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Re: Adnexal Mass (Postreproductive group)From: Terry J. DuBose (tjdubose@chrp.uams.edu)Fri Jul 18 09:19:55 1997
Sorry about the delay in this response. I missed the original message until Mark Lawson pointed it out to me. As far as ovarian follicular measurements: I had always read that ovulation normally took place after the dominate follicle reached 22-25 mm and harvest should take place at between 18 & 22 mm. The measurement is the mean of 3 diameters of the follicle, exclusive of ovarian tissue. There is a good discussion of the topic in the latest edition of Berman MC; Obstetrics and Gynecology: Diagnostic Medical Sonography, A Guide to Clinical Practice, 2nd ed.; Lippincott, 1997; see Chapter 28, Role of Sonography in Infertility Management and in Contraception, pp. 551-573. I know of no "Official Standards" for these measurements, at least the AIUM hasn't published any. The main differences are in the measurements used, in Berman it is said: "At the time of ovulation, the mean diameter of the lead follicle measures approximately 20-24 mm, although the range has been reported to be from 18 to 28 mm." Now as far as 2D measures vs. 3D. Most normal follicles are unilocular and fairly spherical, or only slightly ovoid. So there probably will not be large differences in the 2D and 3D means. However, the best fertility specialists that I have known were very picky about measurements and would not accept incomplete or sloppy work. For success in fertility, precise timing and hormonal tracking and all is critical. I realize that this doesn’t say much about surgical intervention for adnexal masses, but assuming that the surgery is for “abnormal” masses, knowing what normal must be important. I would think that the architecture of the mass would be as important as the size in deciding on surgery. Hope this helps. Peace, Terry J. DuBose
At Tue, 15 Jul 1997, Zach Newton wrote:
>
-- Peace, Terry J. DuBose, M.S., RDMS; OBGYN.net Sonographer Correspondent Assistant Professor & Program Director, Diagnostic Medical Sonography University of Arkansas for Medical Sciences, Fellow, AIUM tjdubose@chrp.uams.edu http://www.uams.edu/chrp/dmshome.htm http://www.io.com/~dubose/ http://www.obgyn.net/CORRESP/DUBOSE.HTM VOICE: 501-686-6510 FAX: 501-686-5613 Now is the time for all good folks to come to the aid of the Earth.
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