Contrast-enhanced ultrasound reveals real-time spatial changes in vascular perfusion during early implantation in the macaque uterus

Christopher S. Keator, Jonathan R. Lindner, J. Todd Belcik, Cecily V. Bishop, Ov D. Slayden

    Research output: Contribution to journalArticlepeer-review

    26 Scopus citations


    Objective: To use contrast-enhanced ultrasound (CEU) to quantify blood flow in the macaque uterus during early pregnancy. Design: Prospective nonhuman primate study. Setting: Oregon National Primate Research Center. Animals: Naturally cycling female rhesus macaques (Macaca mulatta). Intervention(s): Female macaques were mated on days 11-14 of the cycle. Females were then imaged by CEU and Doppler ultrasound once every 3 days from day 21 through day 39 of the fertile cycle. Main Outcome Measure(s): Visualization and quantification of uterine vascular perfusion. Result(s): CEU identified the primary placental disc and underlying vessels approximately 2 days earlier than Doppler ultrasound was able to observe endometrial thickening. CEU revealed spatial differences in vascular perfusion between the endometrium, myometrium, and endometrial- myometrial (junctional) zone. Myometrium displayed the highest rate of blood flow (>10 mL/min/g tissue). There was less blood flow in the endometrium and junctional zone (<3 mL/min/g). A brief fall in progesterone was observed during early implantation, which was correlated with reduced blood flow to all three uterine compartments, but did not reduce flow to the placenta. Conclusions: CEU provides a sensitive, noninvasive method to assess vascular perfusion of the uterus during embryo implantation in macaques. We propose CEU as a new diagnostic tool to monitor vascular changes associated with early pregnancy in women.

    Original languageEnglish (US)
    Pages (from-to)1316-1321.e3
    JournalFertility and sterility
    Issue number4
    StatePublished - Mar 15 2011


    • Contrast-enhanced ultrasound
    • Doppler ultrasound
    • endometrium
    • implantation
    • macaque
    • pregnancy
    • progesterone
    • uterus
    • vascular perfusion

    ASJC Scopus subject areas

    • Reproductive Medicine
    • Obstetrics and Gynecology


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