Endometrial Thickness and Subendometrial Vascularity in Anovulatory Polycystic Ovarian Syndrome Patients Treated by Metformin

Abstract

Abstract Background PCOS, the commonest endocrinalogical disorder affecting women of age group between 18 and 44 years. PCOS compromises fertility through various pathways as hyperandrogenism, insulin resistance and impedance of the uterine and endometrial blood flow. Metformin improves the blood flow to the endometrium through reducing androgen level and correction of insulin resistance. The commonest parameters used to detect the endometrial receptivity outcome are endometrial vascular indices. Aim of the Work to evaluate the outcome of metformin administration in anovualtory PCO patients and its effect on the endometrium, including its role in ovulation and improvement of pregnancy rates. Patients and Methods this study included 85 patients from Ain Shams University outpatient gynecology and infertility clinic during the period from January 2018 till June 2018. These patients were investigated before treatment with ultrasound on day 14, 21 to evaluate the endometrial receptivity parameters such as endometrial thickness, uterine artery vascularity, endometrial and subendometrial vascularity. The patients received metformin 500mg three times per day for three months. After this duration they were reevaluated by ultrasound at days 14, 21 to detect any improvement. Results metformin therapy resulted in a significant increase of endometrial thickness and had a significant effect on uterine RI and PI. On the endometrial level, the endometrial and subendometrial R.I and P.I were significantly reduced after metformin treatment indicating better blood flow. Conclusion Metformin therapy improves endometrial vascularity, in addition to increasing endometrial thickness and improved impedance observed in uterine artery flow.