الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Unexplained infertility is diagnosed in couples in whom standard investigations including semen analysis, tests of ovulation, and tubal patency are normal. 46 patients divided into two groups: Fertile (control) group: N = 21, with age ranging from 20 – 40 years. Infertile group: N = 25, with age ranging from 19 – 40 years. included in this study using the1.5 Tesla MRI device &Trans vaginal probe at Diagnostic Radiology Departments, Mansoura University Hospitals. Transvaginal color Doppler sonography is a reliable non-invasive investigation of uterine and sub-endometrial perfusion and uterine receptivity as well which in turn could predict the implantation outcome and reveal the underlying etiology of unexplained infertility. Hence, Doppler is a recommended assessment in infertile cases. Increasing the impedance of uterine vessels increases the luteal blood flow and the patient should be referred for treatment. Based on Doppler findings, the perfusion of the endometrium is a major contributor to the pathology of unexplained infertility as reports have shown that such cases demonstrated a higher resistance to blood flow in the left uterine artery than fertile controls which means an impaired peri-implantation endometrial blood flow, while for right uterine artery and spiral artery, there is no difference in between the two groups. Arterial spin labeling MRI (ASL-MRI) is a non-contrast-enhanced perfusion-weighted technique. It uses magnetically labeled water in blood as an endogenous tracer instead of an externally injected tracer and enables noninvasive quantitative tissue blood flow measurements without ionizing radiation exposure and administration of contrast materials. This study aimed to the assessment of the role of arterial spin labeling MRI (ASL-MRI) in the detection of myometrial and endometrial perfusion changes in patients with unexplained infertility and detect to what extent this affection can impair fertility. Therefore, our study aims to discover if there is a difference in uterine artery parameters in women with unexplained infertility using Doppler ultrasound indices and uterine perfusion using Arterial spin labeling MRI. The present study has been conducted on 46 women; 25 presented with unexplained infertility and 21 fertile women. All patients underwent pelvic MRI examination using a 1.5-tesla system (Philips Ingenia) with arterial spin labeling technique using the same scanning parameters. And Doppler TVS US. There was statistically significantly higher PS/ED ratio, RI, and PI in infertile group vs. fertile group, and a statistically significantly lower ED and MD in infertile group vs. fertile group. The difference in PS and TAMx between both groups was not statistically significant. By Comparing MRI measurements in fertile vs. infertile group no statistically significant difference in all studied parameters.