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Clinical Significance of Transvaginal Color Doppler Ultrasonography of the Ovarian Artery as a Predictor of Ovarian Response in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer

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Abstract

Purpose : Our purpose was to verify whether the blood flow impedance of the ovarian stromal artery in transvaginal color Doppler ultrasonography can predict the in vitro fertilization and embryo transfer (IVF–ET) outcomes.

Methods : Transvaginal color Doppler ultrasonographic examinations were performed in 99 patients undergoing controlled ovarian hyperstimulation (COH) for IVF–ET. The pulsatility index (PI) was evaluated in the bilateral ovarian stromal arteries on the starting day of COH (PI1) and the day of hCG administration (PI2). The patients were classified into three groups by the mean PI1, PI2, and ΔPI (PI1 − PI2), respectively, and the IVF–ET outcomes were analyzed and compared.

Results : There were no significant differences in the duration of COH, the total dosage of gonadotropins used for COH, the serum E2 concentration on day of hCG administration, the number of follicles on the day of hCG administration, the number of oocytes retrieved or fertilized in vitro, and the number of embryos transferred between their respective PI1, PI2, and ΔPI values. However, the pregnancy rate was significantly lower in the higher PI1 and PI2 groups than in the lower groups (p < 0.05, p < 0.05). Significant positive correlations were also found between PI1 and PI2 and the total dosage of gonadotropins for COH (Y = 0.483 X + 27.1, r = 0.052, p < 0.05; Y = 0.877 X + 26.6, r = 0.075, p < 0.05).

Conclusions : Our results showed that the lower PI in the ovarian stromal artery during COH is associated with the higher the pregnancy rate and the smaller amount of gonadotropins used for effective COH. This study suggests that the color Doppler ultrasonographic index (PI) of the ovarian stromal artery during COH may be useful for predicting the success of IVF–ET in infertile patients.

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REFERENCES

  1. Brinsden PR: A Textbook of In Vitro Fertilization and Assisted Reproduction, 2nd edn. New York, Parthenon Publishing, 1999, pp 91–92

    Google Scholar 

  2. Speroff L, Glass RH, Kase NG: Clinical Gynecologic Endocrinology and Infertility, 6th edn. Baltimore, Williams & Wilkins, 1999, pp 1135–1136

    Google Scholar 

  3. Taylor KJ, Burns PN, Wells PN, Conway DI, Hull MG: Ultrasound Doppler flow studies of the ovarian and uterine arteries. Br J Obstet Gynaecol 1985;92:240–246

    Google Scholar 

  4. Strizhakov AN, Medvedev MV, Davydov AI, Bunin I, Podzolkova NN: Possibilities of Doppler ultrasonics in the study of blood flow in the iliac and ovarian arteries in healthy women. Akush Ginekol (Mosk) 1989;7:28–31

    Google Scholar 

  5. Scholtes MC, Wladimiroff JW, van Rijen HJ, Hop WC: Uterine and ovarian flow velocity waveforms in the normal menstrual cycle: A transvaginal Doppler study. Fertil Steril 1989;52: 981–985

    Google Scholar 

  6. Hata K, Hata T, Senoh D, Makihara K, Aoki S, Kitao M: Transition of ovarian arterial compliance during the human menstrual cycle, assessed by Doppler ultrasound—correlation with serum hormone levels. Nippon Sanka Fujinka Gakkai Zasshi 1990;42:662–666

    Google Scholar 

  7. Kurjak A, Kupesic-Urek S, Schulman H, Zalud I: Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women. Fertil Steril 1991;56:870–873

    Google Scholar 

  8. Kupesic S, Kurjak A: Uterine and ovarian perfusion during the periovulatory period assessed by transvaginal color Doppler. Fertil Steril 1993;60:439–443

    Google Scholar 

  9. Tekay A, Jouppila P: Intraobserver reproducibility of transvaginal Doppler measurements in uterine and intraovarian arteries in regularly menstruating women. Ultrasound Obstet Gynecol 1996;7:129–134

    Google Scholar 

  10. Engmann L, Sladkevicius P, Agrawal R, Bekir J, Campbell S, Tan SL: The pattern of changes in ovarian stromal and uterine artery blood flow velocities during in vitro fertilization treatment and its relationship with outcome of the cycle. Ultrasound Obstet Gynecol 1999;13:26–33

    Google Scholar 

  11. Weiner Z, Thaler I, Levron J, Lewit N, Itskovitz-Eldor J: Assessment of ovarian and uterine blood flow by transvaginal color Doppler in ovarian-stimulated women: Correlation with the number of follicles and steroid hormone levels. Fertil Steril 1993;59:743–749

    Google Scholar 

  12. Schurz B, Schon HJ, Wenzl R, Eppel W, Huber J, Reinold E: Endovaginal doppler flow measurements of the ovarian artery in patients with a normal menstrual cycle and with polycystic ovary syndrome during in vitro fertilization. J Clin Ultrasound 1993;21:19–24

    Google Scholar 

  13. Tekay A, Martikainen H, Jouppila P: Blood flow changes in uterine and ovarian vasculature, and predictive value of transvaginal pulsed colour Doppler ultrasonography in an invitro fertilization programme. Hum Reprod 1995;10:688–693

    Google Scholar 

  14. Bhal PS, Pugh ND, Chui DK, Gregory L, Walker SM, Shaw RW: The use of transvaginal power Doppler ultrasonography to evaluate the relationship between perifollicular vascularity and outcome in in-vitro fertilization treatment cycles.HumReprod 1999;14:939–945

    Google Scholar 

  15. Pirhonen J, Pulkkinen M: The effect of nimesulide and naproxen on the uterine and ovarian arterial blood flow velocity. A Doppler study. Acta Obstet Gynecol Scand 1995;74:549–553

    Google Scholar 

  16. Geber S, Caetano JP: Doppler colour flow analysis of uterine and ovarian arteries prior to and after surgery for tubal sterilization: A prospective study. Hum Reprod 1996;11:1195–1198

    Google Scholar 

  17. La Torre R, Montanino-Oliva M, Marchiani E, Boninfante M, Montanino G, Cosmi EV: Ovarian blood flow before and after conservative laparoscopic treatment for endometrioma. Clin Exp Obstet Gynecol 1998;25:12–14

    Google Scholar 

  18. Farquhar CM, Rae T, Thomas DC, Wadsworth J, Beard RW: Doppler ultrasound in the nonpregnant pelvis. J Ultrasound Med 1989;8:451–457

    Google Scholar 

  19. Zaidi J, Collins W, Campbell S, Pittrof R, Tan SL: Blood flow changes in the intraovarian arteries during the periovulatory period: Relationship to the time of day. Ultrasound Obstet Gynecol 1996;7:135–140

    Google Scholar 

  20. Tinkanen H, Kujansuu E, Laippala P: Vascular resistance in uterine and ovarian arteries: Its association with infertility and the prognosis of infertility. Eur J Obstet Gynecol Reprod Biol 1994;57:111–115

    Google Scholar 

  21. Contart P, Baruffi RL, Coelho J, Mauri AL, Petersen C, Franco Junior JG: Power Doppler endometrial evaluation as a method for the prognosis of embryo implantation in an ICSI program. J Assist Reprod Genet 2000;17:329–334

    Google Scholar 

  22. Schild RL, Knobloch C, Dorn C, Fimmers R, van der Ven H, Hansmann M: Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril 2001;75:361–366

    Google Scholar 

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Republic of Korea

    Seok Hyun Kim, Seung Yup Ku, Byung Chul Jee, Chang Suk Suh, Shin Yong Moon & Jin Yong Lee

  2. Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, Republic of Korea

    Seok Hyun Kim & Chang Suk Suh

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  1. Seok Hyun Kim
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  2. Seung Yup Ku
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  3. Byung Chul Jee
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  5. Shin Yong Moon
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Correspondence to Seok Hyun Kim.

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Kim, S.H., Ku, S.Y., Jee, B.C. et al. Clinical Significance of Transvaginal Color Doppler Ultrasonography of the Ovarian Artery as a Predictor of Ovarian Response in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer. J Assist Reprod Genet 19, 103–112 (2002). https://doi.org/10.1023/A:1014776519239

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