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.
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
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