Coexistence of polycystic ovaries and uterine fibroids and their combined effect on the uterine artery blood flow in relation to age and parity.

OBJECTIVE

To examine the coexistence of fibroids and ultrasonically diagnosed polycystic ovaries (PCO) and their combined effects on the uterine artery blood flow in relation to age and parity in women with regular menstruation.

STUDY DESIGN

One thousand seventy women, 18-40 years old, with gynecologic or infertility problems, were investigated with transvaginal ultrasound for uterine fibroids and PCO. A subgroup of 468 patients with regular cycles had repeated examinations up to ovulation time. Midcycle mean uterine artery pulsatility index (PI) and Doppler pulse waveform patterns were examined in relation to age, parity, PCO and fibroids. Cross tabulation with chi2 and ANOVA were used for data analysis. A two-tailed p value < 0.05 was taken as significant.

RESULTS

One hundred eleven of 343 patients > 35 years old (32.4%) had PCO compared to 479/727 younger women (65.9%) (p < 0.001). Furthermore, fewer patients with PCO (67 of 590, 11.4%) had fibroids as compared to patients with normal ovaries (131 of 480, 27.3%) (p < 0.001). This negative correlation was maintained irrespective of age, parity or ethnic origin. PCO were associated with higher uterine artery PI and more unfavourable Doppler pulse waveform patterns in women < 35 years old and nulliparous women. This effect was not maintained in parous women and those > or = 35 years old. Fibroids did not alter the effect of PCO but increased the uterine artery blood flow in patients with normal-looking ovaries.

CONCLUSION

The effect of PCO on the uterine artery blood flow is modulated by age and parity but not by fibroids, which are less common in women with PCO.