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Indian Journal of Obstetrics and Gynecology

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A Prospective Observational Study to Evaluate the Findings of Transvaginal Sonography and Endometrial Biopsy in Detecting Ovulation of Infertile Woman

Juhi Deshpande, Senior Resident, Department of Obstetrics and Gynecology, Maharani Laxmibai Medical College, Jhansi, Uttar Pradesh 284001, India. , Juhi Deshpande* , Sanjaya Sharma** , Sushila Kharkwal***

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Indian Journal of Obstetrics and Gynecology 6(1):p 19-24, Jan-Feb 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6118.3

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Abstract

Introduction: Nearly 40% of the infertile women present with ovulation-related causes and 70% of these patients can be diagnosed and treated effectively. Thus, knowing the time of ovulation is crucial in management of infertility. Transvaginal sonography (TVS) and endometrial biopsy are being used to detect ovulation in infertile women. Aim: To assess qualitatively the usefulness of serial TVS in detecting ovulation and compare the findings with endometrial biopsy (EB) findings. Methods: In thisprospective observational study on 100 infertile women, after obtaining the informed consent, detailed history and clinical examination of the patients was performed. TVS was performed on every alternate day after 11th day of menstrual cycle till the evidence of ovulation or up to 17th day of cycle and EB was done on day 1 of next menstrual cycle for histopathological evaluation of endometrium. The results of TVS and EB for detecting ovulation were compared with Chi square test. Results: In this study, the same 100 patients after serial TVS were subjected to EB. Ovulatory cycle was observed in 73 cases with TVS while secretory phase was detected in 63 cases in EB and proliferative phase was seen in 29 cases. Non dominant follicle was seen in 11 cases in TVS out of which only 9 cases in EB showed proliferative endometrium. Failure to rupture of follicle was seen in 10 cases in TVS. Signs of Polycystic ovarian syndrome (PCOS) were detected in 6 cases by TVS. Thus, there is better detection rate of ovulation by TVS (sensitivity = 100%) compared to EB (P < 0.00354; Chi-square test), while specificity was greater (96%) with EB. Conclusion: Our observations indicate that serial TVS along with EB together can be a useful to detect ovulation in the management of infertility. In addition, TVS can also provide details of any uterine, endometrial, cervical or adnexal pathology.

Keywords: Transvaginal Sonography; Infertility; Ovulation; Secretory phase; Proliferatory phase; Endometrial Biopsy. 

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6118.3

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