Power Doppler ultrasound assessment of follicular vascularity in the early follicular phase and its relationship with outcome of in vitro fertilization.
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.
Shrestha
S M
SM
School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Costello
M F
MF
Sjoblom
P
P
McNally
G
G
Bennett
M
M
Steigrad
S J
SJ
Hughes
G J
GJ
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