Summary. The waveforms of vessels supplying the ovaries of women on an in‐vitro fertilization (IVF) programme were studied using transvaginal B‐mode and Doppler ultrasound. There were 125 scans recorded in 65 women at weekly intervals from 3 days after embryo transfer or 5 days after gamete intrafallopian transfer (GIFT) until confirmation of pregnancy or onset of menses. At each examination the signals obtained from vessels supplying the ovaries were recorded and quantified using a resistance index (RI). Fifteen patients became pregnant of whom one has subsequently miscarried. There was a highly significant difference in the RI values between patients who became pregnant and those who did not; no patient who became pregnant had a RI greater than 0.5. Oestrogen to progesterone ratios were calculated in the subgroup of non‐pregnant patients and there was no correlation between these values and the RI values. This new technique enables prediction of IVF treatment failure earlier than has been reported previously and may reflect the inadequacy of the corpus luteum.

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Ultrasonic localization of parathyroid tissue has been attempted in 24 patients with hyperparathyroidism prior to surgical exploration of the neck. All 24 patients had biochemically proven hyperparathyroidism. Standard contact diagnostic ultrasound equipment fitted with a 5 MHz transducer was used, and transverse and longitudinal scans of the region of the thyroid gland were performed at 5 mm intervals. The normal anatomical structures identified were the lobes of the thyroid gland, trachea, common carotid arteries, and jugular veins. The longus colli muscle on each side was used as a major landmark. These structures define the site where most parathyroid glands are found in the neck. In 18 of the 24 patients the suspected parathyroid tumor was visualized preoperatively and confirmed at operation. The abnormal glands ranged in size from 5 to 12 mm in transverse diameter. In 3 patients false‐positive diagnoses were made by ultrasound; at operation the abnormalities proved to be thyroid nodules protruding from the posterior surface of the thyroid gland. Ultrasonography is of little value in the presence of multinodular goiter. Three adenomas and 3 hyperplastic parathyroid glands greater than 5 mm in diameter were not identified. Localization of enlarged parathyroid glands by echography may be difficult when normal anatomical landmarks are altered by the presence of multinodular goiter or because of previous surgery. The sensitivity of this technique for identifying in the neck parathyroid glands larger than 5 mm in diameter was found to be 79.3% with 11.5% false‐positive and 8.6% falsenegative results.

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