Human Reproduction, Vol. 11, No. 1, pp. 109-113, 1996
© 1996 European Society of Human Reproduction and Embryology
research-article |
Associations between ultrasound indices of follicular blood flow, oocyte recovery and preimplantation embryo quality
1Department of Obstetrics and Gynaecology, King‘s College School of Medicine and Dentistry London, UK 2Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine UK 3Thomson Medical Centre Thomson Road, Singapore
Correspondence: 4To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, King’s College Hospital, Denmark Hill, London SE5 8RX, UK
The aim of this study was to elucidate possible relationships between ultrasound indices of follicular blood flow, oocyte recovery and the subsequent production and morphological quality of preimplantation embryos. A total of 27 women with bilateral tubal occlusion, undergoing treatment for infertility by in-vitro fertilization and embryo transfer, contributed data from 29 cycles. Transvaginal ultrasono-graphy with colour Doppler imaging and pulsed Doppler spectral analysis was used to obtain indices of blood flow for each follicle immediately before it was aspirated. The main outcome measures for each follicle were the pulsatility index, peak systolic velocity, recovery or non-recovery of an oocyte and the subsequent production or non-production of an embryo. A total of 126 follicles were studied, 102 oocytes were recovered and 58 embryos (49 at grades I or II) were produced. There were six clinical pregnancies (pregnancy rate 27.3% per embryo transfer, 22.2% per patient). There was a significant correlation (P<0.0001, ×2 test) between whether or not follicular blood flow was detected and whether or not an oocyte was recovered. The sensitivity of a test based on the presence of detectable blood flow and the subsequent recovery of an oocyte was 74% and the positive predictive value was 93%. The peak systolic velocity (PSV, measured in cm/s, mean ± SD) in follicles with detectable blood flow was significantly higher in follicles that were associated with the production of a preimplantation embryo (19.7±10.8) compared with those that were not (9.9±5.3, P<0.0001), Student‘s t-test). There was a 70% chance of producing a grade I or II embryo if the follicular blood velocity was >10 cm/s, compared with 14% if the PSV was <10 cm/s, or 18% if no blood flow was detected. We conclude that there is a physiological relationship between follicular blood velocity, oocyte recovery and the production of a high-grade preimplantation embryo, which may form the basis of a useful clinical test.
Key words: colour Doppler imaging/follicular blood flow/IVF/oocyte recovery/transvaginal ultrasonography
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