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.
Purpose : This longitudinal study aimed to compare ovarian perifollicular and endometrial blood flow (PFBF and EBF, respectively) during the follicular phase in pregnant and nonpregnant IVF cycles. Methods : Serial transvaginal scans were performed in 15 subjects undergoing IVF treatment. Both PFBF and EBF were subjectively graded (grades 0-4 for PFBF and grades 1-3 for EBF). After confirmation of clinical pregnancy, the treatment cycles were grouped into 'Pregnant' and 'Non-pregnant' cycles. Ovarian PFBF and EBF were retrospectively compared between the two groups. Results : In pregnant cycles, the proportion of large (≥15 mm) follicles with high (2-4) grade PFBF increased with time throughout the follicular phase, and the proportion of large follicles with poor (0-1) grade PFBF decreased. In non-pregnant cycles these trends were reversed. There was no difference in EBF between the two groups. Conclusion : The pattern of ovarian PFBF but not EBF may be predictive of treatment outcome.
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