Three-dimensional power Doppler study of endometrial and subendometrial microvascularization in women with intrauterine device-induced menorrhagia

Objective: To evaluate endometrial and subendometrial microvascularization, using three-dimensional (3D) power Doppler ultrasound, in women with intrauterine device (IUD)-induced menorrhagia; and whether those potential findings could predict the risk of bleeding before IUD insertion. Design: Prospective clinical trial. Setting: University teaching hospital. Patient(s): One hundred twenty women, who requested the insertion of a copper IUD for contraception. Intervention(s): Endometrial thickness and volume, uterine artery pulsatility index and resistance index, and endometrial and subendometrial 3D power Doppler vascularization index, flow index, and vascularization flow index were measured twice: immediately before and 3 months after IUD insertion. Main Outcome Measure(s): Doppler indices before and after IUD insertion. Result(s): Before IUD insertion, no significant difference was detected in the clinical characteristics, endometrial thickness and volume, and Doppler indices between women who had IUD-induced menorrhagia (n = 47) and those without menorrhagia (n = 73). However, after IUD insertion, there was a significant increase in the endometrial and subendometrial vascularization index, flow index, and vascularization flow index in women with menorrhagia, whereas other parameters remained not significantly different between the two groups. Conclusion(s): Endometrial and subendometrial microvascularization increases in women with IUD-induced menorrhagia; however, this finding has no predictive value before IUD insertion. (C) 2013 by American Society for Reproductive Medicine.