Quantification of ovarian stromal Doppler signals in postmenopausal women receiving hormone replacement therapy.
OBJECTIVE
To investigate the effect of continuous-combined hormone replacement therapy (HRT) on ovarian circulation, we used three-dimensional power Doppler ultrasound to assess ovarian stromal blood flow in postmenopausal women.


METHODS
Forty healthy, postmenopausal women were enrolled in this prospective, controlled study. They were divided into two groups: the control group (20 patients with no HRT treatment) and the HRT group [initially 20 patients, but later 15 patients who completed the study, using continuous-combined conjugated equine estrogen (0.625 mg/day) plus medroxyprogesterone (5 mg/day)]. All patients underwent transvaginal three-dimensional power Doppler ultrasonography at the time of recruitment and 3 months later. The ovarian stromal flow indices, including vascularization-flow index (VFI), flow index (FI), and vascularization index (VI), were measured. Blood withdrawals for serum follicle-stimulating hormone and estrogen level testing were obtained before and after 3 months of treatment.


RESULTS
All the variables in the hormone profile showed significant difference (P < 0.05) after 3 months of treatment in the HRT group. Of interest, the three-dimensional power Doppler indices of ovarian stromal flow, VFI (0.13 +/- 0.11 --> 0.59 +/- 0.49), FI (30.47 +/- 12.06 --> 38.41 +/- 10.21), and VI (0.31 +/- 0.27 --> 1.12 +/- 0.95) all showed significant increase (P < 0.05) after 3 months of HRT treatment.


CONCLUSIONS
There was a significant increase in ovarian stromal flow indices after 3 months of treatment in the HRT group, but not in the controls. Monitoring the ovarian flow changes by three-dimensional power Doppler may be of clinical importance when HRT is given.
Pan
Hsien-An
HA
Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan.
Li
Chin-Hsien
CH
Cheng
Yueh-Chin
YC
Wu
Meng-Hsing
MH
Chang
Fong-Ming
FM
D004958:Estradiol / Q000097:blood; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000494:pharmacology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008525:Medroxyprogesterone / Q000494:pharmacology; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging*; D017698:Postmenopause; D045167:Progesterone Congeners / Q000494:pharmacology; D011446:Prospective Studies; D012039:Regional Blood Flow; D018608:Ultrasonography, Doppler
D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D004958:Estradiol; D008525:Medroxyprogesterone