The role of antioxidants in the complex therapy of patients with endometriosis-associated infertility

Objective. To study the role of antioxidants in the complex therapy of patients with endometriosis-associated infertility on the example of evaluating the effectiveness of ubidecarenone. Patients and methods. Forty-three patients with endometriosis-associated infertility and nineteen fertile women with complete reproductive function were examined. In order to improve the receptivity of endometrium and correct the antioxidant status in infertile patients with endometriosis after laparoscopy, therapy with Synergin® was administered at a dosage of 2 capsules per day for 3 months. After therapy, an assessment of endometrium and intrauterine perfusion was made. Results. There was a significant decrease in intrauterine perfusion in patients with endometriosis-associated infertility compared to the control group. However, after therapy with Synergin® within 3 months and correction of endothelial dysfunction in infertile patients with endometriosis, an improvement in intrauterine perfusion was revealed. Thus, prior to therapy, subendometrial blood flow was assessed in 13% of patients as satisfactory, in 77% – it was reduced, in 10% – it was absent; after therapy, 86% of patients showed satisfactory blood flow and 14% had decreased blood flow. Endometrial blood flow was reduced in 32% of patients and in 68% were absent prior to treatment, and after treatment, it was assessed as satisfactory in 45% and was reduced in 55%. Conclusion. Pathogenetic antioxidant therapy is necessary in the complex therapy of infertility in patients with external genital endometriosis after surgical treatment. Key words: α-Tocopherol, infertility, coenzyme Q10, endometrium receptivity, endometriosis

Ultrasound Markers of Implantation

ABSTRACT Endometrial 3D power Doppler indices change significantly during the normal menstrual cycle. Vascularity indices of the endometrial and subendometrial vessels increase throughout the proliferative phase of the menstrual cycle, reaching a maximum value 2 to 3 days prior to ovulation. From this peak, vascularity indices decrease and reach a nadir 2 to 5 days after ovulation. Reduced endometrial perfusion assessed by 3D power Doppler ultrasound is most likely related to increased uterine contractility. If prolonged, it may cause endometrial hypoxia, leading to detrimental effect on implantation potential. In normal spontaneous menstrual cycles, endometrial vascular indices increase progressively during the course of the luteal phase. Endometrial and subendometrial perfusion is negatively affected by serum estradiol concentrations, which can explain why patients with hyperstimulation have lower endometrial and subendometrial blood flow during the early luteal phase. Our results indicate that 3D power Doppler implantation markers are crucial for planning a single embryo transfer in order to select the most suitable cycle for transfer of a single cryopreserved embryo. How to cite this article Mercé LT, Barco MJ, Kurjak A. Ultrasound Markers of Implantation. Donald School J Ultrasound Obstet Gynecol 2012;6(1):14-26.