Application value of uterine and ovarian volume, endometrial thickness combined with ovarian hemodynamics in polycystic ovarian syndrome / 中国医师进修杂志

ABSTRACT

Objective:To explore the value of uterine volume, ovarian volume (OV), endometrial thickness (ET) combined with ovarian hemodynamics in polycystic ovarian syndrome (PCOS).Methods:Fifty-three patients with PCOS diagnosed in the Third Affiliated Hospital of Wenzhou Medical University from October 2017 to October 2019 were selected as observation group and 53 healthy women of child bearing age who underwent physical examination at the same time were selected as control group. Patients with PCOS were divided into groups according to their different menopause times and ovalution statusafter ovulation promotion. The uterine volume, OV, ET, peak ovarian systolic velocity (PSV), ovarian artery resistance index (RI), and ovarian artery pulsation index (PI) was measured and recorded by transvaginal color Doppler ultrasound and compared between observation group and control group; and the above indicators in PCOS patients before and after chorionic gonadotrophin injection and 7 d after ovulation were compared.Results:Before treatment, the value of uterine volume, RI and PI of the observation group were lower than those of the control group (30.28 ± 11.37) cm 3 vs. (38.41 ± 13.02) cm 3, 0.31 ± 0.04 vs. 0.73 ± 0.09, 0.86 ± 0.24 vs. 1.16 ± 0.32, the OV, ET, and PSV were higher than those of the control group (15.04 ± 3.06) cm 3 vs. (6.35 ± 1.32) cm 3, (1.32 ± 0.41) mm vs. (0.64 ± 0.16) mm, (12.27 ± 2.83) cm/s vs. (9.37 ± 1.53) cm/s, and the differences were statistically significant ( P<0.05). Before treatment, the uterine volume and OV of PCOS patients had no significant differences in different menopause groups ( P>0.05). In menopause 10 - 15 d group, menopause 16 - 30 d group, menopause 31 -90 d group, and menopause>90 d group, the ET and PSV were gradually higher, the RI and PI were gradually lower, and the differences were statistically significant ( P<0.05). After ovulation promotion among 53 PCOS patients, 48 patients succeeded in ovulation promotion and 5 patients failed. On the day of chorionic gonadotrophin injection and mid luteal phase,the OV, ET and PSV in the successful ovulation induction group were lower than those in the failed ovulation induction group, and the uterine volume, RI and PI were higher than those in the failed ovulation induction group, and the differences were statistically significant ( P<0.05). In the successful ovulation induction group, the ET, RI, PI onthe day of chorionic gonadotrophin injection were lower than those onmid luteal phase, PSV was higher than that on mid luteal phase, and the differences were statistically significant ( P<0.05). Receiver operating characteristic (ROC)curveanalysis showed that that the area under the curve(AUC) of the value of uterine volume, OV, ET, and ovarian hemodynamic indicators joint examinationfor PCOS was 0.897 (95% CI 0.795 - 0.968), with a sensitivity of 95.0%, and a specificity of 80.2%, and all were higher than that of the single examination ( P<0.05). Conclusions:The value of uterine volume, OV, ET combined with ovarian hemodynamics are beneficial to observe the ovarian function of PCOS patients and the developmental potential of the basal layer of the endometrium, and have good application value for the evaluation of PCOS patients and guidance of clinical diagnosis and treatment.