Color Doppler Sonographic Analysis of Pelvic Venous Blood Flow in Infertile Women with Polycystic Ovary Syndrome, Poor Ovarian Reserve, and Unexplained Infertility

OBJECTIVE: To examine pelvic venous congestion (PVC) in infertile women with polycystic ovary syndrome (PCOS), poor ovarian reserve (POR), and unexplained infertility (UI) and compare it to that in a healthy fertile control group. STUDY DESIGN: This prospective study was conducted at Sifa University Hospital in 47 patients with PCOS, 30 patients with POR, 34 patients with UI, and 42 healthy fertile control subjects. The patients were examined with transvaginal Doppler ultrasound for the presence of PVC. They were also questioned and physically examined for signs and symptoms of pelvic congestion syndrome. Serum estradiol (E2), total testosterone, and luteinizing hormone/follicle-stimulating hormone levels were measured in patients with PCOS as well as in PVC (+) and (-) patients. RESULTS: PVC was observed in 31 (20.3%) patients. We observed that PVC was significantly more common in the PCOS group but not in the POR and UI groups (p=0.04). Considering all participants, uterine and ovarian volumes and spontaneous abortion number were significantly higher in the PVC (+) group, and E2 level was significantly higher in PVC (+) patients (p=0.03). CONCLUSION: Impaired pelvic venous circulation may be a contributing factor to infertility in patients with PCOS.