The assessment of uterine and ovarian perfusion in infertile patients

ObjectiveTo evaluate ovarian and uterine perfusion in 790 infertile patients.Study designTransvaginal color Doppler assessment of the ovarian and uterine circulation in infertile patients with benign pelvic lesions, uterine anomalies and ovarian or uterine dysfunction.ResultsUterine anomalies were detected in 146 patients: 135 septate and 11 bicornute uteri. No alteration, in terms of resistance index (RI), was detected for main uterine arteries in patients with duplication anomalies of the uterus. Submucous fibroids were identified in 25 patients, while subserous leiomyoma were diagnosed in five patients. The mean RI for these lesions covered the value of 0.55 +/- 0.09. Endometrial polyps altered the endometrial perfusion in 26 infertile patients (RI = 0.48 +/- 0.06), while 11 avascular intrauterine synechiae were identified. Functional ovarian cysts were transitory present in 59 patients. The RI varied from 0.52 +/- 0.06 for follicular and 0.46 +/- 0.08 for corpus luteum cysts. Ovarian endometrioma were visualized in 78 infertile patients. Forty eight of them were vascularized at the level of the hilus, while 16 showed pericistic vascular location (RI ranged from 0.40 to 0.59). Dermoid cysts (n = 12) were mostly avascularized (75%), while polycystic ovaries demonstrated increased intraovarian vascularity in all the examined cases. The mean RI detected within the ovarian stroma was 0.52 +/- 0.06. In 11 patients premature menopause was predicted due to low volume of the ovary (< 2 cm3) and absence of the intraovarian vascularity. Hydrosalpynx or sactosalpynx were imaged in 154 patients. The RI varied from 0.44 in acute to 0.74 in chronic stage of the disease.ConclusionTransvaginal color Doppler allows precise estimation of the functional state of the reproductive organs in infertile patients.