Power Doppler ultrasound assessment of follicular vascularity in the early follicular phase and its relationship with outcome of in vitro fertilization
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Objective : To determine whether ovarian perifollicular blood flow (PFBF) in the early follicular phase (EFP) was associated with treatment outcome.
Design : Retrospective longitudinal cohort study.
Setting : Tertiary referral centre/university hospital.
Patients : Thirty-four women underwent 37 IVF cycles, which resulted in 35 embryo transfers.
Interventions : Serial transvaginal scans using power Doppler ultrasound during the follicular phase. Ovarian PFBF of follicles ≥5 mm was subjectively assessed using a modified grading system (grades 0–4).
Main outcome measures : 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.
Conclusion : 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.
KEY WORDS:Early follicular phase IVF perifollicular vascularity power Doppler ultrasound pregnancy rate
The authors wish to thank Dr Gillian Heller, Senior Lecturer, Department of Statistics, Macquarie University, Australia for her kind help in statistical analysis. The authors also would like to acknowledge the IVF Australia-Eastern Suburb clinic nurse coordinators Di Craven, Mary O’Neil and Robyn Grant for their kind cooperation.
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