Three-dimensional power Doppler indices of ovarian stromal blood flow and serum vascular endothelial growth factor after laparoscopic ovarian drilling in women with polycystic ovary syndrome

Abstract

Objective: To evaluate the effects of laparoscopic ovarian drilling (LOD) on threedimensional (3D) power Doppler indices of ovarian stromal blood flow and serum vascular endothelial growth factor (VEGF) levels in women with polycystic ovary syndrome (PCOS).Design: Prospective controlled study. Setting: Minia University Hospital, Minia, Egypt. Material and methods: 30 clomiphene citrate resistant women with PCOS undergoing LOD and 30 fertile women with normal ovaries were recruited in this study. Hormonal profile, Doppler indices of ovarian stromal blood flow and serum VEGF assays before and after LOD were evaluated and compared between the two groups. Evaluation was done at the beginning of the study, 1 week after LOD and at 3 and 6 month follow up periods.Main outcome measures: 3-D power Doppler indices of both ovaries and serum VEGF concentration.Results: Before LOD, serum levels of VEGF, total testosterone (T), free androgen index (FAI), LH, LH:FSH ratio, total antral follicle count (AFC), total ovarian volume (OV) and the 3D power Doppler blood flow indices were significantly higher in the PCOS group than in the control group. After LOD, there was a significant reduction in the serum levels of VEGF, T, sex-hormone binding

A Comparative Study on Quantitative Assessment of Blood Flow and Vascularization in Polycystic Ovary Syndrome Patients and Normal Women Using Three-Dimensional Power Doppler Ultrasonography

“…The results were in accordance with those recently presented by Al-Rab et al [3], El Behery et al [4] and Elmashad et al [5]. They used similar 3D power Doppler ultrasonography to compare VI, FI and VFI between normal and PCOS group.…”

“…Normal reference value taken for LH was 1.7-13.3 mIU/ml, FSH was 4.5-11.0 mIU/ml, S. estradiol was 40.7-220.4 pg/ml, S. testosterone was 9.0-56.0 ng/dl, DHEAS was 65-524 lg/dl, fasting insulin was 1.1-17.0 lg/ml, fasting glucose was 70-100 mg/dl, HOMA IR was B 2, TSH was 0.39-6.2 lIU/ml and S. prolactin was 2.1-47.6 ng/ml. The Rotterdam's consensus defined the polycystic ovary as having 12 or more follicles, measuring between 2 and 9 mm, and/or an ovarian volume (OV) [ 10 cm 3 . Only one ovary meeting these criteria is sufficient to establish the presence of polycystic ovaries [1].…”

A comparison of Doppler measures of ovarian blood flow between women with and without ovarian dysfunction and correlations of Doppler indices with ovarian dysfunction markers: a meta-analysis

“…Among the included studies, Kupesic et al ( 19 ) found a stronger negative correlation (r=−0.67) between follicle stimulating hormone (FSH) and FI in infertile women with normal FSH levels who underwent IVF procedures. Al-Rab et al ( 16 ) found no correlation between FSH and either FI or VI in PCOS patients. Outside this meta-analysis, Wu et al ( 43 ) found strong negative correlations between FSH and ovarian volume, antral follicle count, peak flow velocity and end-diastolic peak velocity in infertile women.…”

“…Although many studies have utilized Doppler ultrasonography for women with ovarian dysfunction, the outcomes reported have not always been consistent. For example, a study found no differences ( 15 ), but others have reported significant differences ( 16 , 17 ) in Doppler indices between women with and without PCOS. Some authors have found no correlation between Doppler FI or VI and antral follicles in women with infertility problems ( 15 , 18 ), others have found moderate to high correlations ( 11 , 16 , 19 ).…”

“…For example, a study found no differences ( 15 ), but others have reported significant differences ( 16 , 17 ) in Doppler indices between women with and without PCOS. Some authors have found no correlation between Doppler FI or VI and antral follicles in women with infertility problems ( 15 , 18 ), others have found moderate to high correlations ( 11 , 16 , 19 ). Similarly, whereas good correlations are observed between PI and testosterone levels in women with PCOS by some authors ( 20 , 21 ), others have reported weak correlations ( 22 , 23 ).…”