ASSOCIATION BETWEEN OVARIAN RESERVE AND ULTRASOUND-DOPPLER PARAMETERS IN ENDOMETRIOSIS-ASSOCIATED INFERTILITY

Background. Endometriosis is a chronic gynecological disease that is frequently associated with infertility in women of reproductive age. Ovarian endometriosis, particularly endometriomas, may affect ovarian tissue and follicular function and may therefore be associated with a reduction in ovarian reserve. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) are widely used markers for assessing ovarian reserve. According to current recommendations, transvaginal ultrasonography is an important imaging modality for the diagnosis and assessment of endometriosis, while a comprehensive evaluation of clinical and ultrasound parameters may provide a more accurate assessment of reproductive potential [1,2]. However, the relationship between the morphological characteristics of endometriomas, ovarian reserve markers, and Doppler-derived blood-flow parameters remains insufficiently characterized.

Objective. To investigate the relationship between ovarian reserve parameters, including serum AMH levels and antral follicle count, and ultrasound-Doppler characteristics of the ovaries and endometrium in women with endometriosis-associated infertility, and to evaluate their potential role in assessing reproductive potential.

Materials and Methods. The study is planned to include women of reproductive age with endometriosis-associated infertility. Clinical and anamnestic characteristics, the stage of endometriosis, the presence of ovarian endometrioma, its size and localization, and unilateral or bilateral ovarian involvement will be assessed. Ovarian reserve will be evaluated based on serum AMH levels and the number of antral follicles determined by transvaginal ultrasonography. Doppler assessment will include vascular resistance and blood-flow parameters, including the resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV). Endometrial thickness and morphology, as well as endometrial and subendometrial vascularization, will also be evaluated. The obtained data will be analyzed using correlation and multivariable statistical methods.

Expected Results. The study is expected to determine the relationships between endometrioma characteristics, ovarian reserve parameters, and ultrasound-Doppler findings. Particular attention will be given to the associations of AMH levels and AFC with endometrioma size, unilateral or bilateral localization, ovarian morphometric characteristics, and blood-flow parameters. A comprehensive assessment of these parameters may allow the identification of potential predictors of reduced reproductive potential and the development of criteria for stratifying patients according to reproductive risk.

Conclusion. Comprehensive assessment of ovarian reserve, morphological characteristics of endometriomas, and ultrasound-Doppler parameters of the ovaries and endometrium may contribute to a more objective evaluation of reproductive potential in women with endometriosis-associated infertility. Identification of clinically relevant associations between these parameters may provide a basis for developing an individualized prognostic algorithm and optimizing reproductive management in this patient population.