ENDOMETRIAL BLOOD-FLOW RESPONSE TO HORMONE REPLACEMENT THERAPY IN WOMEN WITH PREMATURE OVARIAN FAILURE - A TRANSVAGINAL DOPPLER STUDY

Objective: To evaluate the endometrial blood flow response to hormone replacement therapy (HRT) in women with premature ovarian failure who plan to enter an oocyte donation program. Design: Transvaginal color D oppler ultrasound examinations were performed in women with ovarian fa ilure before and during a cycle of standard HRT and in those with norm al menstrual cycles. Blood flow response was assessed by visualization of arterial wave forms in the endometrial region. The transvaginal co lor flow mapping system was used. Resistance indexes were calculated f or analysis and correlated with plasma E(2) and P concentrations. Pati ents: Eighteen women with ovarian failure (study group), and 12 volunt eers with normal ovarian cycles (control group). Results: Data for res istance indexes were divided into five phases according to the day of hormonal cycle: 0, pretreatment phase; I, early follicular phase (days 5 to 7); II, late follicular phase (days 11 to 13); III, early luteal phase (days 17 to 21); and IV, late luteal phase (days 23 to 25). All women with ovarian failure demonstrated continuous forward end-diasto lic flow velocities at phase I, whereas none showed this pattern durin g the pretreatment period (phase 0). Women with ovarian failure in the early follicular phase had a significantly higher resistance index (0 .85 +/- 0.1; mean +/- SD) than that in the late follicular phase (0.57 +/- 0.1), and the resistance index in the early luteal phase (0.67 +/ - 0.1) was significantly higher than that of the late follicular phase . There was no difference in the resistance index between early and la te luteal phases. A similar pattern of lower resistance index around m idcycle was observed in the control group. However, a comparison of th e resistance indexes between ovarian failure and control patients reve aled a significant difference between values in the early follicular p hase only (0.85 +/- 0.1 versus 0.68 +/- 0.1). In the late follicular p hase and during the entire luteal phase, the mean resistance index did not differ between the study and control groups. Conclusions: The obs erved data suggest that standard HRT in women with premature ovarian f ailure enables restoration of endometrial blood flow to normal. This m ay imply uterine receptivity for oocyte donation.