[Study on relationships between sonographic endometrial images and ovarian hormone levels]

Sixty-seven and 109 sonographic endometrial images obtained from 67 infertile patients and 5 healthy volunteers with normal ovulatory cycles, respectively, were investigated with regard to serum estradiol (E2) and progesterone (P) levels. The ultrasound devices used were sector electronic scanners (3.5 MHz). 1) Endometrial images were able to be classified into four pattern types, according to the criteria reported by Sakamoto (1985), using a gray-scale contact compound scan. Pattern 1: linear cavity echo, pattern 2: thick hypoechoic endometrium surrounded by thin border echo, pattern 3: thickened border echo, pattern 4: entire echogenic endometrium. 2) Both E2 and P levels were low in pattern 1. The E2 level was significantly higher in pattern 2 than in pattern 1 (p less than 0.01), indicating pattern 2 reflects E2 surges prior to ovulation. The P level was high in pattern 3; and in pattern 4, it was significantly higher than in patterns 1 and 2 (p less than 0.01), indicating that patterns 3 and 4 are in the early and mid-luteal phase, respectively. 3) Sonograms obtained from 12 cases with suspicious luteal phase defects showed an abnormal pattern in the mid-luteal phase. These results indicate that the sonographic endometrial images reflect respective ovarian hormone levels.