Polycystic ovarian syndrome: assessment with color Doppler angiography and three-dimensional ultrasonography.

Abstract

We conducted a three‐dimensional ultrasonographic evaluation of the size and structure of the ovaries of women who had clinical and biochemical findings suggestive of polycystic ovary syndrome. We carried out a comparative color Doppler frequency and color Doppler amplitude study of the vascular patterns of these ovaries. This study involved 65 women of reproductive age with polycystic ovary syndrome and 25 eumenorrheic women who were not taking hormonal contraceptives and who had a body mass index below 25 kg/m2. Compared to controls, women with polycystic ovary syndrome had larger ovaries and thicker stroma, increased impedance in the uterine arteries, increased stromal vascularity with decreased impedance that persisted throughout the menstrual cycle, and a lack of luteal conversion.

3D Ultrasound in Gynecology and Reproductive Medicine

“…Studies by Schild et al [41] and Yaman et al [51] demonstrated no significant differences between endometrial thickness or endometrial volume measurements in patients who conceived compared with those who did not, but the studies did suggest that a minimal volume of 2.0-2.5 cm 3 was required for implantation to occur. This concept is supported by Raga et al [52], who assessed endometrial volume in 72 women on the day of embryo transfer, and noted that no pregnancies occurred in patients with an endometrial volume below 1 cm 3 and that implantation rates were significantly lower when the endometrial volume was less than 2 cm 3 . It is uncertain if volume measurements provide more predictive information than standard 2D measures of endometrial thickness as this has not been thoroughly assessed in randomized, blinded trials.…”

The New Three-dimensional Ultrasound Modes allow a Better Polycystic Ovary Syndrome Ultrasound Diagnosis beyond the Rotterdam Criteria

“…38 With the pioneering studies focused on Doppler, it was observed that resistance and pulsatility indices were very low in PCOS patients-related to good vascularization-but without changes throughout the cycle, this feature seems to be characteristic of PCOM, 21,38,39 although it is not internationally accepted. 39 This situation might change with the introduction of 3D digital Doppler angiography. 21,22 This new 3D US mode has allowed observing the following key events in this group of patients:…”

Three‐dimensional Ultrasonography in Gynecology

“…30 This technique may be particularly useful for assessing ovarian anatomy in patients with polycystic ovarian syndrome because it allows improved evaluation of the size and the structure of the ovaries. By using 3DUS and CDI, Dolz et al 31 showed that, in comparison with ovulatory women with normal cycles, patients with polycystic ovarian syndrome have decreased resistive and pulsatility indices in the vasculature of the ovarian stroma, increased stromal vascularity that starts in the follicular phase and persists throughout the menstrual cycle, stromal vascular flow with peak systolic velocities similar to those in corpora lutea, and lack of luteal conversion.…”

“…The value of volume measurements in infertility has been explored in a number of studies. 22,30,31 The utility of measurements of the ovary in polycystic ovarian syndrome and follicle size for better cycle monitoring has prompted a desire for more precise assessment of these irregularly shaped structures. Volume calculations of regular structures based on 2D variables are generally considered accurate, but for irregular structures, a more reliable and reproducible method of volume calculations must be used.…”

“…Optimal follicular volumes for oocyte recovery, fertilization, and cleavage are desired, and ultrasonography can be used for cycle monitoring without hormonal estimations. 31 The shape and number of the follicles influence the reliability of the standard 2DUS technique of follicular volume measurement. Volume measurements with 3DUS allow for accurate measurement of irregularly shaped follicles, which are often distorted by adjacent follicles, because the changing contours are outlined serially to obtain the specific volume measurement.…”