Evaluation of ovarian volume, stromal blood flow and antral follicular count in case of infertility by spectral color doppler and transvaginal 3D ultrasonography
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 9, Pages 316-322
AbstractFertility is a complex equation of continuous hormonal changes. The present study was evaluation of ovarian volume, stromal blood flow and antral follicular count in case of infertility by spectral color doppler and transvaginal 3D ultrasonography. The present study was conducted to assess ovarian volume, stromal blood flow and antral follicular count in case of infertility by spectral color doppler and transvaginal 3d ultrasonography.
Materials & Methods: Patients between the ages of 20 and 40 years were included in both infertility (50) and pregnancy control groups (50). Basal ovarian volume and AFC are measured intravaginally. USG. Relevant clinical data and hormonal tests will be recorded for each patient. The machines used in this study are GE Voluson S8 USG-machine, Logiq p9 USG.
Results: Based on the criterion of >11 antral follicular count which gave sensitivity and specificity of 20% and 56% respectively that 43 subjects in the infertile group and 34 subjects in the control group had antral follicular count of less than 11 while seven (07) subjects in the infertile group and 34 subjects in the control group had antral follicular count of equal to or more than 11. The difference in between infertile and control group was found to be statistically significant (p = 0.03). Ovarian volume less than 11.75 cc was seen in 45 (90%) patients in infertile group and 33 (66%) patients in the control group. Ovarian volume (in cc) of more than or equal to 11.75 was seen in 05 (10%) of patients in the infertile group while 17 (34%) patients in the control group. The difference between the two group was found to be statistically significant (p = 0.004). The cut -off for ovarian volume at 11.75 cc was decided based on sensitivity and specificity of 12% and 66% respectively. PSV of less than 13 cm/sec was seen among 37 patients from infertile group while PSV of ≥13 cm/sec was seen among 13 patients from infertile group. In control group, 28 patients had PSV of <13 cm/sec while 22 patients had PSV of ≥13 cm/sec. However, the difference was not found to be statistically significant (p=0.05). The distribution was uniform across the infertile and control group and difference was not found to be statistically significant (p = 1).
Conclusion: AFC, ovarian volume, stromal blood flow (in terms of PSV and RI) can be used as predictors for determining infertility state among females of reproductive age group and further can be used in determining further management for the same. Although our study also showed that in fertile group, there was no positive correlation between AFC and ovarian volume, PSV. The mean AFC in our study population was different from that noted in other studies from different parts of the world and it could be due to racial, socio-economic and geographical factors. A cut-off value of 11 for AFC may be used as one of the factor in females undergoing infertility assessment. Other factors such as Ovarian volume, Stromal blood flow (in terms of PSV and RI) can also be used during assessment along with AFC for management of infertility among Indian women
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