Undescended ovary and unicornuate uterus: simplified diagnosis by the use of clomiphene citrate ovarian stimulation and magnetic resonance imaging (MRI).
BACKGROUND
Although the association between unicornuate uterus and undescended ovaries is well established, little information is available on this entity, suggesting the possibility that many cases are not recognized at all. Consequently, important clinical information is missed in many patients worldwide.


METHODS
During a period of 5 years, eight cases of unicornuate uterus were observed in our infertility clinic. The first three patients received magnetic resonance imaging (MRI) after mild clomiphene citrate (CC) stimulation due to a discrepancy between estradiol levels and follicular growth and because a suspected ectopic ovary could not be visualized on ultrasound. Based on this experience, five consecutive patients were offered MRI after CC stimulation as part of this study.


RESULTS
In five out of eight patients with unicornuate uterus (62.5%) an undescended ovary could be visualized in the upper abdomen. Abdominal ultrasound revealed the ectopic ovary in only two cases. The use of CC stimulation undoubtedly facilitated the diagnosis of the undescended ovary on MRI.


CONCLUSIONS
It is suggested that MRI after CC stimulation is an excellent non-invasive method to diagnose undescended ovaries in women with a unicornate uterus.
Ombelet
W
W
Department of Obstetrics and Gynecology, Ziekenhuizen Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. willem.ombelet@pandora.be
Grieten
M
M
DeNeubourg
Ph
P
Verswijvel
G
G
Buekenhout
L
L
Hinoul
P
P
deJonge
E
E
D000328:Adult; D002996:Clomiphene; D000013:Congenital Abnormalities / Q000175:diagnosis; D005260:Female; D005300:Fertility Agents, Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000209:etiology*; D010062:Ovulation Induction; D014463:Ultrasonography; D014599:Uterus / Q000002:abnormalities*
D005300:Fertility Agents, Female; D002996:Clomiphene