Follicular vascularity--the predictive value of transvaginal power Doppler ultrasonography in an in-vitro fertilization programme: a preliminary study

• Published in: Human reproduction (Oxford) Vol. 12; no. 1; pp. 191 - 196
• Main Authors: Chui, D K, Pugh, N D, Walker, S M, Gregory, L, Shaw, R W
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.01.1997
• Subjects: Adult; Arteries - physiology; Biological and medical sciences; Birth control; Female; Fertilization in Vitro; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Oocytes - physiology; Ovarian Follicle - blood supply; Ovarian Follicle - diagnostic imaging; Pregnancy; Pulsatile Flow; Sterility. Assisted procreation; Treatment Outcome; Ultrasonography, Doppler - methods; Uterus - blood supply; Sonography; Doppler ultrasound study; Human; Regional blood flow; Prognosis; Assisted procreation; In vitro fertilization embryo transfer; Ovary; Transvaginal route; Female genital system; Female; Hemodynamics; Ovarian follicle
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/12.1.191

The aim of this prospective study was to investigate the ability of transvaginal power Doppler ultrasonography to assess the relationship between follicular vascularity and outcome in women undergoing in-vitro fertilization. Each of 38 subjects underwent a single transvaginal power Doppler ultrasound scan on the day of oocyte collection, where the vascularity of individual ovarian follicles was assessed, using a subjective system, and graded 1 to 4. In addition, conventional pulsatility indices (PI) of the uterine and intra-ovarian (stromal) arteries were calculated, which showed no significant differences between the pregnant and non-pregnant groups. Using power Doppler ultrasonography, a total of 188 follicles was studied. The follicular vascularity grade was found to be independent of follicular size and there was no significant difference in fertilization rates with different degrees of vascularity, although there was a trend towards higher fertilization rates with higher grade vascularity. There were 10 pregnancies, giving a pregnancy rate of 26.3% per embryo transfer. Pregnancies were confined to those women whose embryos were derived from follicles with grade 3 and 4 vascularity (pregnancy rates per embryo transfer of 12.5 and 61.5% respectively), with only those from grade 4 follicles resulting in livebirths. This preliminary study suggested that high grade follicular vascularity is associated with increased pregnancy rate and that there is a possible link between follicular vascularity and implantation potential.