Clinical Significance Of Transvaginal Ultrasound Valuating Metformin Therapeutic Effect In Polycystic Ovary Syndrome Patients Accompanied By Insulin Resistance

Objective: To investigate the clinical value of transvaginal color Doppler ultrasound (TV-CDU) and to discuss the ovarian morphological parameter and blood dynamics parameter in polycystic ovarian syndrome (PCOS) accompanied with insulin resistance (IR) treated with metformin.Methods: The 39 cases patients with PCOS-IR were treated with metformin lasting three months. The features of ovarian morphology (stromal area SA, total area TA, follicles count FC) and the blood parameters of ovarian stromal artery (peak systolic velocity PSV, peak diastolic velocity PDV, resistence index RI, peak systolic velocity/ peak diastolic velocityS/D) in 39 cases with PCOS-IR were detected with TV-CDU; The levels of Luteinizing Hormone (LH), follicle stimulating hormone (FSH), testosterone (T), fasting blood-glucose (FBS) and fasting serum insulin (FIN) were tested; the insulin resistence index (IR) were calculated before and after metformin treatment. The statistical relativity analysis was proceeding about the change of the ovarian morphological parameter and blood dynamics parameter and the blood hormone level.Results: The result was adopted the images of 36 cases patients with PCOS-IR except for 3 cases gestation. (1)The levels of T and IR were decreased significantly (P<0.01); LH, LH/FSH were also decreased significantly (P<0.05) (2)the ovarian morphological parametes SA and SA/TA dropped significantly (P < 0.01) and TA dropped too (P<0.05) (3)the blood parameters PSV and PDV went down significantly (P<0.05) while RI and S/D went up significantly (P<0.01, P<0.05) (4)The relativity shows, the lower of IR is a high degree related to the lower of T (r=0.72) and a middle degree related to the lower of LH, LH/FSH (r=0.41, 0.51). The lower of SA is a high degree related to the lower of T, IR (r=0.65, 0.73) and FC, SA/TA is a high degree related to the lower of T, IR (r=0.71, 0.70). FC is significant related to the lower of T, IR respectively. The rise up of RI shows a negative degree related to the lower of T, IR (r=-0.72, -0.65) and the lower of PSV is a middle degree related to the lower of IR, T (r=0.68, 0.69).Conclusions: TV-CDU is useful to assess the effect of metformin by combining the ovarian morphological parameters and blood dynamics parameters.