Perifollicular blood flow Doppler indices, but not follicular pO2, pCO2, or pH, predict oocyte developmental competence in in vitro fertilization.
OBJECTIVE
To assess the relationships among perifollicular blood flow; follicular fluid pO2, pCO2, and pH; oocyte developmental capacity; preimplantation embryo quality.


METHODS
Prospective study.


METHODS
Academic, tertiary care institution.


METHODS
Unselected, gonadotropin-stimulated IVF cycles.


METHODS
Color, pulsed Doppler analysis of perifollicular blood flow, and follicular pO2, pCO2, and pH determinations of randomly designated, mapped ovarian follicles.


METHODS
Fertilization and day 3 embryo cleavage and morphology.


RESULTS
Perifollicular vascularity indices were significantly and negatively correlated with day 3 embryo cleavage. Pulsatility index and S-D ratio also were significantly and negatively correlated with follicular pO2. The same correlation was found between resistance index and the fertilization rate of preovulatory oocytes. No relationship existed between follicular metabolic analysis and fertilization or embryo quality. The resistance index had a sensitivity of 0.57 and a specificity of 0.71 for the prediction of advanced embryo cleavage status.


CONCLUSIONS
Results confirm and extend previous reports demonstrating that color, pulsed Doppler ultrasound analysis of individual preovulatory follicles during IVF therapy may provide an indirect index of the developmental competence of the corresponding oocyte. Although these methods may provide means to select embryos for transfer with the highest implantation potential, the moderate predictive power showed so far may limit their clinical applicability.
Huey
S
S
The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, USA.
Abuhamad
A
A
Barroso
G
G
Hsu
M I
MI
Kolm
P
P
Mayer
J
J
Oehninger
S
S
D000328:Adult; D001755:Blastocyst / Q000502:physiology; D002245:Carbon Dioxide / Q000378:metabolism; D016922:Cellular Senescence / Q000502:physiology; D002970:Cleavage Stage, Ovum; D005260:Female; D005307:Fertilization in Vitro; D005544:Forecasting; D006801:Humans; D006863:Hydrogen-Ion Concentration; D009865:Oocytes / Q000502:physiology*; D006080:Ovarian Follicle / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism; D010313:Partial Pressure; D011446:Prospective Studies; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color
D002245:Carbon Dioxide; D010100:Oxygen