THE ASSESSMENT OF UTERINE AND OVARIAN PERFUSION IN INFERTILE PATIENTS

Objective: To evaluate ovarian and uterine perfusion in 790 infertile patients. Study design: Transvaginal color Doppler assessment of the o varian and uterine circulation in infertile patients with benign pelvi c lesions, uterine anomalies and ovarian or uterine dysfunction. Resul ts: Uterine anomalies were detected in 146 patients: 135 septate and 1 1 bicornute uteri. No alteration, in terms of resistance index (RI), w as detected for main uterine arteries in patients with duplication ano malies of the uterus. Submucous fibroids were identified in 25 patient s, 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 II avascular intrauterine synechiae were ident ified. Functional ovarian cysts were transitory present in 59 patients . The RI varied from 0.52 +/- 0.06 for follicular and 0.46 +/- 0.08 fo r corpus luteum cysts. Ovarian endometrioma were visualized in 78 infe rtile patients. Forty eight of them were vascularized at the level of the hilus, while 16 showed pericistic vascular location (RI ranged fro m 0.40 to 0.59). Dermoid cysts (n = 12) were mostly avascularized (75% ), while polycystic ovaries demonstrated increased intraovarian vascul arity in all the examined cases. The mean RI detected within the ovari an stroma was 0.52 +/- 0.06. In 11 patients premature menopause was pr edicted due to low Volume of the ovary (< 2 cm(3)) 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 stag e of the disease. Conclusion: Transvaginal color Doppler allows precis e estimation of the functional state of the reproductive organs in inf ertile patients. (C) 1997 Elsevier Science Ireland Ltd.