Comparison of follicular vascularization in normal versus polycystic ovaries during in vitro fertilization as measured using 3-dimensional power Doppler ultrasonography.
OBJECTIVE
The growth of the follicles induced by gonadotropins during IVF treatment is accompanied by physiologic angiogenesis, which is essential for the maturation of the oocytes. We describe the IVF-induced changes in the vascularization and compare normal with polycystic ovaries (PCOs).


METHODS
Prospective study.


METHODS
Assisted reproductive unit at a university hospital.


METHODS
Sixty women who underwent IVF cycles.


METHODS
The ovarian vascularization was measured after pituitary down-regulation, FSH stimulation, and hCG-injection using three-dimensional power Doppler ultrasonography.


METHODS
The total ovarian vascularization was divided by the number of follicles.


RESULTS
After pituitary suppression, the ovarian vascularization/follicle was lower in polycystic ovary (PCO) patients. During ovarian stimulation, follicles in PCOs required a lesser amount of FSH to acquire the same level of vascularization than the follicles in normal ovaries. In addition, hCG induced an increase in the follicular vascularization in both normal and PCOs. The follicle count correlated with the total vascularized volume in the ovaries throughout the IVF cycle.


CONCLUSIONS
Follicles in PCOs seem to be less vascularized than the follicles in normal ovaries after GnRH treatment but not after gonadotropin stimulation. It is possible that restricted blood supply to the follicles in PCO might be associated with the follicular arrest that is observed. We could confirm that follicles in PCO are more sensitive to gonadotropin stimulation than follicles in normal ovaries.
Järvelä
Ilkka Y
IY
Diana, Princess of Wales Centre for Reproductive Medicine, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, United Kingdom. ijarvela@cc.oulu.fi
Sladkevicius
Povilas
P
Kelly
Simon
S
Ojha
Kamal
K
Campbell
Stuart
S
Nargund
Geeta
G
D000328:Adult; D001808:Blood Vessels / Q000000981:diagnostic imaging / Q000187:drug effects; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D021621:Imaging, Three-Dimensional; D006080:Ovarian Follicle / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000187:drug effects; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone