Endometrial and Subendometrial Vessels in Cases of Unexplained Infertility (Case Control Study)

Abstract
Background: Infertility defined as failure to conceive after 12 months of unprotected regular intercourse. Unex-plained infertility describes couples with infertility in whom standard investigations including semen analysis, tests of ovulation, and tubal patency have no gross abnormality.
Aim of Study: To evaluate the endometrial and suben-dometrial blood flow in mid-luteal phase after measuring serum progesterone level in unexplained infertility patients and compare those parameters with fertile women in order to reveal the role of the uterine perfusion in unexplained infertility.
Patients & Methods: In this study, we collected 100 participants presented to the outpatient clinic in Kasr El-Aini maternity hospital, we classify them into two groups: Group A: 50 women presented with unexplained infertility either primary or secondary (the case group). Group B: 50 women who had no history of infertility and at least have one child who came for any gynecological procedure (the control group) Primary outcome measures (VI) (FI) & (VFI) of endometrial and subendmetrial areas using (VOCAL) in mid luteal phase after measurement of serum progesterone level in both groups.
Results: As regards endometrial vascularity index (VI), it was higher in control group (0.64±0.05) than in case group (0.51±0.09), Sub endometrial (VI) also was higher in control group (2.34±0.13) than in case group (1.92±0.22), endometrial flow index (FI), it was higher in control group (29.26±1.98) than in case group (24.47±4.19), sub endometrial flow index (FI), it was higher in control group (36.29±3.10) than in case group (30.52±2.52), endometrial vascular flow index (VFI), it was higher in control Group (0.36±0.05) than in case group (0.25±0.04) & subendometrial vascular flow index (VFI), it was higher in control group (1.13±0.25) than in case group (0.83±0.07) all of that are statistically significant. As regards to serum progesterone level it was higher in control group (12.87±2.47) than in case group (12.66±3.17) which was statistically insignificant.
Conclusion: From our study we found that impairment of uterine perfusion could have a role in cases of unexplained infertility.