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Abstract Type of study: Prospective observational study. Setting: Department of Obstetrics & Gynecology in Benha University Hospital in the period between January and December 2013. Objective: Evaluation of the differences between fertile and infertile females regarding the three-dimensional ultrasound markers of ovarian reserve and between the right and the left ovaries in women in each group. Participants and method: Women enrolled in the study were divided into study & control groups: Study group: One hundred women diagnosed as having infertility (more than 24 months of no conception). Control group: One hundred normal fertile women (≥2 previous full term pregnancy), they all had regular spontaneous menstrual cycles with a baseline transvaginal scan showing normal ovaries. Exclusion criteria of both groups were: 1. Ovarian follicles ≥ 10mm or ovarian cyst on the baseline scan. 2.Persistent corpus luteum.3. Previous ovarian surgery and evidence of other pelvic pathology.4. The use of exogenous hormones in the past 3 months.5. Presence of endometriomas.6. Tubal or uterine factor of infertility.7. Male or coital factor of infertility.8. Age less than 18 years or more than 35 years. After inclusion, One hundred infertile and one hundred fertile women had a 3D power Doppler transvaginal scan in the early follicular phase (between the third and the fifth day of the menstrual cycle). SonoAVC follicle™ program was used to asses antral follicle count where the number and the size of every follicle in the ovary was calculated and color coded and stratified in a table. The virtual organ computer- aided analysis (VOCAL™) imaging program was used to calculate the volume and vascularity indices of both ovaries.The outcome measures included are: antral follicle count (AFC), small (2-6mm) AFC, larger (7-9mm) AFC, total ovarian volume (OV) and ovarian vascular indices; vascularization index (VI), flow index (FI) and vascularization flow index (VFI). The ultrasongraphic and flow data from the right and left ovaries were evaluated with student t-tests for paired samples. Results: The Mean ± SD for total AFC were 4.570±3.736 and 10.6±4.5 for infertile and fertile groups respectively, small AFC (2-6mm) were 4.2±5.3 and 7.5±2.2 for infertile and fertile groups respectively, mean VI were 8.889±5.962 and 15.54±8.87 for infertile and fertile groups respectively and mean VFI were 1.19±0.72 and 2.51±1.04 for infertile and fertile groups respectively. All of them were significantly higher for fertile group than the infertile group. The Mean ± SD of OV were 15.28±12.11 for the infertile group and 12.6±4.8 for fertile group and the mean total OV of infertile group was significantly higher than the fertile group. The Mean ± SD of larger (7-9 mm) AFC were 1.2±1.1 and 1±1.9 for infertile and fertile groups respectively and the Mean ± SD for FI were 30.85±8.69 and 32.058±5.144 for infertile and fertile groups respectively and the difference between the infertile and fertile group was statistically insignificant regarding both of them. Regarding the RT and the LT ovaries in the infertile group; the Mean ± SD for the AFC were 2.54±1.7 and 3.2±1.4 for RT and LT ovaries respectively and the Mean ± SD for the FI were 30.088±6.146 and 34.058±5.844 for RT and LT ovaries respectively and the Mean ± SD for the VFI were 2.28±1.34 and 2.81±1.12 for RT and LT ovaries respectively; all of them show a statistical significant difference in between the RT and the LT ovaries in the infertile group. While the Mean ± SD for the ovarian volume were 8.26±7.22 and 7.2±5.43 for RT and LT ovaries respectively and the Mean ± SD for the VI were 8.224±6.012 and 9.324±5.634 for RT and LT ovaries respectively and both of them show a statistical non-significant difference in between the RT and the LT ovaries in the infertile group. In the fertile group; the Mean ± SD for the AFC were 6.8±2.4 and 6.1±2.8 for RT and LT ovaries respectively and the Mean ± SD for the ovarian volume were 6.2±3.2 and 5.4±4.2 for RT and LT ovaries respectively and the Mean ± SD for the VI were 14.54±8.41 and 15.98±7.87 for RT and LT ovaries respectively and the Mean ± SD for the FI were 29.85±8.69 and 31.65±8.65 for RT and LT ovaries respectively and the Mean ± SD for the VFI were 1.14±0.52 and 1.28±0.78 for RT and LT ovaries respectively and all of them show a statistical non-significant difference in between the RT and the LT ovaries in the fertile group. |