title: Power Doppler ultrasound assessment of follicular vascularity in the early follicular phase and its relationship with outcome of in vitro fertilization.
abstract: OBJECTIVE
  To determine whether ovarian perifollicular blood flow (PFBF) in the early follicular phase (EFP) was associated with treatment outcome.
  
  
  METHODS
  Retrospective longitudinal cohort study.
  
  
  METHODS
  Tertiary referral centre/university hospital.
  
  
  METHODS
  Thirty-four women underwent 37 IVF cycles, which resulted in 35 embryo transfers.
  
  
  METHODS
  Serial transvaginal scans using power Doppler ultrasound during the follicular phase. Ovarian PFBF of follicles > or =5 mm was subjectively assessed using a modified grading system (grades 0-4).
  
  
  METHODS
  Ovarian PFBF and pregnancy.
  
  
  RESULTS
  Treatment cycles were retrospectively divided into two groups: Group 1 (n=20) had cycles with at least one small (5-10 mm) or medium (11-14 mm) size follicle(s) of high grade (2-4) PFBF on cycle day 5 or 6 or 7; and Group 2 (n=17), had cycles that did not. Group 1 had a significantly higher proportion of high grade large follicles in the late follicular phase (35% vs. 21%) (OR 2.0; 95% CI 1.1-3.7) and higher clinical pregnancy rate (47% vs. 12%) (OR 6.3; CI 1.1-35.7) compared to Group 2.
  
  
  CONCLUSIONS
  High grade ovarian PFBF in the EFP during IVF is associated with both high grade PFBF in the late follicular phase and a higher clinical pregnancy rate.
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Shrestha
authors.forename: M F
authors.initials: MF
authors.lastname: Costello
authors.forename: P
authors.initials: P
authors.lastname: Sjoblom
authors.forename: G
authors.initials: G
authors.lastname: McNally
authors.forename: M
authors.initials: M
authors.lastname: Bennett
authors.forename: S J
authors.initials: SJ
authors.lastname: Steigrad
authors.forename: G J
authors.initials: GJ
authors.lastname: Hughes
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005498:Follicular Phase / Q000097:blood*; D006801:Humans; D015588:Observer Variation; D006080:Ovarian Follicle / Q000098:blood supply* / Q000000981:diagnostic imaging*; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler / Q000379:methods*; D014621:Vagina / Q000000981:diagnostic imaging