ULTRASOUND STUDIES OF VASCULAR AND MORPHOLOGICAL-CHANGES IN THE HUMANUTERUS AFTER A POSITIVE SELF-TEST FOR THE URINARY LUTEINIZING-HORMONESURGE

The aim of the study reported here was to establish complementary data for changes in uterine size, echogenicity and vascularity during the menstrual cycle relative to a positive self-test for urinary luteinizi ng hormone (LH) and day 1 of next menses, Thirteen volunteers (aged 23 -32 years) with apparently regular menstrual cycles were recruited fro m the nursing staff. The plan was to examine all women by transvaginal ultrasonography with colour Doppler imaging on day 11 of the menstrua l cycle, A urinary LH self-test was to be used daily until a positive result was obtained and the women were to be re-scanned daily until th e dominant follicle had ruptured, All women were then to be scanned at least every 48 h (within +/-2 h of the same time of day) until day 6 of the next menstrual cycle, Matched samples of peripheral blood were taken at the time of each scan for hormone analysis, The main outcome measures were the times of follicular rupture, a positive test result for urinary LH and the start of menses, uterine volume, cavity length, endometrial thickness and grade, pulsatility index (PI), and time-ave raged and peak systolic maximum velocities in uterine and radial arter ies and in subendometrial vessels. Nine women fulfilled the criteria f or an ovulatory cycle, and seven provided data over the complete study , The principal changes relative to a positive Urinary LH test were (i ) a continued rise in endometrial thickness to days 3 and 4 (this inde x then remained relatively constant, but the layered appearance was lo st) and (ii) a gradual decrease in the uterine arterial PI, There was a significant rise in uterine volume, cavity length and uterine arteri al PI around the time of the next menses, and a fall in endometrial th ickness and blood velocity in the uterine and radial arteries and sube ndometrial vessels, The data may have implications for the assessment of reproductive status and the design of future studies on disorders o f implantation or menstruation.