The Effect Of Fertility Stress On Endometrial And Subendometrial Blood Flow Among Infertile Women

Objective To investigate the effect of fertility stress on endometrial and subendometrial blood flow among infertile women.Methods Between October 2015 to August 2016,300 infertility women at the Department of Reproductive Medicine Center in The First Affiliated Hospital of Zhengzhou University were recruited to the study as a case group.90 cases of healthy women as a control group.The fertility problem inventory(FPI)was adopted to evaluate fertility stress.Three-dimensional power Doppler ultrasonography(3D PD-US)was performed during the proliferative phase of the menstrual cycle(days 5-11)to measure endometrial thickness,pattern,endometrial and subendometrial volume(V),the vascularization index(VI),the flow index(FI)and the vascularization-FI(VFI).Then,300 infertile women were equally separated into three groups(high-score group?middle-score group and low-score group)based on total FPI scores and 90 healthy women were selected as controls.Means and SDs ?t test ??2 test?ANOVA and Pearson correlation analysis were utilized to explore the relation of infertility stress and endometrial and subendometrial blood flow among female infertility.Results 1.No differences were found among the two groups with regard to general characteristics,endometrial thickness,pattern,endometrial and subendometrial V,VI and VFI.2.In high score group,the scores of total FPI,social concern,relationship concern,sexual concern,need for parenthood and rejection of childfree lifestyle were(194.88±16.403),(39.47± 5.897),(38.22±7.418),(51.82±6.1698),(36.24±7.351)and(29.12±5.347).In middle score group,the scores of total FPI,social concern,relationship concern,sexual concern,need for parenthood and rejection of childfree lifestyle were(163.41±12.149),(31.62± 5.499),(40.18±9.49),(46.48±7.089),(30.78±6.780)and(26.19±8.64).In low score group,the scores of total FPI,social concern,relationship concern,sexual concern,need for parenthood and rejection of childfree lifestyle were(137.06±17.738),(24.72± 5.861),(24.92±6.890),(41.25±8.739),(29.65±6.662)and(16.53±5.120).3.The endometrial and subendometrial FIs associated with different stress levels significantly differed among the three groups(F=32.96,P<0.001;F=47.67,P <0.001,respectively).The endometrial and subendometrial FIs in the control group were significantly higher than those in the high-score group and low-score groups.The endometrial and subendometrial FIs in the low-score group were significantly higher than those in the high-score group.4.The total FPI score was closely related to the endometrial and subendometrial FIs(r=-0.304,P<0.001;r=-0.407,P<0.001,respectively).Conclusions 1.Infertility women related to greater infertility stress.2.The scores of the four groups were similar in terms of endometrial thickness,pattern,endometrial and subendometrial Volume and vascularization index and vascularization-flow indexes;however,the endometrial and subendometrial flow indexes significantly differed.3.This study demonstrates that fertility stress is closely associated with endometrial and subendometrial FIs,but it is not related to endometrial thickness,type or endometrial and subendometrial VIs and VFIs.