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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.
Geber, Selmo; Vaintraub, Marco Túlio; Rotschild, Gisele; Sampaio, Marcos.
Afiliação
  • Geber S; Centro de Medicina Reprodutiva, ORIGEN, Av. Contorno 7747, Lourdes, Belo Horizonte, MG, CEP 30110120, Brazil. selmogeber@origen.com.br
Arch Gynecol Obstet ; 287(2): 369-73, 2013 Feb.
Article em En | MEDLINE | ID: mdl-22987256
PURPOSE: 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. METHODS: 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 <30 pg/ml and endometrial thickness was <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. RESULTS: All 70 patients had normal ovarian morphology. For the patients who had estradiol levels ≤30 pg/ml, the mean pulsatility index of the uterine arteries was 2.95 ± 0.79 and for those who had levels >30 pg/ml the mean PI was 2.22 ± 0.8 (p = 0.005). For the patients who had endometrial thickness ≤5 mm the mean PI was 2.86 ± 0.82 and for those with endometrial thickness >5 mm the mean PI was 2.17 ± 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 %. CONCLUSIONS: 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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fertilização in vitro / Monitoramento de Medicamentos / Fluxometria por Laser-Doppler / Gosserrelina / Endométrio / Artéria Uterina / Fármacos para a Fertilidade Feminina Tipo de estudo: Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: Arch Gynecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fertilização in vitro / Monitoramento de Medicamentos / Fluxometria por Laser-Doppler / Gosserrelina / Endométrio / Artéria Uterina / Fármacos para a Fertilidade Feminina Tipo de estudo: Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: Arch Gynecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha