Ovarian Artery Research Articles

Anatomical variants of the uterine artery: 214 angiotomographies

The aim of the work is to know the changes that the uterine artery undergoes with age, the determination of its origin and its possible variants. Cross-sectional, comparative, descriptive, retrospective study Angiotomographies of the abdomen and pelvis of female patients were obtained, reformatted in 3D, analyzing the uterine arteries (thickness, origin and trajectory). Measurements were carried out by two medical specialists in diagnostic imaging. 107 CT angiograms of patients with a mean age of 56.62±16.97 years (range 1890) were included. The average thickness of the uterine arteries was 2.16 mm (±0.38 mm). Divided by laterality and age groups, they were 2.35 mm, 2.19 mm and 2.36 mm on the right side and 2.19 mm, 2.07 mm and 2.15 mm on the left side, respectively. There was no statistically significant difference in thickness between the three groups (p=0.08). Five types of anatomical variants are described with prevalence of 85.1% in type I, 6.75% in type II, 5.4% in type III, 2.02% in type IV and 0.67% in type V, the latter coming directly from the left ovarian artery. There are five diffe– rent anatomical variants in our population, Type I is the most predominant. There are no significant morphological changes with age, except for an increase in vascular lesions, mainly atherosclerosis, in people over 50 years of age.

Ovarian Reserve and Pelvic Ultrasound Assessment in Familial Mediterranean Fever.

IntroductionFamilial Mediterranean fever (FMF) is an inflammatory rheumatic disease that affects people in their reproductive period. The aim of this study was to investigate the number of gravida, ovarian reserve, and ovarian doppler characteristics in FMF patients.MethodsThe study design is cross-sectional. Between November 1, 2018, and October 31, 2019, 40 FMF patients, and 40 age-matched volunteers were included in the study. Early follicular phase follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), progesterone, and anti-Mullerian hormone (AMH) levels, as well as ovarian volume, antral follicle count (AFC), ovarian stromal artery doppler findings, and pelvic pathologies, were evaluated.ResultsThe number of gravida, and the AFC was significantly higher in the control group (16.00 ± 5.22) compared to the patients with FMF (13.00 ± 4.09) (p = 0.026). LH values were significantly higher in the FMF group. Thirteen patients (32.5%) received anakinra and colchicine, and 27 patients (67.5%) received only colchicine. There was no significant difference between the patients receiving anakinra, and the patients receiving colchicine in terms of AMH, FSH, AFC, and E2 values.ConclusionFMF patients were found to have low gravida and AFC, and a significant portion was observed to have pelvic fluid and hydrosalpinx. In conclusion, the presence of pelvic fluid, hydrosalpinx, and low AFC persist in FMF patients despite colchicine and/or anti-interleukin-1 treatments. The low gravida may be related to these pathologies detected in patients with FMF.

Ovarian, uterine, and luteal vascular perfusions during follicular and luteal phases in the adult cyclic female rabbits with special orientation to their histological detection of hormone receptor

Understanding the does reproductive hemodynamic changes during the estrous cycle is crucial for improving reproductive competence and fertility potential in this species. The objective of this study is to investigate the hemodynamic variations in ovarian (OA) and uterine (UA) arteries, histological and morphometric changes in ovarian and uterine tissues throughout the follicular (FP) and luteal (LP) phases in rabbits and determine estrogen (ER), progesterone (PR) receptors, and vascular endothelial growth factor (VEGF) distributions using immunohistochemistry.Fourteen adults pluriparous New Zealand rabbits were divided into rabbits at the FP (Day − 1; n = 7) and those at the LP (Day 9; n = 7). Animals were subjected to Doppler, hormonal (estrogen [E2], progesterone [P4], insulin-like growth factor [ILGF], and VEGF), histological, and immunohistochemical analyses. In LP, OA Doppler indices were significantly increased, whereas peak systolic velocity (PSV) was decreased compared with that in FP. UA Doppler indices were significantly decreased in the LP, whereas PSV was increased (P < 0.05). E2 levels were increased in the FP, whereas P4 levels were increased in the LP. The morphometric analysis of uterine tissues during the LP revealed an increase in the mean uterine endometrium length, endometrial connective tissue area percentage (%), endometrial glands number, myometrial area (%) and thickness. Furthermore, ovarian follicles and corpus luteum (CL) displayed strong positive immunoreactivity for ER, PR, and VEGF-A during both phases. The ovarian sections displayed a substantial (P < 0.05) increase in the area % of VEGF-A in the ovarian follicles during FP while in the CL during LP. Conversely, area percentage of VEGF-A immunoreactivity in the uterine luminal and glandular epithelia during the FP and LP revealed no differences. However, the number of VEGF-A–stained blood capillaries revealed an increase during LP than FP. In conclusion, this study demonstrated for the first time the changes in both ovarian and uterine arteries during two different phases of the rabbit cycle in relation to the histo-morphometric analysis and distribution of ER, PR, and VEGF-A, which regulate uterine functions that play a role in reproduction.

Intra-abdominal hemorrhage due to segmental arterial mediolysis of an ovarian artery pseudoaneurysm and concomitant aneurysmal subarachnoid hemorrhage: illustrative case.

Aneurysmal subarachnoid hemorrhage (SAH) is one of the most severe neurosurgical diseases in which systemic management is important from the acute phase to the chronic phase. The authors reported a case of aneurysmal SAH associated with intra-abdominal hemorrhage possibly caused by segmental arterial mediolysis (SAM). A 60-year-old woman collapsed suddenly at home. On arrival at our hospital, she was comatose and her head computed tomography (CT) showed SAH, probably from an anterior cerebral artery aneurysm. Simultaneous body CT to screen for pneumonia associated with COVID-19 incidentally detected an intra-abdominal hematoma and the bleeding point. Emergent ventriculostomy was conducted first. Because abdominal angiography detected a ruptured pseudoaneurysm of an ovarian artery, emergency embolization was subsequently performed for hemostasis. However, she deteriorated again, and her pupils became fully dilated. The patient died on day 3 of hospitalization. Patients with aneurysmal SAH rarely have intra-abdominal hemorrhage in the acute stage and may have a fatal outcome. Intra-abdominal hemorrhage should be suspected in the setting of unstable vital signs, and prompt treatment is necessary.

Frequency Of Ovarian Artery Doppler Indices in Patients of Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder. It is characterized by changes in Doppler indices of ovarian arteries. These changes are more prominent than the morphological changes of ovary and uterus. Objective: The aim of the analysis was to calculate the percentage of deranged ovarian artery in patients with polycystic ovarian syndrome ovarian patients. Methods: This observational study was conducted on total 225 women of reproductive age ranging between 18-40 years presented with the PCOS at the hospital. The gold standard for diagnosis of deranged ovarian artery in PCOS is transvaginal ultrasound. The Doppler ultrasound helps to calculate the resistive and pulsatility indices of ovarian artery. The pulsatility Index and Resistive Index was calculated and percentage frequency was estimated from the calculated results. Ovarian blood flow is deranged if its indices are above or below the normal range. The resistive index (RI) measured by Doppler imaging was between 0.80 to 0.95 and pulsatility index (PI) range was between 2.01 to 4.30. The data were arranged according to BMI of patients. The age and duration of PCOS were also considered for data stratification. Results: The study showed that about 191 (85%) patients out of 225 with PCOS have deranged ovarian artery Doppler. The range of pulsatility index was between 2.01 to 4.30 while the range of resistive index was between 0.80 to 0.95. The mean duration of PCOS and means age of patient was calculated. It was found that the deranged ovarian blood flow was more common in the women of age 27-5.9 years. 18.4-7.1 months was the mean duration of PCOS. The mean BMI of the patient was 27.2-4.9kg/m2.Conclusion: A significant number of women suffering from PCOS have deranged ovarian artery Doppler indices. This study evaluated the putative role of Doppler indices in diagnosis of suspicious PCOS patients.

Increased clitoral artery pulsatility index and decreased sexual desire level in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is claimed to effect the sexual desire, and recently, blood flow in the clitoral artery (CA) was measured by Doppler ultrasound (USG) examination and the level of sexual desire was objectively demonstrated by determining the pulsatility index (PI). In the present study, it was aimed to quantitatively determine the sexual desire levels in women with PCOS using Doppler USG and to compare the data with healthy women. The study included 71 patients diagnosed with PCOS and 78 healthy women who applied to our tertiary hospital gynecology clinics and for control purposes. Pulsatility indices were determined by measuring blood flows in the clitoral artery, uterine artery, ovarian artery and labial artery using Doppler USG in all participants. The clitoral artery pulsatility index was found to be increased significantly in women with PCOS. The mean age was 28.5 ± 3.7 in the polycystic ovary syndrome group and 30.0 ± 5.2 in the control group. The mean clitoral artery pulsatility index (1.4 ± 0.5 cm/sec) in the PCOS group was significantly higher than the control group (1.2 ± 0.4 cm/sec) (p = 0.033 cm/sec).The mean ovarian artery pulsatility index (0.8 ± 0.2 cm/sec) in the PCOS group was also significantly higher than the control group (0.7 ± 0.2 cm/sec) (p = 0.015 cm/sec). PCOS is showed to influence sexual desire with an objective measurement. Since trying to obtain objective data about the level of sexual desire, questionnaires were not applied to the participants and no questions were asked. In our study, it was found that the clitoral artery pulsatility index, that is, the rate of resistance in the blood flow to the clitoral region, increased significantly in women with PCOS. This finding shows that the level of sexual desire in women with PCOS has decreased compared to healthy women.

Relaxin and Erythropoietin Significantly Reduce Uterine Tissue Damage during Experimental Ischemia-Reperfusion Injury.

Successful uterus transplantation, a potential treatment method for women suffering from absolute uterine infertility, is negatively affected by ischemia–reperfusion injury (IRI). The aim of this study is to investigate the protective effect of relaxin (RLX) or/and erythropoietin (EPO) on experimental uterus IRI. Eighty rats, randomly assigned into eight groups (n = 10/group), were pretreated with either saline, 5 μg/kg human relaxin-2, 4000 IU/kg recombinant human erythropoietin or their combination. Ischemia was achieved by clamping the aorta and ovarian arteries for 60 min, following 120 min of reperfusion and tissue sampling. For sham animals, clamping was omitted during surgery. There were no differences in tissue histological score, malondialdehyde (MDA) and superoxide dismutase (SOD) levels, myeloperoxidase (MPO) and TUNEL-positive cell count between all sham-operated rats. Pretreatment with RLX preserved normal tissue morphology, reduced MDA levels, MPO and TUNEL-positive cell count, preserved SOD activity and upregulated NICD and HES1 gene expression when compared to the control group. Pretreatment with EPO reduced MDA levels. In conclusion, pretreatment with RLX, EPO or a combination of both EPO and RLX significantly alleviates uterine tissue damage caused by IRI.

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.

Histological and ultrastructural studies of female reproductive vasculature of one humped camel in relation to possible thermoregulation and ovarian hormones.

The study was designed to explore anatomical and histological vasculature changes in the female genital system of camel and serological aspects that might be responsible to maintain thermoregulation. Twenty-four adult female camels were sampled during breeding (November-April) and non-breeding (May-October) season. Blood was collected for estrogen, progesterone and cortisol level estimation. Genital organs were sampled and described after slaughtering. Samples were taken from the ovarian artery (OA), vein (OV) and arterio-venous complex (AVC), for light and scanning electron microscopy. Sections were stained with Hematoxylin and Eosin. (H&E), Masson’s trichrome, Weigert’s elastic and toluidine blue. Temperature and relative humidity were used to calculate stress indicator. Stress indicator was higher in non-breeding season (NBS). Anatomical and histological vasculature (OA, OV, AVC) dynamics were significantly higher in breeding season (BS) especially diameter of left OA. Parameters of OA were positively associated with estrogen level. Collagen, elastic, smooth muscles and mast cells were recorded least in BS compared to NBS. Unique venous structure, intra-mural venules (IMV), was discovered in tunica intima of OA, seen positively and negatively associated with estrogen and cortisol level in BS, respectively. Scanned electron-micrograph exhibited penetration and wrapping of OA by small thinned-walled venules that may form IMV. The AVC was too tightly packed to differentiate due to the collapse of the wall. Hormonal, seasonal, stress indicator and vascular dynamic of female genital system are interlinked and IMV in association with OA and OV may be proposed as the site of counter-current exchange in female reproductive system of the camel.

Abstract No. 136 Abdominal aortic angiogram: a necessary step to look for ovarian artery supply during fibroid embolization?

Practice variation within the interventional radiology community has raised question whether abdominal aortic angiograms (AAs) should be obtained during uterine fibroid embolization (UFE) to identify arterial supply to uterine fibroids from the ovarian arteries (OAs). Our institutional trend has favored the use of AAs at the time of UFE. We report the retrospective utility of AAs in identifying the OAs and the effect of these findings on procedural and clinical management12.

Diagnosis of Idiopathic Premature Ovarian Failure by Color Doppler Ultrasound under the Intelligent Segmentation Algorithm.

The aim of this study was to explore the application value of transvaginal color Doppler ultrasound based on the improved mean shift algorithm in the diagnosis of idiopathic premature ovarian failure (POF). In this study, 80 patients with idiopathic POF were selected and included in the experimental group, and 40 volunteers who underwent health examinations during the same period were selected and included in the control group, who underwent transvaginal Doppler ultrasound examination. At the same time, an improved mean shift algorithm was proposed based on artificial intelligence technology and applied to ultrasound image processing. In addition, the ovarian artery parameters of patients were compared in two groups, including peak systolic flow rate (PSV), diastolic flow rate (EDV), resistance index (RI), and pulsatile index (PI). The results showed that the relative difference degree (RDD) of the segmentation results of the algorithm in this study was significantly lower than that of Snake, Live_wire, and the traditional mean shift algorithm, while the relative overlap degree (ROD) and Dice coefficient were opposite, and the differences were significant (P<0.05). The mediolateral diameter of control group was 2.87±0.31cm, and the anteroposterior diameter was 1.86±0.28 cm; while those were 2.11±0.36 cm and 1.13±0.34 cm, respectively, in the experimental group, showing significant differences between the groups (P<0.05). Of the 80 patients in the experimental group, 132 cases with ovarian arteries were found; among 40 patients in the experimental group, 76 cases were found with ovarian arteries, and the hemodynamic detection rate of the experimental group was significantly lower than that of the control group (P<0.05). The ovarian artery parameters PI, RI, and S/D of the experimental group were significantly higher than those of the control group, and the differences were statistically significant (P<0.05). The results showed that the segmentation results of the improved algorithm in this study were more superior to the segmentation results of other algorithms. The regional information loss of the segmentation results was not serious, and the resolution was higher and the definition was higher. The transvaginal color Doppler ultrasound based on the artificial intelligence segmentation algorithm can clearly show the functional status and hemodynamics of the patient's ovaries. The ovarian artery parameters PI and RI can be used as specific indicators for evaluating the POF.

Clinical Value of Three-Dimensional Transvaginal Ultrasound in Diagnosis of Endometrial Receptivity and Ovarian Function in Patients with Infertility.

Objective A case-control study was conducted to explore the clinical value of three-dimensional transvaginal ultrasound in the diagnosis of endometrial receptivity (ER) and ovarian function in patients with infertility. Methods A total of 308 infertile women treated in our hospital from March 2020 to June 2021 were enrolled as the observation group, and another 300 women of childbearing age who underwent physical examination in the same period were enrolled as the control group. The clinical value of three-dimensional transvaginal ultrasound in ER in patients with infertility was analyzed by comparing the classification of endometrial and subendometrial blood perfusion, endometrial AUC value and Pi value, and subendometrial AUC value and Pi value. According to the number of oocytes obtained, the patients were assigned into the normal response group (182 cases, ≥5 oocytes) and the low response group (126 cases, <5 oocytes). The levels of some hormones, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and FSH/LH, were measured. Transvaginal ultrasonography was performed to detect ovarian volume (OV), antral follicle count (AFC), and peak flow rate of the ovarian interstitial artery (PSV). The peak of end-diastolic flow velocity (EDV) and other indexes were analyzed. The correlation between FSH level, FSH/LH, and ultrasound indexes was analyzed, and the ROC curve was established to analyze the value of transvaginal Doppler ultrasound in evaluating ovarian reserve function and predicting ovulation. Results There were significant differences in late proliferation type I and type III, ovulatory type II and type III (P < 0.05). There exhibited no significant difference in late proliferation type II, ovulation stage type I, and implantation window stage type I, type II, and type III (P > 0.05). Regarding the endometrial AUC and Pi values, the endometrial AUC and Pi values in the observation group were lower compared to the control group during late proliferation and ovulation (P < 0.05). There exhibited no significant difference in AUC and Pi (P > 0.05). Regarding the subintimal AUC and Pi values, the subintimal AUC and Pi values in the observation group were higher compared to the control group during late proliferation and ovulation (P < 0.05). There exhibited no significant difference in AUC and Pi during the implantation window (P > 0.05). There exhibited no significant difference in menarche age, age, body mass index, and menstrual cycle between the normal response group and the low response group (P > 0.05). The levels of EDV, OV, AFC, and PSV in the normal response group were higher compared to the low response group (P < 0.01). Compared with the low response group, the levels of FSH and FSH/LH in the normal response group were lower, but the levels of LH and E2 in the normal response group were higher (P < 0.05). The results of correlation analysis of FSH, FSH/LH, and ultrasound parameters between the normal response group and the low response group indicated that FSH was negatively correlated with E2, EDV, OV, AFC, and PSV in 308 infertile women (r = −0.817, -0.846, -0.707, -0.845, -0.911, P < 0.01), but it was positively correlated with FSH/LH (r = 0.714, P < 0.01). The ultrasound parameters of ovarian reserve function in the normal response group and the low response group were compared with the indexes that predicted ovulation. The results of ROC curve analysis indicated that the cutoff values of EDV, OV, AFC, and PSV were 4.141, 3.726, 4.106, and 13.944, respectively, the specificity of each index was higher than 90.00%, and the sensitivity was higher than 80.00% except PSV. Conclusion Transvaginal ultrasound can not only accurately evaluate the ER of infertile women but also directly observe follicular development and monitor ovulation, which is of high value in evaluating ovarian reserve function and predicting ovulation.

Evaluation of Endocrine and Metabolic Changes in Polycystic Ovary Syndrome by Ultrasonic Imaging Features under an Intelligent Algorithm.

To explore the application of intelligent algorithm-based ultrasound in the evaluation of polycystic ovary syndrome (PCOS) and the endocrine and metabolic changes of PCOS, 44 patients diagnosed with PCOS were recruited and rolled into three groups regarding detection methods. Backpropagation algorithm-based ultrasonic detection was adopted for the patients in the experimental group. The patients in the control group were tested by conventional ultrasound. In addition, 18 healthy volunteers were selected as the normal group. The results showed that the images processed by the backpropagation algorithm were substantially better than the traditional ultrasound images (P < 0.05), and the image display was clearer. S, A, and S/A ratios measured by two different detection methods were 7.8 mm2, 3.5 mm2, and 0.449 in the experimental group, respectively, which were significantly different from 6.3 mm2, 2.6 mm2, and 0.413 in the control group (P < 0.05). The PI and RI values of the interstitial ovarian artery in the experimental group were lower than those in the control group, and the systolic peak velocity (PSV) and end diastolic velocity (EDV) values were higher than those in the control group (P < 0.05). Compared with the control group, the ovarian volume, interstitial vascularization-flow index (VFI), and flow index (FI) in the experimental group were substantially increased, and the total number of detected follicles was more (P < 0.05). The level of follicle-stimulating hormone (FSH) in PCOS patients was substantially lower than that in normal controls (P < 0.05). The LH, E2, P, and T of PCOS patients were substantially higher than those of normal controls (P < 0.05). Ultrasound on account of the backpropagation algorithm can directly display the three-dimensional structure of the ovary and follicle and accurately measure the ovarian volume and follicle number. Endocrine and metabolic indicators can provide objective information for the clinical diagnosis of PCOS and can be used as a way of clinical evaluation of PCOS.

Hysterectomy with opportunistic salpingectomy and its influence on structural-functional parameters of ovarian tissue

The study examined the development of posthysterectomy syndrome in patients after hysterectomy with preservation of ovarian tissue.&#x0D; The aim of the study was to assess the functionality of ovarian tissue in patients with hysterectomy and opportunistic salpingectomy performed for uterine fibroids.&#x0D; Materials and methods of the research. The study was performed in 160 women of reproductive age. The first group included 90 patients after vaginal hysterectomy with tubectomy and associated with laparoscopy, the second group - 70 patients after abdominal hysterectomy with tubectomy. The control group included 50 women of reproductive age 45.7±1.3 years with asymptomatic fibroids. The diagnostic algorithm included assessment of hormonal status and instrumental study of structural and functional parameters of ovarian tissue both at the stage of preoperative observation and for 12 months, 3 and 5 years after surgery.&#x0D; Research results and their discussion. At the preoperative stage in both groups found a higher percentage of thyroid disease, hypertension and metabolic disorders, as well as combined proliferative processes of the uterus. Normal ultrasound picture of the ovaries was found in 67.8 % - in the first group and in 47.1 % - in the second group. Significant increase in blood flow in the ovarian artery, in the remote period showing atrophic changes with the development of ovarian depletion syndrome. Assessment of hormonal status in both groups shows marked changes in baseline levels of gonadotropic hormones (FSH and LH): increase in baseline FSH levels by 2.2 times, LH - 1.5 times against the control group (p &lt;0.05), dyshormonal disorders persist for up to 5 years after surgery in one third of cases, and up to 36 months - there is an increase in the proportion of cystic and trophic changes, most pronounced in patients with reduced ovarian reserve, dysmetabolic manifestations and combined proliferative processes of the uterus and appendages before surgery, and syndrome chronic pelvic pain and venous pelvic blood supply in the postoperative period.&#x0D; Conclusions. The technique of performing a hysterectomy does not have a significant effect on the functional state of the ovaries in the long term. The main indicators of ovarian blood flow and steroid hormone production after hysterectomy with opportunistic salpingectomy for uterine fibroids are close to the reference values up to 36 months postoperatively

Diagnostic accuracy of sonographic transvaginal ovarian biophysical profile as a predictor of infertility taking transvaginal ultrasound as a gold standard

Ovarian biophysical profile refers to assessment of ovaries to produce a successful conception and implantation environment. The ovarian scoring system for reproduction comprises the following parameters, taken in mid-cycle: ovarian volume, follicular size, and ovarian artery Doppler flow Resistive index and pulsatility index. Objective: To determine the diagnostic accuracy of sonographic transvaginal ovarian biophysical profile as a predictor of infertility taking transvaginal ultrasound as gold standard. Material and methods: The study comprised women visiting the department with diagnosed infertility for treatment during the period of two years. A total of 550 cycles were inducted primarily referred for ovarian assessment by ultrasound with patent tubes and normal utero-ovarian morphology. All those women having no conception with normal semen analysis of their husbands. Male factor infertility was also excluded. Baseline transvaginal sonography (TVS) was performed at proliferative phase, of the cycle. Mature follicles were studied by TVS. On an individual basis, the following parameters, that is, follicle size, ovarian volume and ovarian artery Doppler Pulsatility index, Resistive index were studied. Follicle size and ovarian artery Doppler flow were highly significant for a pregnancy. Results: The Ovarian biophysical profile was determined by applying the ovarian scoring system for reproduction (OSSR). In this research we compare infertile females with fertile. Out of 550 patients 243 (44.18%) patients were infertile and 307 (55.82%) were normal were discussed, as for as the primary infertile females were 99 (18.00%) and secondary infertile females were 144 (26.18%) and normal were 307 (55.82%). Out of five hundred and fifty cycles 331 woman had a perfect ovarian biophysical profile score of 10. The mean score of fertile was 9.39 ±1.56 and in infertile female was 7.05±2.55. The p- values &lt;0.001. The sensitivity and specificity of ovarian biophysical profile at cut off value 1is 100% and 0.04%. The sensitivity and specificity of ovarian biophysical profile at cut off value 8 it can be consider to rule out in future with 85.3% and 63.8% respectively. Conclusions: Ovarian scoring system for reproduction (OSSR) can prove to be a simple, diagnostic and authentic score to predict the ovarian environment and thereby helping in the prediction of the outcome in infertility. Six out of the nine parameters were found to be high score to predict a pregnancy all by themselves, but these parameters needed expertise and better instrumentation for evaluation. Of the remaining three parameters, two was same or equal on an individual basis and one was found to be not significant.

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.

Peripartum hemorrhage: Two cases of ruptured ovarian artery aneurysms with additional multifocal intact aneurysms.

We report two cases of peripartum ruptured ovarian artery aneurysms (OAA). One patient was treated through endovascular embolization and the other with percutaneous thrombin injection. Multiple additional unruptured OAAs were incidentally discovered in each patient. We describe the pathophysiologic basis for OAA rupture, approaches to treatment, and suggest management strategies for incidentally discovered ovarian aneurysms.

THE ROLE OF COLOUR DOPPLER IMAGING IN THE DIAGNOSIS OF PCOS

PCOS(Poly Cystic Ovarian Syndrome) is a hormonal disorder that affects women during their reproductive years (18-30year ).It is a condition that affects ovulation and the ovaries.Many fluid-filled sacs develop inside the ovaries in PCOS.These are follicles,each of which contains an immature egg.The egg is never mature enough to cause ovulation to occur. Important alterations in ovarian vascularization at the level of introvarian arteries occur in PCOS patients. Objective: Is colour Doppler ultrasonography is helpful in evaluation of PCOS. Method: An electronic database search with data range from 1999-2021 was performed(Science Direct, Google Scholar, PubMed, Springer).28 articles were found.All studies fully available evaluating PCOS ondoppler ultrasound. Results: Performance of Doppler ultrasound diagnosis was evaluated. PCOS patients had decreased ovarian artery pulsatility index (PI), resistance index (RI), and SD ratios and increased uterine artery pulsatility index (PI), resistance index (RI), and SD ratios. Conclusion: It is concluded that lowest ovarian stromal resistance levels were found in the patients than the controls.

Perioperative And Postoperative Comparison of Groups with Uterine Artery and Ovarian Artery Ligation and Groups without Artery Ligation in Laparoscopic Myomectomy

Perioperative And Postoperative Comparison of Groups with Uterine Artery and Ovarian Artery Ligation and Groups without Artery Ligation in Laparoscopic Myomectomy

THE ROLE OF COLOUR DOPPLER IMAGING IN THE DIAGNOSIS OF PCOS

PCOS(Poly Cystic Ovarian Syndrome) is a hormonal disorder that affects women during their reproductive years (18-30year ).It is a condition that affects ovulation and the ovaries.Many fluid-filled sacs develop inside the ovaries in PCOS.These are follicles,each of which contains an immature egg.The egg is never mature enough to cause ovulation to occur. Important alterations in ovarian vascularization at the level of introvarian arteries occur in PCOS patients. Objective: Is colour Doppler ultrasonography is helpful in evaluation of PCOS. Method: An electronic database search with data range from 1999-2021 was performed(Science Direct, Google Scholar, PubMed, Springer).28 articles were found.All studies fully available evaluating PCOS ondoppler ultrasound. Results: Performance of Doppler ultrasound diagnosis was evaluated. PCOS patients had decreased ovarian artery pulsatility index (PI), resistance index (RI), and SD ratios and increased uterine artery pulsatility index (PI), resistance index (RI), and SD ratios. Conclusion: It is concluded that lowest ovarian stromal resistance levels were found in the patients than the controls.