Diagnostic importance of uteral sonography in amenorrheic patients

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Objective: To obtain the sonographic criteria for assessment of endometrial hormonal reaction.

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Methods: 68 patients with normogonadotropic secondary amenorrhea were observed. Mean duration of amenorrhea was 6,8±2,4 year. Estradiol di propionate 0,1% solution 2,0ml i/m during 2 days was given to stimulate hormonal transformation of endometrium. Ultrasound monitoring of uterus was performed daily. Mean duration of monitoring was 4,4±1,2 day. Endometrial thickness and sonographic structure were registered.

Results: Menstrual reaction had 12 patients (17,6%) after exogenous estradiol administration. However, prolipherative reaction of endometrium after estradiol treatment was occur in majority of patients 59 (86,8%). Mean endometrial thickness was 0,3±0,1 cm. Only 9 from 56 patients failed menstrual reaction on estradiol stimulation, had no increasing in endometrial thickness, detected during ultrasound monitoring. Thus, it became possible to diagnose Asherman’s syndrome among that group of patients.

Conclusion: Exogenous estradiol administration along with sonographic monitoring of the endometrium appeared to be a useful diagnostic criteria for distinguish the level of lesion in the reproductive system at patients with normogonadotropic amenorrhea.