A Study On The Correlation Between The Ovarian Physiological Function Curve And Female's Reproduction State

Objective: By examing the ovarian volume, follicle size and the ovarian artery blood flow indexes on 120 normal married women (which were divided into 4 groups according to age) and 30 infertile female through Transvaginal Color Doppler Flow Image (TV-CDFI), to demonstrate the change characteristics of ovarian indexes in normal menstrual cycle, different stages of age and infertile female. In order to search the correlations between ovarian functions, form and women's age, and provide a reliable basis of finding the cause of infertility and its'treatment measure. Method:Ultrasound examination was performed on 120 normal married women without any ovarian disease and 30 original infertile females (at the average of 31.2) selected from out-patient department during October, 2003 to October, 2004. The normal women were divided into 4 groups according to age (Ⅰ: 20～30 years old;Ⅱ: 31～40 years old ; Ⅲ: 41～50 years old; Ⅳ: 51～60 years old ). And all of the specimens were examined respectively by Transvaginal Color Doppler Flow Image(TV-CDFI) from the 8-11th day, 13-16th day, 20-24th day of menses cycle. The Transvaginal Color Doppler Imaging of HDI 4000 with frequency of 7 MHz made by Philips Company was used. The specimens were required to discharge their urinary bladder thoroughly and lying on their back before the test. And the transvaginal probe was wrapped with condom smoothing with coupling agents before put the probe into vaginal gently. ①the ovarian size: Revolved the transvaginal probe softly and scanned the left ovary. Frosted the window when images became the clearest. Then estimated the length and width of the ovary. And then unfrosted the window, Revolved the transvaginal probe in lengthways and crosswise to estimated thickness of the ovary. And then estimated the right ovary in the same way. Ovary volume was calculated by ellipse volume formula: V=0.523×length×width×thickness. ②follicle size and number: measure the follicle length and thickness at the largest section of the largest follicle and counted out their average data. And calculated the whole follicle numbers on the ovary at the same time. ③the blood perfusion state: monitored the ovary blood perfusion state by putting the end of the transvaginal color Doppler on corresponding places of infundibulopevic ligament, ovary door and ovary skinniness , and then monitored pulsation index(PI), resistance index(RI) and systolic phase/diastolic phase(S/D). ④investigating whether there were any out of steps between the follicle's growth and the cycle of the uterus endomembrane. All of the data got from the measurement were disposaled statistically through analysis of variance.Result: The distribution of ovarian blood vessels: there were two types of blood vessels while approaching the ovary door(direct entry and spiral entry). The former is much like the kidney artery, one or several little artery enter the ovary directly without spiral and distorted phenomena. The latter appears spiral and distorted form before they enter the ovary door. The distribution of blood vessels in ovary substance is different according to menstrual cycle: some are like spots, some are flying around predominant follicle (it only can be observed when the follicle diameter is more than10mm) and some distribute like islands in progeste. 98.6% of the ovary blood flow signals can be observed in the procreate women, but only 45.3% of ovary blood flow signal can be observed when women around their peirmenopausal period. Here are the results of the examined indexes: 1. Ovary indexes changing during normal menstruous period on the healthy adult women: when women at the age between 20 to 40, the data of PI, RI and S/D tested from ovarian artery show the lowest during ovulational period(P<0.01). The data have no obvious difference in prefollicle period and corpus luteum period(P>0.05). But, as regards to the prefollicle's number and size, they show their largest during ovulational period(P<0.01), and they have also no obvious difference in prefollicle period and corpus luteum period(P>0.05). When their ages above 40, there will be no any changes as stated above. Still farther, the Indexes tested haveno difference between left and right ovary(P>0.05). 2. The ovary indexes changes at different ages on healthy adult women: During prefollicle period and corpus luteum period, the data of PI, RI and S/D are no obvious difference among every different groups, But at the group of age above 50, they appear to be the highest. And the lowest numbers of data appear at the group of age from 20 to 30. Therefore, the indexes numbers show descending order according to ages. With regard to number and size of follicle, there are no obvious difference shown in the preceding three groups. But they shown their lowest after age of 50. So there is obvious difference between the former three groups and the group ages are more than 50(P<0.01). In ovulation period, the data of PI, RI and S/D were no obvious different between the two preceding groups, But they lower than the latter two groups evidently(P<0.01). The counts of follicles were almost remain the same among the preceding three groups. Follicle sizes and ovary volumes are no obvious difference between the preceding two groups, but much bigger than the latter two groups. Both the follicle size and ovary volume are being the lowest when the women's age get above 50. More over, the Indexes are remain the same between left and right ovary. 3. The result of ovary indexes changes in infertile females group: The ovarian volume is obviously smaller than the normal procreate women (P<0.05),the PI, RI and S/D of the ovarian arteries have no cyclicity changes(P>0.05). The follicle...