Measurement of perifollicular blood flow of the dominant preovulatory follicle using three-dimensional power Doppler.
OBJECTIVE
To establish whether we might predict the outcome of unstimulated in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles with quantitative indices of perifollicular blood flow assessed with three-dimensional (3D) reconstruction of power Doppler images.


METHODS
This prospective study included an analysis of 52 unstimulated cycles. Color and power Doppler ultrasound examinations of a single dominant preovulatory follicle were performed on the day of oocyte pick-up. With 3D reconstruction and processing, quantitative indices were obtained i.e. the percentage of volume showing a flow signal (VFS) inside a 5-mm capsule of perifollicular tissue and the percentage of VFS of each of the three largest vessels in this capsule. These indices as well as pulsed Doppler indices were compared between the groups of cycles with different outcomes using a one-way ANOVA test.


RESULTS
In nine cycles no oocyte was retrieved (Group A), in seven cycles no fertilization occurred (Group B) and in 30 cycles no implantation occurred (Group C). Six cycles resulted in pregnancy (Group D). There were no statistically significant differences in pulsed and power Doppler indices between these groups. However, the percentage of VFS in the capsule was higher than average in cycles with implantation (19.22 +/- 16.82 vs. 12.42 +/- 8.89, NS) and the percentage of VFS in the main vessel exhibited lower than average values in cycles with implantation (20.66 +/- 10.05 vs. 39.84 +/- 20.15), but only reached borderline statistical significance (F = 2.457, P = 0.074).


CONCLUSIONS
It can be hypothesized that the follicles containing oocytes able to produce a pregnancy have a distinctive and more uniform perifollicular vascular network.
Vlaisavljević
V
V
Department of Reproductive Medicine and Gynecologic Endocrinology, Gynecology and Perinatology Service, Maribor Teaching Hospital, Maribor, Slovenia. vlai@sb-mb.si
Reljic
M
M
Gavrić Lovrec
V
V
Zazula
D
D
Sergent
N
N
D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006080:Ovarian Follicle / Q000098:blood supply*; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic; D018615:Ultrasonography, Doppler, Color / Q000379:methods