Predictors of IVF outcome by three-dimensional ultrasound.
BACKGROUND
Our study was designed to evaluate whether ovarian antral follicle number, ovarian volume, stromal area and ovarian stromal blood flow are predictive of ovarian response and IVF outcome. A total of 56 women with normal basal serum FSH concentrations who had no history of ovarian surgery, no ovarian and/or uterine pathology, were non-smokers and undergoing their first IVF cycle using a standard long GnRH agonist protocol were examined.


METHODS
Total ovarian antral follicle number, total ovarian volume, total stromal area and mean flow index (FI) of the ovarian stromal blood flow were determined by three-dimensional (3D) and power Doppler ultrasound after pituitary suppression. Pretreatment 3D ultrasound ovarian measurements were compared with subsequent ovulation induction parameters [peak estradiol (E2) on HCG administration day and number of oocytes] and cycle outcome (fertilization and pregnancy rates).


RESULTS
The total antral follicle number achieved the best predictive value for favourable IVF outcome, followed by ovarian stromal FI, peak E2 on HCG administration day, total ovarian volume, total ovarian stromal area and age. Using these six parameters, we were able to predict a favourable IVF outcome in 50% (11/22) of patients and poor outcome in 85% (29/34) of patients.


CONCLUSIONS
Three-dimensional ultrasound facilitates determination of the antral follicle number, ovarian volume calculation, evaluation of the ovarian stroma and analysis of the intensity of ovarian stromal blood flow in a short time without increasing the patient's discomfort.
Kupesic
S
S
Department of Obstetrics and Gynaecology, Medical School University of Zagreb, Sveti Duh Hospital, Sveti Duh 64, HR-10000 Zagreb, Croatia. sanja.kupesic@zg.tel.hr
Kurjak
A
A
D000328:Adult; D000375:Aging / Q000502:physiology; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D021621:Imaging, Three-Dimensional; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000628:therapy*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D012039:Regional Blood Flow; D016896:Treatment Outcome; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D004958:Estradiol