Intraovarian Doppler velocimetry in ovulatory, dysovulatory and anovulatory cycles.

We have evaluated 48 spontaneous ovarian cycles in 23 women by transabdominal Doppler ultrasound. A total of 1064 intraovarian flow velocity waveform recordings were obtained. The ultrasound assessment of follicular growth, and changes in the concentrations of urinary luteinizing hormone and serum progesterone were used to classify the cycles. After follicular rupture (and presumed ovulation) in 30 cycles, the intraovarian flow velocity waveform (dominant ovary) showed a turbulent flow during the luteal phase ('luteal conversion'). The maximal resistance index was lower compared to values obtained during the follicular phase, and from the contralateral ovary. The intraovarian flow velocity waveform from 12 abnormal cycles showed similar quantitative and qualitative changes. When ovulation did not occur (three cases of the luteinized unruptured follicle syndrome, three anovulatory cycles), there was no evidence of 'luteal conversion' and the velocimetry values were similar throughout the study. Intraovarian Doppler velocimetry makes it possible to distinguish between ovulatory and anovulatory cycles, and provides a non-invasive diagnosis of the luteinized unruptured follicle syndrome.