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11953

Assessment of Sub-Endometrial Blood Flow and Endometrial Leukemia Inhibitory Factor as a Marker for Endometrial Receptivity in Women with Unexplained Infertility

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Last updated: 24 Dec 2024

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Abstract

Background: Infertility is customarily defined as the inability to conceive after 1 year of regular unprotected intercourse. The infertility evaluation is typically initiated after 1 year of trying to conceive, but in couples with advanced female age (> 35 years), most practitioners initiate diagnostic evaluation after an inability to conceive for 6 months. Aim of the Work: To assess endometrial receptivity in women with unexplained infertility using sub-endometrial vascular flow resistant index and endometrial leukemia inhibitory factor (LIF). Patients and Methods: This clinical controlled trial was conducted at Ain Shams University Maternity Hospital during the period from August 2014 to September 2017 on 140 patients divided into two equal groups: Group I (study group): women with unexplained infertility defined as inability to conceive inspite of regular marital life for at least 12 months. Group II (control group): matched women with infertility due to tubal factor, recruited from outpatient gynecology or infertility clinic at Ain Shams University Maternity Hospital. Results: A cutoff value for LIF staining score of ≤1 predicted unexplained infertility with a sensitivity of 73.33% and specificity of 70.67%; whereas a cutoff of > 0.71 for subendometrial blood flow RI predicted unexplained infertility with a sensitivity of 70.67% and specificity of 86.67%. A cutoff of ≤10 mm for endometrial thickness had the highest sensitivity of 100%, but lacked specificity (only 16%). Conclusion: Leukemia inhibitory factor may be a predictor for unreceptive endometrium in cases of unexplained infertility. Subendometrial blood flow RI and endometrial thickness may be used rather than LIF IHC (due to its invasive nature)for the prediction of endometrial factor status in cases of unexplained infertility because of the statistically significant negative correlation between the above parameters. Recommendations: Further studies are needed to evaluate the predictive value of the multiple logistic model including (endometrial thickness, subendometrial blood flow color Doppler and LIF IHC score and even other proposed cytokines as VEGF, IL6 and integrins) in unexplained infertility.  

DOI

10.12816/0041682

Keywords

sub-endometrial blood flow, endometrial leukemia, inhibitory factor, Endometrial receptivity, Unexplained infertility

Authors

First Name

Hazem A.

Last Name

El-Zenneni

MiddleName

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Affiliation

Departments of Obstetrics & Gynecology Faculty of Medicine - Ain Shams University

Email

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City

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Orcid

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First Name

Rowaa A. Moustafa

Last Name

Moustafa

MiddleName

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Affiliation

Departments of Obstetrics & Gynecology Faculty of Medicine - Ain Shams University

Email

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City

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Orcid

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First Name

Amr Ahmed

Last Name

Riad

MiddleName

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Affiliation

Departments of Obstetrics & Gynecology Faculty of Medicine - Ain Shams University

Email

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City

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Orcid

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First Name

Ibrahim S.

Last Name

El-Shazly

MiddleName

-

Affiliation

Departments of Obstetrics & Gynecology Faculty of Medicine - Ain Shams University

Email

dr.ibrahim.elshazly@gmail.com

City

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Orcid

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First Name

Magda N.

Last Name

Nasr Eldeen

MiddleName

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Affiliation

Departments of Obstetrics Pathology Faculty of Medicine - Ain Shams University

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City

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Orcid

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Volume

69

Article Issue

5

Related Issue

2195

Issue Date

2017-10-01

Receive Date

2018-08-30

Publish Date

2017-10-01

Page Start

2,389

Page End

2,399

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_11953.html

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https://ejhm.journals.ekb.eg/service?article_code=11953

Order

4

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Assessment of Sub-Endometrial Blood Flow and Endometrial Leukemia Inhibitory Factor as a Marker for Endometrial Receptivity in Women with Unexplained Infertility

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Type

Article

Created At

22 Jan 2023