title: Intraobserver and interobserver reproducibility of ovarian volume, antral follicle count, and vascularity indices obtained with transvaginal 3-dimensional ultrasonography, power Doppler angiography, and the virtual organ computer-aided analysis imaging program.
abstract: OBJECTIVE
  The purpose of this study was to assess intraobserver and interobserver reproducibility of the parameters of ovarian response and oocyte ability, studied by 3-dimensional ultrasonography and power Doppler angiography (PDA), and the possible influence of the ovarian functional stage.
  
  
  METHODS
  Twenty-nine women were included in an in vitro fertilization program. Fourteen women were evaluated after pituitary suppression (basal group), and 15 were scanned on the human chorionic gonadotropin administration day, after gonadotropin ovarian stimulation (stimulated group). A first observer acquired 2 volumes for each ovary. Another observer performed a second analysis of the volumes acquired by the first observer. We analyzed ovarian volume, follicle number in the basal group, vascularization index, flow index, and vascularization-flow index. The volumes were processed by the Virtual Organ Computer-Aided Analysis imaging program using plane A and 15 degrees rotational steps.
  
  
  RESULTS
  Ovarian volume showed excellent intraobserver and interobserver agreement, with an intraclass correlation coefficient (Intra-CC) and an interclass correlation coefficient (Inter-CC) close to the unit. The Intra-CC and Inter-CC about the number of follicles were 0.964 and 0.978, respectively. Vascularity indices showed an Intra-CC greater than 0.90. The vascularization index and the vascularization-flow index showed higher interobserver than intraobserver reproducibility (Inter-CC > 0.96 for both). The flow index Inter-CC was 0.898. The reproducibility differences between the basal and stimulated ovary measurements were not significant.
  
  
  CONCLUSIONS
  There is an excellent intraobserver and interobserver reproducibility of the ovarian volume, follicle counts, and 3-dimensional PDA indices. The ovarian functional stage has no influence on the reliability. Three-dimensional ultrasonography and PDA improve the study of ovarian parameters, and their reliability impels a change in the current clinical routine of performing and interpreting ultrasonography.
authors.affiliation: International Ruber Hospital, Enrique Leyra 17, 28029 Madrid, Spain. ltmerce@meditex.es
authors.forename: Luis T
authors.initials: LT
authors.lastname: Mercé
authors.forename: Belén
authors.initials: B
authors.lastname: Gómez
authors.forename: Virginia
authors.initials: V
authors.lastname: Engels
authors.forename: Santiago
authors.initials: S
authors.lastname: Bau
authors.forename: José M
authors.initials: JM
authors.lastname: Bajo
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D015588:Observer Variation; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging*; D010062:Ovulation Induction / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D018608:Ultrasonography, Doppler; D014621:Vagina
chemical_list: D006063:Chorionic Gonadotropin; D005640:Follicle Stimulating Hormone