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OP20.02: HyCoSy for assessment of tubal patency: are findings and procedure success rates different in women who have previously been pregnant?

Methods: Transvaginal 2D and 3D pelvic ultrasound was performed during the early follicular phase of the cycle (day 2 to 5) in 36 women with PCOS, as defined by the Rotterdam guideline, and sub-group analysis conducted based on the subjects’ body mass index (BMI), ovulation status, and hirsutism score. Results: Fourteen lean PCOS women with a BMI < 25 kg/m had significantly higher ovarian stromal vascularity as measured by 3D power Doppler (vascularisation index, VI: 4.678 0.415% versus 3.260 0.375%, p < 0.05; and vascularisation flow index, VFI: 1.753 0.227 versus 1.059 0.134, p < 0.05) than the 10 obese PCOS women with a BMI ≥ 30 Kg/m. Twenty-three PCOS women with hirsutism requiring weekly shaving had significantly higher stromal blood flow as measured by 3D (flow index, FI: 36.233 1.266 versus 30.311 1.862, p < 0.05) than the eight anovulatory normoandrogenic women with polycystic ovaries. Endometrial blood flow was also significantly lower in the hirsute group (endometrial VI and VFI: 0.572 0.064% versus 1.009 0.129% and 0.198 0.027 versus 0.363 0.058 respectively, p < 0.01; and subendometrial 5-mm outer shell VI and VFI: 1.778 0.245 versus 3.083 0.447 and 0.717 0.105 versus 1.283 0.204, p = 0.01). There were no differences in blood flow between the groups when assessed with 2D pulsed wave Doppler. The ovulatory status did not affect any index. Conclusions: Ovarain vascularity is selectively increased in women with PCOS who are lean and/or hirsute. Hirsute women with PCOS also have impaired endometrial perfusion compared to their normoandrogenic counterparts. These features are only evident with 3D ultrasound and are not seen with conventional pulsed wave Doppler.