Hemodynamics of Uterine and Intraovarian Arteries in Ovarian Hyperstimulation Syndrome during Culdocentesis and Persistent Ascites for Predicting Pregnancy Rate

Abstract

Objective. To investigate the effects of culdocentesis on uterine and intrauvanan modynamics and the association between persistent ovarian hyperstimulation syndrome (OHSS) and successful pregnancy. Methods. Women who were admitted to our hospital with severe OHSS and received the transvaginal culdocenteses were included. All patients were divided according to the amounts of ascites removed (patients with ＜ 2000 mL ascites and patients with?2000 mL ascites); and their pulsatility index (pI) and maximum peak systolic velocity (MPSV) of uterine and intraovarian arteries were compared. The correlation between the persistent ascites and successful pregnancy was evaluated. Results. A total of 站patients and 82 culdocenteses (49 culdocenteses in patients with ＜ 2000 mL ascites and 33 culdocenteses in patients with ~?2000 mL ascites) were included. The uterine artery PI value decreased significantly after culdocentesis. Uterine artery PI value reduced after performance of 38 of 49 (78%, ＜ 2000 mL ascites) and 25of 33 (76%,?2000 mL ascites) culdocenteses. Uterine MPSV value and the PI and MPSV values of intraovarian arteries did not reduce significantly after culdocentesis. PI and MPSV values before or after culdocenteses between both groups were not different. Persistent ascites was related to higher rate of pregnancy. Conclusions. Culdocentesis improved uterine perfusion, but did not improve intraovarian perfusion. The improvement of uterine perfusion was not retated to the amount of ascites removed. Persistence of ascites was related to successful pregnancy.