Evaluation of Changes in Doppler Sonographic indices of Uterine and Ovarian Arteries in Women with Endometriosis and Infertility
Adeleh Dadkhah, Zahra Ahmadian Mazhin, Elham Kor, Ghazal Sadri, Shima Ghafourian Noroozi, Seyed Reza Saadat Mostafavi
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ABSTRACT
Background: Endometriosis is an estrogen-dependent
inflammatory disease with a wide range of symptoms such as chronic pelvic pain
and infertility. The mechanism of infertility in women with endometriosis is
unknown. Possible causes, including inflammation and the effect of cytokines,
genetic cause, decreased blood flow and changes in the vascular indices of the
ovaries play an important role in infertility in these women.
Methods: Participants this cross-sectional
study was conducted at the Department of Radiology, Hazrat Rasool Akram
Hospital in Tehran, Iran, in from November 2018 to August 2019. The patients
were given a questionnaire including demographic information and menstrual
status. A digital transvaginal sonography scanner was used for assess the
uterine and adnexa, and color doppler and spectral doppler ultrasonography was
used to determine the RI and PI of uterine arteries and bilateral ovarian
parenchyma.
Result: The study was conducted on 155 non
pregnant-women and diagnosing with endometriosis. The mean age of the women was
32.4(SD=6.2) years with a range of 18-50 years. Among married people, 44
(37.3%) were infertile and 72 (61%) had no infertility. 129 (84.3%) of the
participants had endometrioma cyst. 24 patients (15.7%) had DIE findings without
endometrioma cyst. 142 patients had adnexal adhesion. In spectral
doppler evaluation the mean RI of the right ovary was higher in infertile
patients (0.61, SD = 0.19) than in fertile patients (0.54, SD = 0.13) and
single females (0.58, SD = 0.17), (P = 0.06). Also mean PI of right ovary in
infertile patients (1.2, SD = 0.86) significantly more than fertile (0.82, SD =
0.4) and single patients (1, SD = 0.87), (P = 0.006). The mean RI and PI of the
right ovary were significantly higher in those with severe disease and in
patients with severe adnexal adhesion.
Conclusion: In our study,
which confirms the above findings, the mean PI and RI of the right ovary was
significantly increased in people with infertility compared to fertile women.
In women with primary infertility as a subgroup of infertility, PI, RI of the
right ovary was higher than the others, which indicates increased vascular
resistance and decreased blood flow in the right ovary. However, the vascular
indices of the uterine and left ovaries did not differ significantly between
infertile and non-infertile individuals. There was no significant difference
between the doppler indices in the three different phases of menstruation in
comparison to infertile and fertile patients. In our study, the difference
between doppler indices was observed only in the right ovary which can be due
to functional differences in the ovaries
Keywords: Endometriosis, Infertility,
Doppler
ultrasonography, Resistance Index.
ABSTRACT
Background: Endometriosis is an estrogen-dependent
inflammatory disease with a wide range of symptoms such as chronic pelvic pain
and infertility. The mechanism of infertility in women with endometriosis is
unknown. Possible causes, including inflammation and the effect of cytokines,
genetic cause, decreased blood flow and changes in the vascular indices of the
ovaries play an important role in infertility in these women.
Methods: Participants this cross-sectional
study was conducted at the Department of Radiology, Hazrat Rasool Akram
Hospital in Tehran, Iran, in from November 2018 to August 2019. The patients
were given a questionnaire including demographic information and menstrual
status. A digital transvaginal sonography scanner was used for assess the
uterine and adnexa, and color doppler and spectral doppler ultrasonography was
used to determine the RI and PI of uterine arteries and bilateral ovarian
parenchyma.
Result: The study was conducted on 155 non
pregnant-women and diagnosing with endometriosis. The mean age of the women was
32.4(SD=6.2) years with a range of 18-50 years. Among married people, 44
(37.3%) were infertile and 72 (61%) had no infertility. 129 (84.3%) of the
participants had endometrioma cyst. 24 patients (15.7%) had DIE findings without
endometrioma cyst. 142 patients had adnexal adhesion. In spectral
doppler evaluation the mean RI of the right ovary was higher in infertile
patients (0.61, SD = 0.19) than in fertile patients (0.54, SD = 0.13) and
single females (0.58, SD = 0.17), (P = 0.06). Also mean PI of right ovary in
infertile patients (1.2, SD = 0.86) significantly more than fertile (0.82, SD =
0.4) and single patients (1, SD = 0.87), (P = 0.006). The mean RI and PI of the
right ovary were significantly higher in those with severe disease and in
patients with severe adnexal adhesion.
Conclusion: In our study,
which confirms the above findings, the mean PI and RI of the right ovary was
significantly increased in people with infertility compared to fertile women.
In women with primary infertility as a subgroup of infertility, PI, RI of the
right ovary was higher than the others, which indicates increased vascular
resistance and decreased blood flow in the right ovary. However, the vascular
indices of the uterine and left ovaries did not differ significantly between
infertile and non-infertile individuals. There was no significant difference
between the doppler indices in the three different phases of menstruation in
comparison to infertile and fertile patients. In our study, the difference
between doppler indices was observed only in the right ovary which can be due
to functional differences in the ovaries
Keywords: Endometriosis, Infertility,
Doppler
ultrasonography, Resistance Index.