Anomalous origin of the left suprarenal, inferior phrenic arteries and left ovarian artery in a human cadaver

This report addresses three variants identified within a female cadaver. Specifically, these were an anomalous origin of the right suprarenal artery, an abnormal bilateral ovarian vein branch, and a arterial tortuosity of the left ovarian artery. Indeed, the cadaver evinced abnormal origins in the case of the middle suprarenal artery (MSA), right inferior phrenic artery (IPA), and the renal capsule artery (emanating from the right renal artery). The MSA and IPA shared a common trunk with the inferior suprarenal artery. It was additionally observed that the right ovarian vein anastomoses the branches from the right kidney posterior inferior along with those to the renal fat capsule. Abnormal origin was evident in the case of the left ovarian artery, and arterial tortuosity was apparent in the lower region of the vessels. This report addresses both the clinical import of these variations and their likely causes. In the subdiaphragmatic region, surgical success and prognosis may be impacted by such anomalies; accordingly surgeons must be aware of anatomical variants of the ovarian and suprarenal arteries.

Ovarian and uterine arteries blood flow velocities waveform, hormones and nitric oxide in relation to ovulation in cows superstimulated with equine chorionic gonadotropin and luteolysis induction 10 and 17 days after ovulation

To investigate the ovarian responses, ovarian and uterine hemodynamics, circulating ovarian hormones, and nitric oxide (NO) with their relations in superstimulated cows. Eight Holstein Friesian dry cows previously synchronized with CIDR underwent rectal Doppler ultrasound scanning and blood sampling after administrating eCG (1500 I.U) on day 10 of the second ovulation (day -5). Cows were treated with 12.5 mg prostaglandin F2α (PGF2α) on days 10 and 17 after ovulation. Estradiol, progesterone, and NO were measured. Results showed that from ≥ 13 follicles, five follicles ovulated from both ovaries. The ovulated follicles increased antrum colored area and colored area % till day -1. The developed corpora lutea (CLs) attained similar diameter, area, colored area, and colored area % from day 2 till day 15. The peak point of velocity (PSV) of uterine arteries decreased while that of ovarian arteries increased from day -4 to day 0. Both ovarian arteries diameter, resistance index (RI), PSV, end velocity (EDV) and systolic/diastolic ratio (S/D) positively correlated (P < 0.0001), but their pulsatility index (PI) negatively correlated (P < 0.0001). The uterine arteries PI, RI, PSV, EDV, time average velocity (TAMV) and S/D negatively correlated (P < 0.0001) but their diameters positively correlated. Estradiol increased but progesterone decreased from day -5 till day 0. After ovulation, P4 reached maximum values on day 9 and started to decrease till day 19.NO showed one peak on day -3 and another one from day 3 to day 9. Conclusions: Blood flow of ovarian arteries is different from uterine arteries and depended on pre- or post-ovulation.

Ovarian, uterine, and luteal vascular perfusions during follicular and luteal phases in the adult cyclic female rabbits with special orientation to their histological detection of hormone receptor

Understanding the does reproductive hemodynamic changes during the estrous cycle is crucial for improving reproductive competence and fertility potential in this species. The objective of this study is to investigate the hemodynamic variations in ovarian (OA) and uterine (UA) arteries, histological and morphometric changes in ovarian and uterine tissues throughout the follicular (FP) and luteal (LP) phases in rabbits and determine estrogen (ER), progesterone (PR) receptors, and vascular endothelial growth factor (VEGF) distributions using immunohistochemistry.

Fourteen adults pluriparous New Zealand rabbits were divided into rabbits at the FP (Day − 1; n = 7) and those at the LP (Day 9; n = 7). Animals were subjected to Doppler, hormonal (estrogen [E2], progesterone [P4], insulin-like growth factor [ILGF], and VEGF), histological, and immunohistochemical analyses. In LP, OA Doppler indices were significantly increased, whereas peak systolic velocity (PSV) was decreased compared with that in FP. UA Doppler indices were significantly decreased in the LP, whereas PSV was increased (P < 0.05). E2 levels were increased in the FP, whereas P4 levels were increased in the LP. The morphometric analysis of uterine tissues during the LP revealed an increase in the mean uterine endometrium length, endometrial connective tissue area percentage (%), endometrial glands number, myometrial area (%) and thickness. Furthermore, ovarian follicles and corpus luteum (CL) displayed strong positive immunoreactivity for ER, PR, and VEGF-A during both phases. The ovarian sections displayed a substantial (P < 0.05) increase in the area % of VEGF-A in the ovarian follicles during FP while in the CL during LP. Conversely, area percentage of VEGF-A immunoreactivity in the uterine luminal and glandular epithelia during the FP and LP revealed no differences. However, the number of VEGF-A–stained blood capillaries revealed an increase during LP than FP. In conclusion, this study demonstrated for the first time the changes in both ovarian and uterine arteries during two different phases of the rabbit cycle in relation to the histo-morphometric analysis and distribution of ER, PR, and VEGF-A, which regulate uterine functions that play a role in reproduction.

Ovarian, uterine and luteal hemodynamic variations between pregnant and non-pregnant pluriparous Egyptian buffalos with special reference to their anatomical and histological features

This study determined the ovarian, uterine, and luteal hemodynamic variations using Doppler between pregnant and non-pregnant pluriparous buffalos in relation to their anatomical and histological basics during the first 31 days after natural mating. Adult healthy cyclic Egyptian buffalo (n = 10) were selected and categorized into two groups; group 1 (n = 5) was mated naturally by a fertile bull during the late estrus phase, and group 2 (n = 5) was not mated. Animals were subjected to Doppler ultrasonography to evaluate luteal, ovarian, and uterine blood flows from day 7 until day 31 post-mating. Besides, three pregnant (one month) and other non-pregnant uterus (n = 6) were obtained from a local abattoir to study the anatomical and histological features. Our results revealed that the luteal, ovarian, and uterine arteries cross-sectional diameters/mm increased (P < 0.05) from day 7 till day 31. Resistance (RI) and pulsatility indices (PI) decreased linearly (P < 0.05) in pregnant buffalos till day 31, but the peak systolic, end diastolic velocities and flow volume of those arteries were increased. Additionally, luteal colored areas away and toward CL were increased (P < 0.05) in the pregnant group compared to non-pregnant ones. There was a significant (P < 0.05) increase in the lumen diameter of luteal, ovarian, and uterine artery sections in pregnant buffalos compared to those of non-pregnant ones. While the mean value of tunica media's thickness of both luteal and uterine artery was significantly higher in non-pregnant buffalos than pregnant ones, except for that of the ovarian artery. Additionally, the ovarian and uterine artery tunica muscularis relative area % was (P < 0.05) higher in pregnant buffalos than in non-pregnant ones, except for that of the luteal artery. It was concluded that in pregnant buffalos, ovarian, uterine, and luteal blood flows were improved from the first week until 31 days post-mating via a decline in both Doppler indices with an increase in Doppler velocities and blood flow volume in relation to their histological changes based on their anatomical architecture in comparison to non-pregnant one.

Comparison of 1.5 T and 3 T non-contrast-enhanced MR angiography for visualization of uterine and ovarian arteries before uterine artery embolization

OBJECTIVES

This study aimed to compare the performance of non-contrast-enhanced magnetic resonance angiography (NCE-MRA) at 1.5 T and 3 T for the visualization of uterine and ovarian arteries (OAs) before uterine artery embolization (UAE).

METHODS

Preprocedural pelvic NCE-MRA images of 85 symptomatic patients undergoing UAE for the treatment of uterine leiomyomas were reviewed by two specialists in pelvic MRI. Left and right uterine arteries (UAs) were judged separately and scored on a 5-point scale. Score 5 was the highest, in which the UA could be visualized inside the musculature, forming a peritumoral plexus. Score 1 was the lowest, where visualization was limited to the descending segment. The detection of enlarged OAs was also compared. The Mann-Whitney U and Fisher exact tests were used for statistical analysis. p < 0.05 was considered to be statistically significant.

RESULTS

Of the 170 UAs, 110 were classified at 1.5 T and 60 were classified at 3 T. Median (interquartile range [IQR]) score was 3 (IQR: 2-4) for visualization at 1.5 T vs 5 (IQR: 4-5) for 3 T. The scores for UA visualization were significantly higher at 3 T (p < 0.05). For enlarged OAs, NCE-MRA at 1.5 T and 3 T visualized 7 and 5 enlarged OAs, respectively; there was no significant difference between the two field strengths (p = 0.36).

CONCLUSIONS

NCE-MRA performed at 3 T can visualize UAs over a greater range than at 1.5 T. No difference was found regarding the detection of enlarged OAs.

KEY POINTS

• Preprocedural MRA can provide interventional radiologists with valuable information, including the origin and course of the uterine arteries and the existence of collateral feeders to the tumor. • This study demonstrates the superiority of non-contrast-enhanced MRA performed at 3 T over that performed at 1.5 T in the visualization of the uterine arteries in patients undergoing uterine artery embolization for the treatment of uterine leiomyomas. • Non-contrast-enhanced MRA is a useful imaging modality for patients with symptomatic leiomyoma undergoing uterine artery embolization in whom contrast administration is unfeasible. If available, it is preferable to perform the examination with a 3 T MR unit rather than a 1.5 T MR unit.

Comparison of the safety and efficacy of PABO above or below the ovarian artery during cesarean delivery in patients with coexisting placenta accreta and placenta previa

Purpose

To determine the effect of ovarian arteries on the use of prophylactic abdominal aortic balloon occlusion (PABO) in patients with coexisting placenta accreta and placenta previa.

Methods

Thirty-two pregnant women with coexisting placenta accreta and placenta previa treated with PABO in our hospital during 2013-2020 were retrospectively analyzed. The patients were divided into two groups: one with infra-renal abdominal aortic balloon occlusion above the ovarian artery (Group A, n = 15) and the other with occlusion below the ovarian artery (Group B, n = 17). Medical records and relevant imaging of all patients were reviewed. All Cesarean deliveries were scheduled and we decided to perform hysterectomy based on the surgical findings.

Results

Patients in both groups were similar in terms of age, gravidity history, and status of placenta. Regarding their outcomes, estimated blood loss was not significantly different in both groups, although it was lower in Group B than in Group A (3949.5 vs. 4333.8 ml). The other tested parameters did not show any difference. The uterus was preserved in 13 (41%) patients. No access-related or balloon occlusion-related complications occurred in either group.

Conclusions

PABO was safe. However, the balloon location (above or below the ovarian arteries) did not influence the outcomes. Further evaluation and prospective studies are required to evaluate the safety and efficacy of balloon occlusion above or below the ovarian artery in patients with coexisting placenta accreta and placenta previa.

Evaluation of ovarian hemodynamics by color and spectral Doppler in cows stimulated with three sources of follicle-stimulating hormone

This study hypothesized that ovarian response for superovulation is better when using compounds containing luteinizing hormone (LH). To compare the ovarian responses and the ovarian blood flow using three gonadotropins, three equal groups of Holstein cows (N = 18) were treated with Pluset (P), Follitropin (F), and eCG (G). The ovarian response was evaluated from the day of starting treatments (Day -5) till Day 5 after ovulation using Doppler ultrasound. Results revealed that the ovarian arteries pulsatility index (PI), peak systolic velocity (PSV), and the blood flow volume (BFV) varied (P < 0.0001) between both ovarian arteries. Cows treated with P had low number of small and medium follicles and a high number of the large follicles on Day -1. Cows treated with F showed low (P = 0.0001) number and percentage of colored follicles and high % of ovulated follicles (P=0.0001) that obtained high colored areas (P = 0.043) and colored area % (P = 0.001). The G produced more (P = 0.001) colored follicles (Days -1, 0) of low area. Both P and G had the same higher (P = 0.0001) percentages of colored follicles (>80 %) on Day-1 than F (<60 %). F and P had higher ovulated colored follicles % than G. P obtained nearly the same ovulated follicles diameters and areas as F with higher antrum area (P = 0.029) but lower colored area (P = 0.043) and colored area % (P = 0.001). In conclusion, the number and the doses of gonadotropin injections and the side of the ovary influenced the ovarian response.

Are the spectral Doppler indices of ovarian arteries indicative of antral follicular development and predictive of ovulatory responses and embryo yields in superovulated ewes?

Nineteen ewes received 200 mg of pFSH administered in eight decreasing doses from Days 1 to 4, starting three days before CIDR® device removal. Ten ewes received an injection of 350 μg of estradiol benzoate at CIDR® device insertion (Group E) and nine animals served as controls (Group C). B-mode and spectral Doppler ultrasonographic examinations were performed daily throughout superovulatory treatment to enumerate ovarian antral follicles and to determine ovarian blood flow indices, respectively. There were no differences (P > 0.05) in superovulatory responses between left and right ovaries/uterine horns or the two groups of animals. End-diastolic velocity (EDV) and mean velocity (Vm) values were greater (P < 0.05) on Days 1 and 2, and peak systolic velocity (SVp) was greater (P < 0.05) on Day 3 in Group C than in Group E. In Group E 15 correlations was recorded among indices (SVp, Vm, EDV, flow velocity integral-FVI, and pulsatility index-PI) and follicles numbers in different size classes on Days 1, 2 and 4, and seven correlations among indices (SVp, EDV, Vm, and vascular resistance index-RI) and superovulatory/embryo results (numbers of regressing corpora lutea, numbers/percentages of degenerated embryos and viability rates) on Days 1, 2 and 3. In Group C, there were three correlations among EDV and RI and medium-sized/large follicle numbers on Days 1 and 3, and five correlations among indices (EDV, RI and PI) and superovulatory/embryo results (numbers of luteinized unovulated follicles, degenerated embryos and unfertilized eggs) on Days 2 or 4. There was a lack of consistency in the velocimetric correlates of antral follicle numbers and superovulatory responses between the left and right side. Therefore, the usefulness of ovarian arterial indices to predict ovine superovulatory outcomes remains equivocal and requires further confirmatory studies.

Dynamics of uterine and ovarian arteries flow velocity waveforms and their relation to follicular and luteal growth and blood flow vascularization during the estrous cycle in Friesian cows

Doppler ultrasonography enabled understanding of the reproductive system hemodynamics in cyclic and pregnant cattle. To confirm the hypothesis that the ipsilateral ovarian and uterine arterial blood flows to the ovulating ovary are higher than the contralateral one along days and phases (follicular, early luteal, mid-luteal, late luteal) of the estrous cycle, eight cyclic spontaneously ovulating cows were scanned with Doppler ultrasound each other day along three oestrous cycles to monitor the follicular dynamics, the vascularization of the ovulatory follicle (OF), the corpus luteum (CL) developmental dynamics, the ipsilateral and the contralateral ovarian and uterine arterial diameters and their blood flow. Results proved the hypothesis. Both days and phases of the estrus cycle influenced (P = 0.0001) the follicular dynamic, the luteal hemodynamics, the ovarian and uterine hemodynamic. The ovulatory wave and the mid-luteal non-ovulatory wave had expanding numbers and the diameters of small, medium and large follicles. Though area, antral area, vascularization area of the OF ascended from Day -4 to the day of ovulation (Day 0), but the percent of its vascularization area and that of granulose layer increased till Day -3. The CL diameter increase till Day 15, and its vascularization area increased till Day 13, but its% of vascularization area ascended (P = 0.0001) from Days 1-4 and declined from Days 9-13. Both RI and PI of the ipsilateral ovarian artery were lower than the contralateral one; but, both obtained high values during the follicular phase. A linear increase (P = 0.0001) of uterine horns vascularization area and both ovarian and uterine arteries diameters, PSV and EDV from follicular to late luteal phases accompanied a linear decrease of their PI and RI. In conclusion, the ovarian and uterine blood flows vary according to the estrous day, estrous phase, the ovulating ovary, ovulatory follicle growth and corpus luteum developmental stage.