Utero-ovarian ultrasonographic and Doppler flow analyses in female childhood cancer survivors with regular menstruation and normal circulating follicle-stimulating hormone levels

Objective: To analyze the hormonal, ultrasonographic, and color Doppler parameters in a population-based follow-up study of female childhood cancer survivors with regular menstrual cycle and normal early follicular FSH values. Design: Controlled, prospective clinical study. Setting: University hospital. Patient(S): Twenty-eight female patients affected by a malignant tumor during childhood and 14 age-matched healthy controls. Intervention(S): Hormonal, ultrasonographic, and color Doppler analyses. Main Outcome Measure(s): In the midluteal phase of the cycle, the patients underwent hormonal assay of gonadotropins, E-2, and P; ultrasonographic evaluation of the uterine and ovarian volume, the endometrial thickness, and of the corpus luteum characteristics; color Doppler analysis of uterine, intraovarian, and periluteal arteries. Result(S): A greater uterine volume and a better utero-ovarian vascularization was observed in controls in comparison, with cancer survivors. In patients Who Suffered from childhood malignancies the P values were lower than in controls. On the basis of circulating P (> or < 20 nmol/L) values, we divided the former group in ovulatory and nonovulatory patients. We observed that even if there were no differences between ovulatory cancer survivors and controls, the nonovulatory group showed a reduced uterine volume associated with elevated resistance at the level of uterine and intraovarian arteries. Among these two groups the time elapsed between the diagnosis of cancer and menarche was shorter in nonovulatory than in ovulatory women, and was directly correlated with both uterine volume (r = 0.660) and ovarian volume (r = 0.597). Conclusion(s): Ultrasonographic and Doppler analyses may noninvasively study the subtle utero-ovarian modification after anticancer therapies.