Ovarian Arterial Blood Research Articles

Administration of Estradiol Benzoate Enhances Ovarian and Uterine Hemodynamics in Postpartum Dairy Buffaloes.

The postpartum (PP) period is a crucial stage for the resumption of reproductive performance and ovarian cyclicity in dairy buffaloes. The present study aimed, for the first time, to assess the effect of the administration of estradiol benzoate (EB) on ovarian and uterine hemodynamics in PP dairy buffaloes. Eight pluriparous acyclic domestic buffaloes were enrolled in the present experiment and received a dose of 10 mg of estradiol benzoate (EB) intramuscularly 4 weeks after parturition. All animals were examined two times before EB administration (days -3, and -1) and on the day of EB administration (day 0), followed by examinations on days 1, 3, 5, 7, and 9 post-EB administration. The middle uterine artery (MUA) and ovarian artery (OA) blood flow patterns were assessed using a color Doppler ultrasound device. The reproductive parameters were (1) the cross-sectional diameters (cm) of the OA and MUA, (2) cranial uterine horn thickness (UHT; cm), and (3) hemodynamic changes within the MUA on both the ipsi- and contra-lateral sides of the previous pregnant horn and within the OA corresponding to the ovarian tissues. The examined blood flow parameters were the pulsatility index (PI), resistance index (RI), peak systolic/end-diastolic ratio (S/D), time-averaged maximum velocity (TAV; cm/s), uterine blood flow rate (BFR; bpm), and uterine blood flow volume (BFV; mL/min). Concomitantly, blood samples were collected from the coccygeal vein, and the sera were stored at -18 °C for use in estradiol (E2-17β) and nitric oxide (NO) assays. The results revealed increases in both OA and MUA cross-sectional diameter (cm) on the ipsi-lateral and contra-lateral (p < 0.05) sides within 24 h until day 9 post-treatment. The values of the RI and PI of blood flow within the OA and MUA on the ipsi-lateral and contra-lateral sides of the previous pregnancy were obviously lower (p < 0.05) at 24 h after the administration of EB, and then, started to gradually elevate, reaching the pre-treatment values on day 9 after EB administration. Both the BFR and BFV in the OA and MUA significantly increased from 24 h to 72 h after EB administration on both the ipsi-lateral and contra-lateral sides (p < 0.05); then, their values started to decrease to reach the pretreatment value on day 9 after EB administration. Both E2 and NO concentrations significantly increased (p < 0.05) from 24 h until day 3 after EB injection and then started to decline after that, reaching the pre-treatment value on day 9. In conclusion, the administration of EB enhances the ovarian and uterine blood flow concomitantly with increased levels of NO in PP dairy buffaloes.

Ovarian Dynamics and Blood Flow Indices during Estrus in Purnathadi Buffaloes

The research work was implemented to study the ovarian dynamics and ovarian arterial blood flow by pulse-wave Doppler form with color Doppler ultrasonography during estrus in Purnathadi buffaloes. The mean ovarian diameter of left and right ovary was 2.27±0.08 and 2.37 ± 0.12 cm of right ovary and mean pre-ovulatory follicle diameter was 1.22 cm during estrus Purnathadi buffaloes. The mean ovarian pulsatility index and resistance index was 1.45 and 0.75 during estrus. The mean ipsilateral (on the side of pre-ovulatory follicle) and contralateral ovarian artery pulsatility index during estrus was 1.63±0.02 and 1.62±0.02. The mean ipsilateral (on the side of pre-ovulatory follicle) and contralateral ovarian artery resistance index during estrus was 0.77±0.01 and 0.75±0.01 respectively. The ovarian artery indices show non significant levels irrespective of presence of pre-ovulatory follicle.

Nanodelivery System for Ovsynch Protocol Improves Ovarian Response, Ovarian Blood Flow Doppler Velocities, and Hormonal Profile of Goats.

Simple SummaryDrug delivery systems depending on nanotechnology have been recently created to improve biological activity of drugs including hormones. Nanoformulated drugs have different pharmacokinetic properties in biological systems compared to their conventional forms due to the acquired new physicochemical properties such as lesser size, high size-to-weight ratio, and different surface charges and shapes. These properties enable them to efficiently deliver into target sites coping with existing biological barriers. Ovsynch protocol, GPG, is one of the most important estrous synchronization protocols due to the possibility of applying timed insemination with this protocol. This protocol is commonly used in many farm animals, as it aids in herd management and eliminates the need for the detection of estrus. However, there are still some shortcomings that restrict the outcomes of this protocol, such as scattering ovulation time, short luteal phase and inadequate luteal function, and low conception rates. Therefore, this study aims to evaluate ovarian response, blood flow of the ovarian and luteal arteries, and hormonal profile of goats receiving either a standard Ovsynch protocol or an Ovsynch protocol delivered via a nanodelivery system with different dosages of hormones. The present study is the first one that poses the idea that the nanodelivery system for the Ovsynch protocol enables lower hormone dose administration and improves the results of the protocol by inducing tighter synchrony of ovulation and better luteal function of synchronized goats.Fifteen cyclic, multiparous goats were equally stratified and received the common Ovsynch protocol (GPG: intramuscular, IM, injection of 50 mg gonadorelin, followed by an IM injection of 125 µg cloprostenol 7 days later, and a further IM injection of 50 mg gonadorelin 2 days later) or the Ovsynch protocol using nanofabricated hormones with the same dosages (NGPG) or half dosages (HNGPG) of each hormone. The ovarian structures and ovarian and luteal artery hemodynamic indices after each injection of the Ovsynch protocol using B-mode, color, and spectral Doppler scanning were monitored. Levels of blood serum progesterone (P4), estradiol (E2), and nitric oxide (NO) were determined. After the first gonadotrophin-releasing hormone (GnRH) injection, the number of large follicles decreased (p = 0.02) in NGPG and HNGPG, compared with GPG. HNGPG resulted in larger corpus luteum (CL) diameters (p = 0.001), and improved ovarian and luteal blood flow, compared with GPG and NGPG. Both NGPG and HNGPG significantly increased E2 and NO levels compared with GPG. HNGPG increased (p < 0.001) P4 levels compared with GPG, whereas NGPG resulted in an intermediate value. After prostaglandin F2α (PGF2α) injection, HNGPG had the largest diameter of CLs (p = 0.001) and significantly improved ovarian blood flow compared with GPG and NGPG. Both NGPG and HNGPG increased (p = 0.007) NO levels, compared with GPG. E2 level was increased (p = 0.028) in HNGPG, compared with GPG, whereas NGPG resulted in an intermediate value. During the follicular phase, HNGPG increased (p = 0.043) the number of medium follicles, shortened (p = 0.04) the interval to ovulation, and increased (p < 0.001) ovarian artery blood flow and levels (p < 0.001) of blood serum P4, E2, and NO, compared with GPG and NGPG. During the luteal phase, the numbers of CLs were similar among different experimental groups, whereas the diameter of CLs, luteal blood flow, and levels of blood serum P4 and NO increased (p < 0.001) in HNGPG, compared with GPG and NGPG. Conclusively, the nanodelivery system for the Ovsynch protocol could be recommended as a new strategy for improving estrous synchronization outcomes of goats while enabling lower hormone dose administration.

Effect of Uterine Artery Ligation and Uterine Artery Embolization on Postpartum Hemorrhage Due to Uterine Asthenia after Cesarean Section and Its Effect on Blood Flow and Function of Uterine and Ovarian Arteries.

Objective To investigate the efficacy of uterine artery ligation (UAL) and uterine artery embolization (UAE) in the treatment of uterine asthenia postpartum hemorrhage (PPH) after cesarean section and its effect on uterine and ovarian artery blood flow and function. Methods 100 patients with uterine asthenia PPH after cesarean section in our hospital from January 2018 to November 2020 were randomly divided into 50 cases in the UAL group and 50 cases in the UAE group. They were followed up for 12 months. The bleeding volume, operation time, immediate hemostasis rate, and hemostasis effective rate; lochia clearance time and menstrual rehydration time; RI and S/D; and serum FSH, E2, and LH levels were compared between the two groups. Results Compared with the UAL group, the amount of bleeding in the UAE group was significantly increased and the operation time was significantly shortened (p < 0.05). There was no significant difference in the immediate hemostatic rate and hemostatic effective rate between the two groups (p > 0.05). There was no significant difference in lochia clearance time and menstrual rehydration time between the two groups (p > 0.05). There was no significant difference in RI and S/D between the two groups (p > 0.05). Compared with before the operation, the levels of FSH and LH in the two groups decreased significantly, and the level of E2 increased significantly (p < 0.05). There was no significant difference between the two groups (p > 0.05). Conclusion The efficacy of UAL and UAE in the treatment of PPH with uterine asthenia after cesarean section and its effect on the blood flow and function of uterine and ovarian arteries are equivalent, but the amount of bleeding in UAL is less and the operation time of UAE is shorter. The appropriate operation method can be selected according to the actual situation.

Effect of Congrong Tusi Pill on Ovarian Artery Blood Flow and Sex Hormones in Adjuvant Treatment of Ovarian Function Decline

Effect of Congrong Tusi Pill on Ovarian Artery Blood Flow and Sex Hormones in Adjuvant Treatment of Ovarian Function Decline

Pulsatility and Resistance Indices of Uterine and Ovarian Arteries in Anovulatory Women With Polycystic Ovary Syndrome.

We aimed to compare the ovarian and uterine artery blood flow of anovulatory patients with polycystic ovary syndrome (PCOS) with those of ovulatory women throughout the menstrual cycle using color Doppler ultrasound. Seventy-one women with PCOS, who were admitted to the infertility outpatient clinic of a training and research hospital, were included in the study. The patients were divided into 2 groups as anovulatory (group 1, n = 23) and ovulatory (group 2, n = 37). Each patient was followed up throughout her menstrual cycle and included in either group 1 or group 2. Anovulatory cycles were determined by consecutive ultrasound examinations, and the progesterone value was measured in the luteal period. Eleven patients were excluded from the study because they did not continue their follow-up. The uterine and ovarian artery pulsatility and resistance indices of all patients in both groups were evaluated 3 times throughout a menstrual cycle: 7th to 10th day, 13th to 17th day, and 21st to 25th day. It was observed that the uterine artery resistances of the patients with anovulatory cycles remained relatively high throughout the menstrual cycle compared with ovulatory cycles. Both pulsatility and resistance indices of uterine and ovarian arteries were significantly higher in anovulatory cycles compared with ovulatory cycles at all evaluation times throughout the menstrual cycle (P < 0.05). Ovarian artery resistance in anovulatory patients did not significantly change during the menstrual cycle. Anovulatory patients with PCOS have higher uterine and ovarian artery resistance than ovulatory artery resistance, and the former shows a significant decrease throughout the cycle.

Normalization of wall shear stress as a physiological mechanism for regulating maternal uterine artery expansive remodeling during pregnancy.

Outward remodeling of the maternal uterine circulation during pregnancy is essential for normal uteroplacental perfusion and pregnancy outcome. The physiological mechanism by which this process is regulated is unknown; we hypothesized that it involved the normalization of wall shear stress (WSS). Pregnant Sprague–Dawley rats underwent unilateral ligation of the main uterine artery and vein at the cervical end of the uterus on gestational day 10, thus restricting inflow/outflow of blood into that uterine horn to a single point at the ovarian end; the contralateral sham‐operated side provided an internal control. This procedure alters uterine hemodynamics by increasing WSS, since the entire uterine horn is supplied by one rather than two vessels. Arterial diameter and blood flow velocity values were measured by intravital ultrasonographic pulse‐wave Doppler on gestational day 20 and used to calculate WSS. Although both ovarian artery lumen diameter and blood velocity increased, WSS was similar in both horns. These data support the concept that increased WSS secondary to hemochorial placentation is the primary physiological stimulus for uterine vascular remodeling and that its normalization may be the primary mechanism that regulates the extent of arterial circumferential growth required to maintain placental perfusion. We further hypothesize that shallow spiral artery invasion, such as occurs in preeclampsia, limits the increase in upstream shear stress and results in attenuated remodeling and placental under‐perfusion.

Survey of changes in ovarian and uterine artery blood flow and indexes by transvaginal Doppler sonography in POI patients and effect of acupuncture on their fertility

Background: Primary ovarian insufficiency (POI) is a common cause of infertility and usually defined by the triad of amenorrhea, estrogen deficiency, and elevated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in women &lt; 40 years of age. The aim of the present study was to investigate the relationship between uterine and ovarian blood flow with acupuncture and fertility ratio in patients of the Firoozgar Hospital Infertility Clinic. Methods: Twenty-nine patients with POI were included in this clinical trial. FSH, LH, estradiol (E2), and anti-Müllerian hormone (AMH) levels were measured. Patients with Turner syndrome were identified and excluded from the study. Selected patients were evaluated using transvaginal color Doppler sonography used to measure ovarian volume, endometrial thickness, flow rates, and uterine and ovarian artery indexes. Patients were treated with acupuncture twice a week for 5 weeks. After the end of treatment, hormonal assays and an ultrasound examination were repeated to check the changes. Results: Indexes of the uterine arteries (Resistance Index, Pulsatility Index) before versus after the intervention were significantly different (P &lt; 0.00) and uterine vascularity increased after treatment in 22 patients (75.8%). LH and FSH hormone levels were significantly decreased after the intervention (P &lt; 0.00), while AMH and E2 levels were significantly increased after treatment (P &lt; 0.00). The post-intervention right ovarian reserve was significantly increased (P = 0.02), whereas there was no significant difference in left ovarian reserve before vs. after treatment (P = 0.39). Spontaneous menstruation was detected after acupuncture in 16 patients. Conclusions: Our study demonstrated changes in vascularity, hormone levels, menopausal symptoms, and menstrual induction in patients after acupuncture intervention. Keywords: POI, acupuncture, arterial indexes.

Effects of Sedation with Medetomidine and Dexmedetomidine on Doppler Measurements of Ovarian Artery Blood Flow in Bitches.

Simple SummaryAlpha-2 agonists have widely been used in dogs as sedative and preanesthetic agents. These drugs have successfully been used in many different reproductive surgical procedures in dogs, including ovariectomy (OV) and ovariohysterectomy (OVH). The main problem associated with the alpha-2 agonists’ use is their dose-dependent cardiovascular effects and the changes induced on organ perfusion. Nowadays, the use of Doppler ultrasonography is the most commonly used method to assess physiological and pathological organ perfusion in veterinary medicine as it is a noninvasive technique. In bitches, Doppler ultrasonography has shown its usefulness to assess placental, ovarian and uterine blood flow during normal and abnormal pregnancy. We compared the ovarian artery flow velocity by duplex Doppler ultrasound before and after sedation with two commonly used alpha-2 agonists: medetomidine and dexmedetomidine. The results showed that the administration of medetomidine or dexmedetomidine induced an important decrease in blood flow velocities in the ovarian artery. Hence, their use could be indicated in surgeries to avoid excessive bleeding of the ovarian pedicle.The aim was to evaluate if medetomidine and dexmedetomidine affected arterial ovarian blood flow in dogs. The dogs were randomly assigned to two different groups. In Group 1, medetomidine (10 µg/kg) was administered intramuscularly and, in Group 2, dexmedetomidine (5 µg/kg) was used. After a preliminary exam, arterial blood pressure (BP) was measured and a duplex Doppler ultrasonographic examination of both ovarian arteries was performed. Twenty minutes after the administration of medetomidine or dexmedetomidine, BP and ovarian Doppler ultrasonography were repeated. High quality tracings of ovarian artery flow velocity were obtained in all dogs and Doppler parameters: Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV) and Resistive Index (RI) were measured before and after drug administration in the left (LO) and right (RO) ovaries. PSV and EDV values decreased significantly after drug administration (p < 0.05) compared to the non-sedated values, but no differences were found between the LO and RO (p > 0.05). The RI was not affected by drugs administration in neither of the groups studied (p > 0.05). In conclusion, the administration of medetomidine or dexmedetomidine causes a decrease in blood flow velocity in the ovarian artery and may be a good choice to avoid excessive bleeding prior surgeries in which ovariectomy.

Effects of Pressing Needles at Four Umbilical Points and Bushen Huoxue Tiaozhou Recipe Combined with Western Medicine on Follicle Stimulating Hormone, Estradiol, Anti-Mullerian Hormone, Antral Follicle Count and Ovarian Artery Blood Flow Parameters in Patients with Decreased Ovarian Reserve

To observe the effects of pressing acupuncture at four points of the umbilical point and Bushen Huoxue Tiaozhou prescription combined with western medicine. A total of 80 patients with hypoovarian function who were admitted to our hospital from December 2018 to December 2020 were selected and divided into groups according to their treatment plan. The control group was given four-point naval acupuncture combined with western medicine treatment and the observation group was based on the control group and was treated with Bushen Huoxue Tiaozhou recipe. The number of clinically cured cases in the observation group reached 15 cases and 18 cases and 5 cases were markedly effective and effective. The total effective rate was 95.00 %, which was higher than that of the control group and was statistically significant (p<0.05). After treatment, estradiol, anti-Mullerian hormone and antral follicle count of the observation group were higher than those of the control group (p<0.05) and follicle stimulating hormone was lower than the control group (p<0.05). After treatment, peak systolic velocity and end-diastolic velocity of the ovarian artery in the observation group were higher than those in the control group (p<0.05) and resistance index and pulsatility index were low in the control group (p<0.05). Pressing acupuncture at the four points of the umbilical cord and Bushen Huoxue Tiaozhou decoction combined with western medicine can promote the blood supply of the ovaries, improve the ovarian function and improve the curative effect.

Melatoninin kaynağı triptofanın IVF hastalarının sonuçlarına ve Doppler parametrelerine etkisi

Aims: Melatonin is the most powerful antioxidant and protects sperm, oocyte and embryo against oxidative stress. The effect of tryptophan, which is the building block of melatonin, on follicular melatonin levels and IVF outcomes is unknown. The objective of this study was to investigate the effect of tryptophan administration, a precursor for melatonin, on the levels of intrafollicular melatonin with the aim to reveal the correlation between tryptophan and the total number and quality of oocytes as well as clinical pregnancy rates. In addition, we aimed to examine the effect of melatonin increased by tryptophan on uterine and ovarian blood flow. Methods: Out of 103 patients who applied to Ondokuzmayis University IVF clinic for IVF treatment, 51 patients were administered a 100 mg dose of tryptophan orally (Group A) and 50 control patients who were randomly selected did not receive tryptophan (Group B). Firstly, follicular melatonin levels were compared between Group A receiving tryptophan and Group B without tryptophan. Both groups were also compared according to the oocyte count, oocyte count, fertilized oocyte count, embryo count and pregnancy rates, ultimately. In addition, all patients were measured for uterine and ovarian artery blood flow by vaginal ultrasound on the day of OPU.. Results: There were no differences in age (32.16 ± 3.82 years vs 33.06 ± 4.44 years) (p = 0.276), BMI (28.45 ± 2.82 kg/m)2 vs 28.15 ± 3.03kg/m2 (p = 0.602) and peak estradiol levels (2451.69 ± 469.75 pg/ml vs 2420.26 ± 443.71 pg / ml) (p = 0.73) between the groups. Group A exhibited high levels of melatonin in the follicular fluid with a mean value of 259.8 pg/ml, whereas Group B had 91.3 pg/ml (p &amp;lt;0.001). There were found significant differences in the oocyte count (9.08 ± 3.22 vs 7.66 ± 1.89) (p = 0,008), mature oocyte count (7.2 ± 2.8 vs 6.1 ± 1.8) (p = 0,021) and fertilized oocyte count (6.35 ± 2.44 vs 5.28 ± 1.69) between group A and group B. Pregnancy rates were higher in group A (35.3%). The pregnancy rate (30%) was lower in Group B, which did not receive tryptophan and had low melatonin levels in follicular fluid. However, there was no statistically significant difference. Uterine, ovarian artery systolic and diastolic blood flows of Group A were significantly lower than Group B (P &amp;lt;0.001). Conclusions: Administration of tryptophan to IVF patients significantly increases the level of melatonin in follicular fluid. The results demonstrate that high levels of melatonin in follicular fluid may increase oocyte count and quality although they do not significantly improve clinical pregnancy rates.

Impact Of Hypotensive Action Of Angiotensin Converting Enzyme Inhibitor On Ovarian-Intraovarian Blood Flow And Follicles Development In Goats Hormonally Stimulated With Repeated Fsh-Ecg Treatment

Background: Recent evidence shows that the renin-angiotensin system (RAS) participates in important reproductive processes, such as steroidogenesis, folliculogenesis, oocyte maturation and ovulation. Several studies have proposed to use an angiotensin-converting enzyme (ACE) as a RAS modulator, aiming to improve reproductive efficiency, however, the presence of the main components of this system in reproductive tissues still need to be further investigated, since the physiological functions seem to be species-specific. The aim of this study was to assess the impact of enalapril-maleate, an ACE inhibitor, during repeated gonadotropins treatment on ovarian blood flow and follicular development in goats. Materials, Methods and Results: Twenty Anglo-Nubian cross-bred goats were equally grouped according to parity (n=10/group): nulliparous and multiparous parity. In each group, five animals were randomly selected to receive 0.4 mg.kg-1 of enalapril-maleate during 11 days of estrus synchronization and gonadotropins treatments. The other animals received the same volume of saline solution. Estrus synchronization of all goats was made by intramuscular administration of PGF2α analog, followed 48 h later by intravaginal insertion of a controlled internal drug release device. Forty-eight hours after device withdrawal, a single dose of 60 mg of FSH plus 300 UI of eCG was administered and repeated every 4 days to complete 3 treatments. Transrectal ultrasonography was performed using pulsed and color Doppler to evaluate Doppler velocimetrics parameters of the ovarian artery and intraovarian blood flow, respectively, and B-mode real-time ultrasound scanner to evaluate the follicular development. In the females treated with enalapril-maleate was observed a significant reduction of systolic and diastolic peak, without difference according to parity. In addition, in the third session of hormonal stimulation, only the groups (nulliparous and multiparous) not treated with enalapril maleate had a significant increase in the intraovarian blood flow (Doppler area). In treated group was also found a greater number of small follicles, a lower proportion of follicle ≥ 5 mm and a smaller follicular size. In the same group, the nulliparous females had a lower proportion of large follicles compared to the saline group, otherwise, there were no differences between the treatments in multiparous goats. In the group treated with enalapril maleate, higher number of large follicles was observed in multiparous animals than in the nulliparous ones.Discussion: In vivo and in vitro studies have shown clear effects of RAS modulation on reproductive aspects. Our results confirmed the hypotensive effect of enalapril maleate on the ovarian artery and intraovarian blood flow, also showing that the administration of the drug reduced the process of follicular depletion and the growth of large follicles. These findings suggest that the hypotensive effects observed in our experiment, result from the treatment with the ACE inhibitor, and that this alteration in hemodynamic parameters may be the main responsible for the lower follicular response observed in animals treated with enalapril-maleate. We suggest that further studies are necessary to elucidate possible effects of the administration of an ACE inhibitor on ovarian activity, especially in the expression of genes associated with follicular, oocyte and embryonic development. Finally, the study conclude that the administration of enalapril-maleate in our experimental condition exhibit a hypotensive effect on ovarian circulatory system but did not show to promote a real benefit of follicular development in goats.

Does bilateral uterine artery ligation have negative effects on ovarian reserve markers and ovarian artery blood flow in women with postpartum hemorrhage?

ObjectiveBilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply.MethodsThis prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and anti-Müllerian hormone (AMH) levels.ResultsThere were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p>0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p>0.05 for all).ConclusionIn this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.

Dynamics of uterine and ovarian arteries flow velocity waveforms and their relation to follicular and luteal growth and blood flow vascularization during the estrous cycle in Friesian cows

Doppler ultrasonography enabled understanding of the reproductive system hemodynamics in cyclic and pregnant cattle. To confirm the hypothesis that the ipsilateral ovarian and uterine arterial blood flows to the ovulating ovary are higher than the contralateral one along days and phases (follicular, early luteal, mid-luteal, late luteal) of the estrous cycle, eight cyclic spontaneously ovulating cows were scanned with Doppler ultrasound each other day along three oestrous cycles to monitor the follicular dynamics, the vascularization of the ovulatory follicle (OF), the corpus luteum (CL) developmental dynamics, the ipsilateral and the contralateral ovarian and uterine arterial diameters and their blood flow. Results proved the hypothesis. Both days and phases of the estrus cycle influenced (P = 0.0001) the follicular dynamic, the luteal hemodynamics, the ovarian and uterine hemodynamic. The ovulatory wave and the mid-luteal non-ovulatory wave had expanding numbers and the diameters of small, medium and large follicles. Though area, antral area, vascularization area of the OF ascended from Day −4 to the day of ovulation (Day 0), but the percent of its vascularization area and that of granulose layer increased till Day −3. The CL diameter increase till Day 15, and its vascularization area increased till Day 13, but its% of vascularization area ascended (P = 0.0001) from Days 1–4 and declined from Days 9–13. Both RI and PI of the ipsilateral ovarian artery were lower than the contralateral one; but, both obtained high values during the follicular phase. A linear increase (P = 0.0001) of uterine horns vascularization area and both ovarian and uterine arteries diameters, PSV and EDV from follicular to late luteal phases accompanied a linear decrease of their PI and RI. In conclusion, the ovarian and uterine blood flows vary according to the estrous day, estrous phase, the ovulating ovary, ovulatory follicle growth and corpus luteum developmental stage.

Primary postpartum hemorrhage: outcome of uterine artery embolization.

To assess the efficacy of uterine artery embolization (UAE) for the management of primary postpartum hemorrhage (PPH) and to determine the factors associated with clinical outcomes especially in relation to the ovarian artery. A retrospective analysis of 33 patients who underwent UAE for primary PPH was performed. Clinical data were used regarding maternal characteristics, cause of bleeding, mode of delivery, bleeding onset after delivery, risk factors for PPH, presence of coagulopathy, details regarding the UAE procedure, and types of ovarian artery flow. We defined two types of ovarian artery flow by initial aortography before UAE (Type A: ovarian artery flow arose directly from the aorta to the uterine artery; Type B: ovarian artery flow that did not obviously arise from the aorta). Clinical success was defined as cessation of bleeding after UAE without the need for hysterectomy. Univariate analysis was performed to determine factors related to clinical outcomes. The major indication of UAE was uterine atony (82%; 27/33). Extravasation of contrast medium was observed in 15 (45%) patients. The clinical success rate was 85% (28/33). In five patients, embolization failed, and these patients were managed by hysterectomy. Univariate analysis showed that retained placental tissue (p < 0.001), type of ovarian artery (p < 0.001) and the existence of extravasation of contrast medium (p = 0.049) were related to the clinical success rate. The clinical success rate was 85% (28/33), and some PPH patients were thought to need ovarian artery embolization in addition to UAE. Advances in knowledge: Initial aortography before UAE may be useful to predict the failure of UAE and the need of ovarian artery embolization. Obvious ovarian arterial blood flow to the uterus by aortography could be a warning sign.

Application of blocking blood flow in laparoscopic opening-taking embryo operation on interstitial tubal pregnancy

Objective To explore the safety and feasibility of blocking blood flow in interstitial tubal pregnancy treated with laparoscopic opening-taking embryo operation. Methods The clinical data of 98 patients with lump interstitial tubal pregnancies (requesting reserve procreate function) from January 2006 to December 2013 were chosen. Among them, 56 patients were in study group (January 2010-December 2013) and 42 patients were in control group (January 2006-December 2009). All patients were treated with opening-taking embryo by laparoscopic operation. In study group, we first blocked the uterine artery and ovarian artery blood supply of pregnancy lump, secondly opened pregnancy lump and stripped gestation sac with hydraulic pressure separation during operation. Whereas, in control group, we opened pregnancy lump and taken out pregnancy tissues according to convention method without blocking blood flow. Operation success rate, operation blood volume, operation time, persistent ectopic pregnancy (PEP) happening rate, fallopian tube unobstructed information, and pregnancy information after operation were compared between two groups. Results In study group, operation success rate was 96.4%, which was significantly higher than that in control group (61.9%) (P<0.01); operation blood volume was[(20.7±10.4)ml], which was significantly less than that in control group [(60.7±18.4)ml](P<0.01); operation time [(46.6±14.2)min] was significantly shorter than that in control group [(66.5±19.4)min](P<0.01); there was no PEP in study group, while there were 5 PEPs (11.9%) in control group. Fallopian tube unobstructed rate after operation in study group (76.9%) was significantly higher than that in control group (41.7%) (P<0.05). Conclusions Application of blocking blood flow in opening-taking embryo by laparoscopic operation on lump interstitial tubal pregnancies is safe and effective. Key words: Fallopian tubes /BS/SU; Pregnancy, tubal /SU; Laparoscopy

Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic

Objective: To compare ovarian stromal artery blood flows measured by Doppler ultrasonography of polycystic ovary syndrome (PCOS) patients and healthy women with polycystic ovarian image in ultrasonography.Methods: Forty-two patients diagnosed with PCOS according to the criteria of 2003 Rotterdam Concencus Conferance on PCOS and 38 healthy volunteers with polycystic ovarian image in ultrasonography were included in the study. Ovarian volumes and ovarian stromal artery blood flows were measured by 3-dimensional (3-D) ultrasonography and Doppler ultrasonography in all patients.Results: In patients with PCOS, ovarian stromal artery pulsatility index (PI) and resistivity index (RI) were found significantly different from healthy women with polycystic ovarian image in ultrasonography (p < 0.05). 3-D ovarian volumes were found significantly higher in patients with PCOS (p < 0.05), and a negative correlation was also obtained between ovarian volumes and ovarian stromal artery resistivity indices.Conclusion: Ovarian stromal artery Doppler examination could have an importance to explain the pathophysiology of PCOS, but there are few publications in the literature about PCOS and the details of ovarian stromal artery Doppler parameters in patients with polycystic ovarian image only. We conclude that Doppler ultrasonography findings of PCOS patients might be helpful in understanding the clinical follow-up and etiology of the disease.

Quantitative analysis of ovarian artery blood flow volume during whole pulsation cycle in patients with polycystic ovary syndrome

Objective To quantitatively analyze the changes of ovarian artery blood flow volume during whole pulsation cycle in patients with polycystic ovary syndrome(PCOS)by pulsed Doppler.Methods The ovarian arteries of 80PCOS patients were examined by transvaginal color Doppler flow image(TV-CDFI).After examination of the parameters of pulsed Doppler,the ovarian artery blood flow volume in whole pulsation cycle was calculated with velocity-time integral while considering the internal diameter of the blood vessels.The results were compared with those of 80 healthy women of childbearing age in the control group.Results The typical spectrum of ovarian artery blood flow in PCOS patients was highspeed low-resistance waveform.The changes of blood flow volume and resistance index(RI)value were not significantly different at different times of the menstrual cycle(P0.05).However,the changes of blood flow volume and RI value in the control group were significanly different at different times of the menstrual cycle(P0.05).The blood flow volume of PCOS patients was significantly increased compared with those of the control group at different times of menstrual cycle(P0.05). The RI value of ovarian artery in PCOS patients was significantly lower than those in the control group during menstrual cycle 3-9days and 26-32days(P0.05),but showing no significant difference during menstrual cycle 11-15days and 18-23 days(P0.05).Conclusion Quantitative determination of ovarian blood flow volume using blood flow whole pulsation period method can provide a relatively accurate and reliable quantitative assessment of the ovarian perfusion in PCOS patients.

Influence of l-arginine supplementation on reproductive blood flow and embryo recovery rates in mares

Supplementation with l-arginine can increase uterine arterial blood flow and vascular perfusion of the preovulatory follicle in mares. Increased vascular perfusion of the preovulatory follicle has been correlated with successful pregnancy in mares. The objective of this study was to determine if supplemental l-arginine would increase ovarian arterial blood flow, vascular perfusion of the preovulatory follicle, and embryo recovery rates in mares. Mares were blocked by age and breed and assigned at random within block to l-arginine supplementation or control groups. Mares were fed l-arginine beginning 17 days before and through the duration of the study. Transrectal Doppler ultrasonography was used to measure ovarian arterial blood flow and vascular perfusion of the preovulatory follicle daily when it reached 35 mm and subsequent CL on Days 2, 4, and 6. Mares, on achieving a follicle of 35 mm or more were bred via artificial insemination and an embryo collection was attempted 7 days after ovulation. Treatment did not affect interovulatory interval (arginine-treated, 18.1 ± 2.6 days; control, 20.7 ± 2.3 days) or embryo recovery rate (arginine-treated, 54%; control, 48%). Mares treated with l-arginine had a larger follicle for the 10 days preceding ovulation than control mares (30.4 ± 1.2 and 26.3 ± 1.3 mm, respectively; P < 0.05) and vascular perfusion of the dominant follicle tended (P = 0.10) to be greater for the 4 days before ovulation. No differences were observed between groups in diameter or vascular perfusion of the CL. Resistance indices, normalized to ovulation, were not significantly different between groups during the follicular or luteal phase. Oral l-arginine supplementation increased the size and tended to increase perfusion of the follicle 1, but had no effect on luteal perfusion or embryo recovery rates in mares.

Comprasion of Ovarian Stromal and Uterin Artery Blood Flow Measured by Color Doppler Ultrasonography in Polycystic Ovary Syndrome Patients and Patients With Ultrasonographic Evidence of Polycystic

Comprasion of Ovarian Stromal and Uterin Artery Blood Flow Measured by Color Doppler Ultrasonography in Polycystic Ovary Syndrome Patients and Patients With Ultrasonographic Evidence of Polycystic