Aki Kido MD, Presenter: Nothing to Disclose

Kaori Togashi MD, Abstract Co-Author: Nothing to Disclose

Mizuki Nishino MD, Abstract Co-Author: Nothing to Disclose

Kanae Miyake MD, Abstract Co-Author: Nothing to Disclose

Kazuhiro Iwasaku MD, Abstract Co-Author: Nothing to Disclose

Shingo Fujii MD, Abstract Co-Author: Nothing to Disclose

Katsumi Hayakawa MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Endometriosis is one of the most important causes of infertility; however the precise mechanism causing infertility is unclear. This study aimed to evaluate the mechanism of infertility caused by endometriosis focusing on uterine contractility, especially uterine peristalsis, which is thought to have an important role in sperm transport.

The study population consisted of 31women(periovulatoy:13 luteal:15, menstrual:3,age 19-51years) with an untreated endometrioma detected on MR imaging recruited from two institutes. Controls were 288studies(96 each in the 3menstrual phases) obtained in 12healthy women(age 22-41years). MR images of controls were obtained four times in a day and twice in each study in the three menstrual phases for another study. MR studies were performed with a 1.5T magnet(Siemens) obtaining T1 and T2-weighted images and 60serial HASTE (half-Fourier acquisition single shot turbo spin echo) images every 2seconds in a midsagittal plane of the uterus. Cine MR imaging was independently visually evaluated at 12X faster than real speed by two radiologists focusing on 1)the presence of uterine peristalsis, defined as wavy movement of subendometrium, 2)the direction and frequency of peristalsis and 3)the presence of sustained uterine contractions. Analysis was made regarding these three points between the two groups in each cycle phase.

Uterine peristalsis was identifiable in 6/13 in periovulatory, 4/15 in luteal and 3/3 in menstrual phase in endometrioma patients and in 87/96, 29/96 and 50/96, respectively of the controls. In the periovulatory phase, detection rates of peristalsis and peristaltic frequency were significantly fewer in endometrioma patients than controls(p<0.05). No significant difference was identified in other phases or direction. Sustained contractions were recognized in 105/288 in controls and 14/31 in endometrioma patients. Although not significant, contraction occurred more frequently in endometrioma patients than in controls in all 3menstrual phases(odds ratio=1.68, 2.29 and 1.52 respectively).

Uterine peristalsis appears suppressed in endometrioma patients during periovulatory phase, and may have an adverse effect on sperm transport.

Kido, A, Togashi, K, Nishino, M, Miyake, K, Iwasaku, K, Fujii, S, Hayakawa, K, et al, , Uterine Peristalsis on Cine MR Imaging in Patients with Endometriosis.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4410985.html