To study the diagnostic accuracy of folliculometry and endometrial echo complex as an evidence of ovulation in infertility.

This clinical study was conducted on 100 infertile women. The women were subjected to follicular monitoring by transvaginal sonography (TVS) from cycle day 8 or 10 of menstruation with 7.5 MHz vaginal probe of Siemens ultrasound machine. Evidence of follicular growth, ovulation, and morphology of endometrial echo complex with its thickness was noted. Endometrial biopsy was performed premenstrually as a day care procedure after excluding pregnancy.

Out of 100 women, 81 cases were with evidence of ovulation on TVS and 68 were confirmed on histopathology. All the studied patients were also evaluated for endometrial thickness on the day of ovulation, echo complex of endometrium suggestive of ovulation was seen in 64 cases, out of these 59 cases were confirmed on histopathology. On histopathological study of 100 cases, we found 69 cases with secretory endometrium, 18 with proliferative endometrium, 10 patients with endometritis, one each with luteal phase defect, irregular shedding of endometrium, and hormonal imbalance.

We found folliculometry predicted ovulation 86% accurately with a specificity of 58.60% and sensitivity of 98.55%. Similarly, appearance of endometrium predicted ovulation 85% accurately with a specificity of 83.80% and sensitivity of 85.50%. Thus, TVS has undeniable advantages in terms of cost, time, acceptability, risk, convenience, and could easily diagnose signs of ovulation in cases of infertility. The TVS has quintessential role as the first diagnostic modality in patients presenting with infertility.

Katiyar S, Arya SB, Goel JK, Sinha M. Sonographic Folliculometry and Endometrial Echocomplex as an Evidence of Ovulation in Infertility Cases. J South Asian Feder Obst Gynae 2017;9(4):331-335.