Doppler Evaluation of Uterine Anomalies and Masses in Infertility

The results of some research indicate that absent diastolic flow in uterine artery might be associated with infertility and poor reproductive performance. Therefore, the uterine artery blood flow can potentially be used to predict a hostile uterine environment. Also high prevalence of increased uterine artery impedance among infertile patients with the diagnosis of endometriosis has been reported. In differentiation between septate uterus from arcuate uterus, septum always shows absent vascularity or high resistance vascularity with an RI of 0.68-1. The muscular septum lacks supporting connective tissue and shows poor preovulatory changes and poor decidualization with consequently poor placentation. Additionally, a vascular septum shows enhanced irritability. Most of the septa show poor vascularization responses in the pregnant state. More muscular and vascularized septae correlate with more complications. Doppler study can help radiologist to differentiate polyps (in which solitary feeding vessel usually shows no branching and tapers as it reaches the center of the lesion) from fibroma (peripheral flow) and adenomyoma (spoke wheel radial pattern).