OP15.02: “Soft marker” evaluation of ovarian mobility in the normal and endometriotic ovary

To determine the prevalence of ovarian immobility with endometriomas as well as the diagnostic accuracy of transvaginal sonographic (TVS) ovarian mobility in both the presence and absence of endometriomas. Multicentre prospective observational study of women presenting with chronic pelvic pain from January 2009 to March 2015. All women with symptoms of chronic pelvic pain +/− history of endometriosis and a plan for laparoscopic endometriosis surgery underwent a detailed history and specialised TVS in a tertiary referral unit prior to laparoscopy. During TVS, ovarian mobility and the presence of endometriomas were assessed. The relationship between TVS ovarian mobility with or without endometriomas were correlated with surgical gold standard. 265/274 (97%) women with preoperative TVS and laparoscopic outcomes were included in the final analysis. Ovarian immobility was significantly associated with endometriomas with a prevalence of 12.2%, 10.8% and 52.7% for fixation of the left, right and bilateral ovaries, respectively, compared with 4.2%, 3.7% and 7.3% of normal ovaries. The sensitivity, specificity, positive and negative predictor values for diagnosing ovarian immobility with endometriomas in the left, right and bilateral ovaries were 50.0/98.5/80.0/94.2 per cent, 44.4/92.3/44.4/92.3 per cent, 74.4/68.6/72.5/70.6 per cent compared with 14.3/92.9/7.1/96.6 per cent, 25.0/87.98.3/96.4 percent and 35.7/97.2/50.0/95.0 percent in left, right and bilateral normal ovaries, respectively (p < 0.05 except for normal left and right ovaries with p = 0.2 and 0.4, respectively). There is a significant association of ovarian immobility with the presence of endometriomas compared with normal ovaries. The performance of ovarian immobility as an ultrasound soft marker is better in the presence of endometriomas.