Impaired uterine artery flow associated with the presence of ovarian endometrioma: preliminary results of a prospective study

Maria Grazia Porpora, Federica Tomao, Lucia Manganaro, Deliar Yazdanian, Eliana Fuggetta, Maria Grazia Piccioni, Pierluigi Benedetti Panici, Giuseppe Benagiano
Journal of ovarian research · 2014 · vol. 7(1) , pp. 1 · doi:10.1186/1757-2215-7-1 · PMID:24401654 · PMC3900471 · W2105088822
article OA: gold CC0 ⤵ 12 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that women with ovarian endometriosis exhibit abnormal uterine artery blood flow, which improves after surgery, correlating with increased pregnancy rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective case-control study evaluated uterine artery resistance index (RI) by transvaginal Doppler at enrollment (mid-luteal phase) and 3 months after laparoscopic surgery in 110 reproductive-age women, comparing 69 with ovarian endometriomas to 41 controls, and examined associations with infertility and pregnancy. Women with ovarian endometriomas showed more frequent uterine artery flow alterations at baseline (RI ≥ 0.8) than controls, and uterine artery flow RI improved significantly after surgery; among infertile patients at baseline, pregnancy rates were higher when uterine artery flow normalized versus when abnormalities persisted. The study reports that 27 of 69 potential endometrioma patients were excluded for not meeting inclusion criteria, which may limit generalizability, and it focuses on preliminary results within the selected cohort. This paper is centrally about endometriosis — specifically ovarian endometrioma–associated uterine artery hemodynamic changes and their relationship to infertility and post-surgical pregnancy outcomes.

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Abstract

BACKGROUND: Aim of this prospective, case-control study was to evaluate uterine arteries' blood flow before and after laparoscopic surgery in patients with ovarian endometriosis and its possible correlation with infertility. METHODS: We prospectively enrolled 110 women of reproductive age; 69 with ovarian endometriomas and scheduled for surgery, and 41 controls. At enrolment, a detailed medical, gynecologic and obstetric history was collected. Fertility and pregnancy desire were assessed. All patients underwent complete physical and gynecologic examination. Transvaginal ultrasound with Doppler color flow was performed to evaluate Resistance Index (RI) of uterine arteries during the secretory phase, at enrolment (T0) and 3 months after laparoscopic surgery (T1). RESULTS: Among cases, 27 patients were excluded because they did not meet the inclusion criteria. At enrolment (T0) unilateral or bilateral flow alterations (RI ≥ 0.8) were found in 38 out of 42 patients with ovarian endometriosis (90%), whereas in the control group only 17 women (41%) had Doppler alterations. The difference in uterine artery RI values between cases and controls was statistically significant (P < 0.0001). A statistically significant improvement in uterine artery flow (P <0.0001) was found 3 months after surgical treatment of endometriosis. Nineteen patients with endometriosis (45%) were infertile before surgery; all of them presented uterine artery Doppler alterations at T0. After surgery the pregnancy rate was significantly higher in patients who presented uterine artery flow normalization than in those with persistent uterine artery flow alterations (p = 0.002). CONCLUSIONS: A strong correlation was found between uterine artery flow abnormalities and ovarian endometriosis. Uterine artery flow improvement following surgery seems to increase the probabilities of achieving pregnancy.

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Condition tags

endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Ovarian Diseases Uterine Artery Adult Blood Flow Velocity Case-Control Studies Endometriosis Endometriosis Endometriosis Endometriosis Female Fertility Humans Infertility, Female Infertility, Female Infertility, Female Laparoscopy Middle Aged Ovarian Diseases Ovarian Diseases

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