Kupesić S, Marton U, Kurjak A
Klinika za ginekologiju i porodnistvo, OB Sveti Duh, Zagreb.
Lijec Vjesn. 1996 Mar;118 Suppl 1:42-4.
To evaluate the value of transvaginal color and pulsed Doppler measurements of the uterine and ovarian arteries in infertile patients with polycystic ovarian syndrome (PCOS).
Prospective controlled trial included forty (40) patients with PCOS and 40 healthy women. All the patients were examined by transvaginal color and pulsed Doppler on the 5th, 10th, 12th, 15th, 21st and 24th day of the menstrual cycle. The hormonal profile (estradiol (E2), luteinizing hormone (LH), follicular stimulating hormone (FSH), progesterone, testosterone and prolactin) was correlated to the Doppler results.
The flow velocity patterns of uterine and ovarian vessels showed changes during the normal ovulatory menstrual cycle, while in the patients with PCOS these changes did not occur. The high resistance index (RI = 1.0) with reverse flow was detected in both ovarian arteries in PCOS group, and showed no cyclic changes. Ovarian stromal and hilar arterial impedance (0.54 +/- 0.05) as well as uterine artery resistance index (0.91 +/- 0.09) did not show significant changes during the menstrual cycle.
Our study suggests that a large fraction of patients suffering from PCOS has elevated uterine artery resistance index despite normal plasma E2 levels. It can be postulated that excessive production of ovarian factor (other than E2) may increase the uterine resistance and alter the endometrial receptivity. This finding may explain why endometrial receptivity is shown to be poor in patients with PCOS. Estimation of uterine and ovarian arterial impedance values seems to have clinical impact in the management of these patients attending an in vitro fertilization program.
评估经阴道彩色及脉冲多普勒测量多囊卵巢综合征（PCOS）不孕患者子宫和卵巢动脉的价值。
前瞻性对照试验，纳入40例PCOS患者和40例健康女性。所有患者在月经周期的第5、10、12、15、21和24天接受经阴道彩色及脉冲多普勒检查。将激素水平（雌二醇（E2）、黄体生成素（LH）、卵泡刺激素（FSH）、孕酮、睾酮和催乳素）与多普勒检查结果进行关联分析。
子宫和卵巢血管的血流速度模式在正常排卵月经周期中会发生变化，而PCOS患者则未出现这些变化。PCOS组双侧卵巢动脉均检测到高阻力指数（RI = 1.0）且有反向血流，且无周期性变化。卵巢基质和门部动脉阻抗（0.54±0.05）以及子宫动脉阻力指数（0.91±0.09）在月经周期中未显示出显著变化。
我们的研究表明，尽管血浆E2水平正常，但很大一部分PCOS患者的子宫动脉阻力指数升高。可以推测，卵巢因子（而非E2）的过度产生可能会增加子宫阻力并改变子宫内膜容受性。这一发现可能解释了为什么PCOS患者的子宫内膜容受性较差。估计子宫和卵巢动脉阻抗值似乎对这些接受体外受精治疗的患者的管理具有临床意义。
