El-Mazny Akmal, Kamel Ahmed, Ramadan Wafaa, Gad-Allah Sherine, Abdelaziz Suzy, Hussein Ahmed M
Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Int J Womens Health. 2016 Nov 28;8:677-682. doi: 10.2147/IJWH.S124229. eCollection 2016.
Angiogenesis has been found to be among the most important factors in the pathogenesis of endometriosis. The formation of new blood vessels is critical for the survival of newly implanted endometriotic foci. The use of 3-D power Doppler allows for the demonstration of the dynamic vascular changes that occur during the process of in vitro fertilization (IVF). We aimed to evaluate the effect of ovarian endometrioma on uterine and ovarian blood flow in infertile women.
In a case-control study at a university teaching hospital, 138 women with unilateral ovarian endometrioma scheduled for IVF were compared to 138 women with male-factor or unexplained infertility. In the mid-luteal (peri-implantation) phase of the cycle, endometrial thickness, uterine and ovarian artery pulsatility index and resistance index, endometrial and ovarian volume, 3-D power Doppler vascularization index (VI), flow index (FI), and vascularization FI (VFI) values were measured in both groups.
There were no significant differences (>0.05) in endometrial thickness, uterine ovarian artery pulsatility index and resistance index, endometrial and ovarian volume, or VI, FI, and VFI between the two groups. Furthermore, the endometrial and ovarian Doppler indices were not influenced by endometrioma size. No significant differences were observed in the ovarian Doppler indices between endometrioma-containing ovaries and contralateral ovaries.
Ovarian endometrioma is not associated with impaired endometrial and ovarian blood flows in infertile women scheduled for IVF, and it is not likely to affect endometrial receptivity or ovarian function through a vascular mechanism.
血管生成被发现是子宫内膜异位症发病机制中最重要的因素之一。新血管的形成对于新植入的子宫内膜异位病灶的存活至关重要。三维能量多普勒的应用能够显示体外受精（IVF）过程中发生的动态血管变化。我们旨在评估卵巢子宫内膜瘤对不孕女性子宫和卵巢血流的影响。
在一所大学教学医院进行的一项病例对照研究中，将138例计划接受IVF的单侧卵巢子宫内膜瘤女性与138例男性因素或不明原因不孕的女性进行比较。在月经周期的黄体中期（着床期），测量两组的子宫内膜厚度、子宫和卵巢动脉搏动指数及阻力指数、子宫内膜和卵巢体积、三维能量多普勒血管化指数（VI）、血流指数（FI）和血管化血流指数（VFI）值。
两组在子宫内膜厚度、子宫卵巢动脉搏动指数及阻力指数、子宫内膜和卵巢体积，或VI、FI和VFI方面均无显著差异（>0.05）。此外，子宫内膜和卵巢多普勒指标不受子宫内膜瘤大小的影响。含子宫内膜瘤的卵巢与对侧卵巢之间的卵巢多普勒指标无显著差异。
卵巢子宫内膜瘤与计划接受IVF的不孕女性的子宫内膜和卵巢血流受损无关，且不太可能通过血管机制影响子宫内膜容受性或卵巢功能。
