title: Periovulatory follicular volume and vascularization determined by 3D and power Doppler sonography as pregnancy predictors in intrauterine insemination cycles.
abstract: OBJECTIVE
  To evaluate the relationship between volume and vascularization of the periovulatory follicle and subfollicular area measured by three-dimensional power Doppler ultrasound (US), and ovulation and pregnancy in patients undergoing intrauterine insemination (IUI).
  
  
  METHODS
  We studied 79 consecutive cycles of IUI on hCG administration day. We measured the periovulatory follicle and subfollicular area by means of three-dimensional power Doppler US. The stored volumes were processed with the VOCAL image processing software to calculate the volume of the follicle and the following vascular indices: vascularization index (VI), flow index (FI), and vascularization flow index (VFI).
  
  
  RESULTS
  The follicular volume was higher in anovulatory cycles (7.7 ± 3.7 cubic centimeters (CC) versus 4.1 ± 2.0 CC; p < 0.001). There was no difference between the follicular volumes in cycles with or without subsequent pregnancy. The vascular indices of the follicle did not differ significantly between ovulatory and anovulatory cycles, and between cycles that did and did not achieve pregnancy. Periovulatory subfollicular VI and VFI were lower in women who became pregnant (VI: 2.9 ± 2.3% versus 5.6 ± 4.6%; p < 0.05, and VFI: 1.1 ± 0.8 versus 2.2 ± 2.2; p < 0.01).
  
  
  CONCLUSIONS
  High values of follicular volume were associated with anovulatory cycles. Subfollicular VI and VFI might be used as markers of follicular quality and pregnancy predictors.
authors.affiliation: Department of Gynecology, Santa Cristina University Hospital, Madrid, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Engels
authors.forename: Luis
authors.initials: L
authors.lastname: Sanfrutos
authors.forename: Tirso
authors.initials: T
authors.lastname: Perez-Medina
authors.forename: Pilar
authors.initials: P
authors.lastname: Alvarez
authors.forename: Ignacio
authors.initials: I
authors.lastname: Zapardiel
authors.forename: Sonia
authors.initials: S
authors.lastname: Godoy-Tundidor
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Salazar
authors.forename: Juan
authors.initials: J
authors.lastname: Troyano
authors.forename: Jose M
authors.initials: JM
authors.lastname: Bajo-Arenas
mesh_terms: D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007247:Infertility, Female / Q000188:drug therapy; D007315:Insemination, Artificial / Q000379:methods* / Q000502:physiology; D006080:Ovarian Follicle / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000502:physiology; D010060:Ovulation / Q000502:physiology; D010062:Ovulation Induction; D011247:Pregnancy; D011446:Prospective Studies; D018608:Ultrasonography, Doppler
chemical_list: D006728:Hormones; D005640:Follicle Stimulating Hormone