T.D. Deutch

The Role of 3-Dimensional Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of Müllerian Duct Anomalies A Review of the Literature

The purpose of this article is to review the published literature and determine the roles that magnetic resonance imaging (MRI) and endovaginal 3‐dimensional ultrasonography (3DUS) play in the diagnosis of müllerian duct anomalies (MDAs).

Automated assessment of ovarian follicles using a novel three-dimensional ultrasound software

OBJECTIVEnTo evaluate the accuracy, efficiency, and applicability of a new automated method of follicular assessment.nnnDESIGNnRetrospective review of three-dimensional ultrasonographic ovarian volumes.nnnSETTINGnAcademic center.nnnPATIENT(S)nThree-dimensional ovarian volumes from patients undergoing IVF.nnnINTERVENTION(S)nThree-dimensional volumes of gonadotropin-stimulated ovaries and simulated ovarian follicles (SOFs) of known volume were evaluated with the new automated follicular assessment software (SonoAVC).nnnMAIN OUTCOME MEASURE(S)n[1] Maximum absolute error for the SonoAVC in assessing the volumes of the SOFs; [2] correlations between the automated and manual follicular measurements; [3] time required to analyze all of the follicles in a given ovarian volume.nnnRESULT(S)nThe SOF of 4, 6, and 10 mm were evaluated. The SonoAVCs maximum absolute error for the volumes of the 4, 6, and 10 mm SOFs was 0 (0%), 0.01 (8.3%), and 0.02 (3.8%) cc, respectively. Three hundred forty-seven follicles, ranging in diameter from 2.3-32 mm, were evaluated. The correlation coefficient for the SonoAVC-generated relaxed follicular diameter and the manual measured mean follicular diameter was 0.99. The time required to analyze all of the follicles in a given ovarian volume for the automated and manual method was 133 versus 361 seconds, respectively.nnnCONCLUSION(S)nThe SonoAVC proved to be a very accurate and efficient way to measure ovarian follicles. The measurements obtained by the SonoAVC correlated extremely well with the manual measurements we obtained.

Effects of progesterone, levonorgestrel and medroxyprogesterone acetate on apoptosis in human endometrial endothelial cells

BACKGROUNDnWe evaluated apoptosis in human endometrial endothelial cells (HEECs) incubated with progesterone, levonorgestrel (LNG) and medroxyprogesterone acetate (MPA).nnnSTUDY DESIGNnHEECs were cultured to near confluence, and the progestogens were added.nnnSETTINGnAcademic Department of Obstetrics and Gynecology.nnnPATIENTSnNo patients were involved.nnnINTERVENTIONSnProgestogens at 5-, 250- and 500-ng/mL concentrations were added to incubations of HEECs for 12, 24 and 48 h.nnnMAIN OUTCOME MEASUREnApoptosis based on terminal deoxynucleotidyl transferase-mediated deoxy-UTP nick-end labeling (TUNEL), and semiquantification of Bax and Bcl-2.nnnRESULTSnNo apoptosis was found by TUNEL, Bax and Bcl-2 after 12 h incubation with any progestogen. TUNEL increased after incubation for 24 and 48 h with progesterone 500 ng/mL; LNG 250, 500 ng/mL and all concentrations of MPA (p<.001), Bax increased and Bcl-2 decreased at all concentrations of MPA and the two highest concentrations of LNG at 48 h (p<.05).nnnCONCLUSIONnMPA results in apoptosis of HEECs.

OC92: Automated calculation of follicular volumes using 3D sonography in women undergoing assisted reproduction: a prospective evaluation of novel software

Objectives: In this study multigate spectral Doppler analysis, a novel ultrasound technology that overcomes the limitations related to the use of a single sample volume, has been applied to the evaluation of hypogastric (Ha) and uterine (Ut) artery flow during IVF treatment, specifically egg donor and recipient cycles. Methods: MSDA using MyLab (Esaote, Florence) was carried out at baseline, during ovulation induction and at egg retrieval in the egg donors, and at baseline and embryo transfer time in the recipients. The analysis in real time included velocity profile (VP), relative wall distension rate (rWDR) and wall shear rate (WSR) of Ha and Ut in the donors and only in Ut for the recipients. Results: A total of 10 egg donors (mean age 24.3 ± 1.8 years) and six recipients (mean age 42.6 ± 3.4 years) were found eligible for the study and successfully evaluated. Compared to conventional spectral Doppler, MSDA revealed different shapes of velocity profiles. There were no significant differences in VP, rWDR and WSR between egg donors at the time of egg retrieval and recipients at the time of embryo transfer in Ut. The rWDR was inversely related to gravity, parity and hematocrit (Hct) (P < 0.05). The WSR of both Ha and Ut were correlated with Hct and the FSH at day 3 (rs = 0.9, P < 0.05). Recipients who conceived had a lower mean WSR (R = 338.3, L = 326.6) than those who did not (R = 512.9, L = 766.3; P < 0.05). WSR of recipients was inversely correlated with positive pregnancy test (rs = −0.878, P < 0.05) bilaterally, while WSR of egg donors was not. Conclusions: This is the first study to provide basic physiological values of VP, rWDR and WSR in patients undergoing ovulation induction for IVF. The measurements in egg donors are to be considered as reference values for patients undergoing IVF since they are young and their ovarian response optimal. Likewise, given the high pregnancy rate in the recipients, the results should be considered promising but not definitive.