Subendometrial and intraendometrial blood flow during the menstrual cycle in patients with endometriosis.

OBJECTIVE

To use power Doppler ultrasound to assess the effect of endometriosis on intraendometrial and subendometrial blood flow during the menstrual cycle.

DESIGN

An observational prospective study.

SETTING

Academic teaching hospital.

PATIENT(S): Thirty patients with histologically confirmed ovarian endometrioma and 15 control women.

INTERVENTION(S): Power Doppler ultrasound examination during the menstrual cycle.

MAIN OUTCOME MEASURE(S): Intraendometrial and subendometrial color signals assessed by power Doppler ultrasound.

RESULT(S): A statistically significant higher proportion of endometrioma patients presented simultaneous intraendometrial and subendometrial color signals in the late secretory cycle phase compared with controls (40.0% vs. 6.7%).

CONCLUSION(S): The higher endometrial perfusion in patients with ovarian endometrioma that is observed in the late secretory phase of the cycle, close to menstrual shedding, favors the hypothesis that women with endometriosis might have higher endometrial vascular activity, thus facilitating the implantation process of endometrial cells outside the uterus.