[Polycystic ovary syndrome--Doppler parameters]

To evaluate the value of transvaginal color and pulsed Doppler measurements of the uterine and ovarian arteries in infertile patients with polycystic ovarian syndrome (PCOS).

Prospective controlled trial included forty (40) patients with PCOS and 40 healthy women. All the patients were examined by transvaginal color and pulsed Doppler on the 5th, 10th, 12th, 15th, 21st and 24th day of the menstrual cycle. The hormonal profile (estradiol (E2), luteinizing hormone (LH), follicular stimulating hormone (FSH), progesterone, testosterone and prolactin) was correlated to the Doppler results.

The flow velocity patterns of uterine and ovarian vessels showed changes during the normal ovulatory menstrual cycle, while in the patients with PCOS these changes did not occur. The high resistance index (RI = 1.0) with reverse flow was detected in both ovarian arteries in PCOS group, and showed no cyclic changes. Ovarian stromal and hilar arterial impedance (0.54 +/- 0.05) as well as uterine artery resistance index (0.91 +/- 0.09) did not show significant changes during the menstrual cycle.

Our study suggests that a large fraction of patients suffering from PCOS has elevated uterine artery resistance index despite normal plasma E2 levels. It can be postulated that excessive production of ovarian factor (other than E2) may increase the uterine resistance and alter the endometrial receptivity. This finding may explain why endometrial receptivity is shown to be poor in patients with PCOS. Estimation of uterine and ovarian arterial impedance values seems to have clinical impact in the management of these patients attending an in vitro fertilization program.