ASSESSING UNEXPLAINED INFERTILITY: THE ROLE OF UTERINE ARTERY DOPPLER ULTRASOUND PARAMETERS

Background: The objective of the study was to assess the diagnostic value of uterine artery Doppler in unexplained infertility Objective: The objective of this study was to evaluate the diagnostic effectiveness of uterine artery Doppler ultrasound parameters in distinguishing unexplained infertility from fertile controls in women. Methods: We conducted a case-control study on unexplained infertility at a Public Tertiary Hospital in Rawalpindi from April 2023 to March 2024. The study included 105 cases of women with unexplained infertility and 35 control women with documented fertility. Women in the case group met specific criteria for unexplained infertility, while controls had successful pregnancies and no known fertility issues. Both groups underwent transvaginal ultrasound and uterine artery Doppler assessments using the Xario 200 ultrasound machine, with experienced radiologists analysing the results. Results: In our study comparing women with unexplained infertility to fertile women, significant differences were found in vascular resistance (P= 0.00), endometrium thickness (P= 0.01), and systolic/diastolic ratio (P= 0.00). The Resistance Index and Systolic/Diastolic ratio had perfect discriminatory power (AUC=1.000), indicating strong diagnostic accuracy, while the Pulsatility Index also showed good performance (AUC=0.986). Conclusions: Uterine artery Doppler indices were higher in unexplained infertile women. The sensitive and specific uterine artery Doppler indices identify excessive uterine blood flow impedance. Uterine artery Doppler may identify high uterine blood flow impedance, helping diagnose unexplained infertility.