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CC BY 4.0 · Rev Bras Ginecol Obstet 2016; 38(01): 035-040
DOI: 10.1055/s-0035-1570112
Original Article

Variabilidade da contagem automática tridimensional de folículos ovarianos durante o ciclo menstrual

Variability of Three-dimensional Automatic Ovarian Follicle Count in Menstrual Cycle
Eduardo Camelo de Castro
1   Unidade de Saúde da Mulher do Curso de Medicina da Pontifícia Universidade Católica de Goiás; Diretor Associado da Humana Medicina Reprodutiva, Goiânia, GO, Brasil
,
Gercino Monteiro Filho
2   Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, GO, Brasil
,
Waldemar Naves do Amaral
3   Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina da Universidade Federal de Goiás; Presidente da Sociedade Brasileira de Ultrassonografia, Goiânia, GO, Brasil
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Resumo

Objetivos Avaliar a variabilidade da contagem automática tridimensional dos folículos ovarianos que mediram 2 a 6 mm e 2 a 10 mm durante o ciclo menstrual. Verificar se este exame pode ser aplicado fora da fase folicular precoce do ciclo.

Método Prospectivo observacional. Foram incluídas todas as pacientes inférteis submetidas à monitorização da ovulação de 20 de abril de 2013 a 30 de outubro de 2014, com 18 a 35 anos; IMC de 18 a 25 kg/m2, eumenorréicas; sem história de cirurgia ovariana e sem alterações nas dosagens do TSH, prolactina, insulina e glicemia. Foram excluídas aquelas que apresentaram cistos ovarianos e as que faltaram algum dia da monitorização. A contagem ultrassonográfica dos folículos foi feita pelo modo 3D com SonoAVC na fase folicular precoce, folicular media, periovulatória e lútea do ciclo.

Resultados Quarenta e cinco mulheres foram incluídas. Houve diferença entre as médias das contagens dos folículos com 2 a 6 mm (p = 0,001) e 2 a 10 mm (p = 0,003) pelo teste de Friedman que avaliou conjuntamente as quatro fases do ciclo. Quando se aplicou o teste t-Student pareado, houve aumento significativo na contagem dos folículos de 2 a 6 mm quando se comparou a contagem desses folículos na fase folicular média e periovulatória com a contagem da fase lútea. Não houve diferença significante entre a contagem destes folículos pequenos nas fases folicular precoce, média e periovulatória.

Conclusões A variação da contagem automática tridimensional dos folículos de 2 a 6 mm, nas fases folicular precoce, folicular média e periovulatória, não mostrou significância estatística. Houve uma variação significativa da contagem automática 3D dos folículos ovarianos de 2 a 10 mm durante o ciclo. A variabilidade significativa da contagem dos folículos de 2 a 10 mm durante o ciclo não permite que este exame seja realizado fora da fase folicular precoce.

Abstract

Objective To evaluate the variability of three-dimensional automatic counts of ovarian follicles measuring 2–6 to 2–10 mm during the menstrual cycle and to determine if this test can be applied outside the early follicular phase of the menstrual cycle. Methods: in a prospective observational study, serial transvaginal ultrasound scans were performed from April 20, 2013, to October 30, 2014, on infertile patients. Inclusion criteria: age between 18 and 35 years, BMI 18–25 kg/m2, regular menstrual cycles, no history of ovarian surgery and no hormonal changes in TSH, prolactin, fasting insulin or glucose. We excluded patients with ovarian cysts or who did not complete one or more days of the serial transvaginal ultrasound scans. The follicle count was performed in 3D mode ultrasound with a SonoAVC system. Visits were scheduled for the early follicular, mid-follicular, periovulatory and luteal phases of the menstrual cycle.

Results Forty-five women were included. The Friedman test showed that the total number of follicles measuring 2–6 mm varied significantly (p = 0.001) across the four periods of the menstrual cycle. The Paired Student t-test showed a significant increase in 2–6 mm follicle count from the mid-follicular and periovulatory phase to the luteal phase. We found no significant intra-cycle variation between the small follicles (2–6 mm) in the early follicular, mid-follicular and periovulatory phases. The Friedman test showed that the total number of follicles measuring 2–10 mm varied significantly (p = 0.003) across the menstrual cycle.

Conclusions The variation of three-dimensional automatic counts of 2–6 mm follicles in the early follicular, mid-follicular and periovulatory phases was not statistically significant. The significant variability in the counts of follicles measuring 2–10 mm across the menstrual cycle does not permit this examination to be performed side the early follicular phase.

Palavras-Chave

ultrassonografia - folículo ovariano - ovário - infertilidade

Keywords

ultrasonography - ovarian follicle - ovary - infertility


Publication History

Received: 09 January 2015

Accepted: 04 November 2015

Publication Date:
30 December 2015 (online)

© 2016. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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