the International Endometrial Analysis group color score for assigning the amount of flow within the endometrium using stored 3-dimensional volume. J. Ultrasound Med. 2017; 36(7): 1347-54. https://dx.doi.org/10.7863/ ultra.16.06002.
  30. Озерская И.А. Эхография в гинекологии. 3-е изд. М.: Издательский дом Видар-М; 2020. 704с. [Ozerskaya I.A. Sonography in gynecology. 3rd ed., Revised. and add. Moscow: Publishing house Vidar-M; 2020. 704 p. (in Russian)].

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2020 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies