The three-dimensional ultrasonographic ovarian vascularity of women developing poor ovarian response during assisted reproduction treatment and its predictive value.
OBJECTIVE
To test the hypothesis that ovarian vascularity is decreased in women who demonstrate poor ovarian response to controlled ovarian stimulation as part of assisted reproduction treatment.


METHODS
Prospective study.


METHODS
University-based Assisted Conception Unit.


METHODS
One hundred forty-one women undergoing their first cycle of assisted reproduction treatment (ART).


METHODS
Transvaginal 3D ultrasound assessment and venepuncture in the early follicular phase of the menstrual cycle immediately before ART.


METHODS
Ovarian vascularity indices (VI, FI, and VFI), ovarian volume (OV), and antral follicle count (AFC).


RESULTS
The ovarian VI (7.5 +/- 5.3 vs. 8.6 +/- 7.3), FI (38.9 +/- 6.9 vs. 38.0 +/- 5.5), and VFI (3.2 +/- 2.6 vs. 3.5 +/- 3.1) were similar in both poor and normal responders. AFC and OV were significantly lower in women who developed poor response (9 +/- 3.3 and 6.3 +/- 3.5 cm(3), respectively) than in normal responders (19.2 +/- 9.9 and 8.9 +/- 4.8 cm(3), respectively). Antral follicle count and basal FSH were the only significant predictors of poor ovarian response on multiple regression analysis.


CONCLUSIONS
Ovarian blood flow, as measured by 3D ultrasound, is not decreased in women who demonstrate a poor response to ovarian stimulation and is not predictive of poor response during IVF treatment. The AFC is the single best predictor of poor ovarian response.
Jayaprakasan
Kannamannadiar
K
Academic Division of Reproductive Medicine and Surgery, School of Human Development, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom. k.jayaprakasan@nottingham.ac.uk
Al-Hasie
Halima
H
Jayaprakasan
Rajisha
R
Campbell
Bruce
B
Hopkisson
James
J
Johnson
Ian
I
Raine-Fenning
Nick
N
D000328:Adult; D005260:Female; D005498:Follicular Phase; D006801:Humans; D021621:Imaging, Three-Dimensional; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000628:therapy*; D016015:Logistic Models; D006080:Ovarian Follicle / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D012039:Regional Blood Flow; D027724:Reproductive Techniques, Assisted; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods*