Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 12 , ISSUE 3 ( July-September, 2018 ) > List of Articles


Role of Three-dimensional Power Doppler Angiography in Assessment of Perifollicular Ovarian Vascularity in Patients Undergoing In Vitro Fertilization: A Single Center Experience

Khushali Gandhi, Sugandha Goel

Keywords : IVF outcome, Number of follicles, Power doppler angiography, Three dimensional

Citation Information : Gandhi K, Goel S. Role of Three-dimensional Power Doppler Angiography in Assessment of Perifollicular Ovarian Vascularity in Patients Undergoing In Vitro Fertilization: A Single Center Experience. Donald School J Ultrasound Obstet Gynecol 2018; 12 (3):162-167.

DOI: 10.5005/jp-journals-10009-1568

License: CC BY-NC 4.0

Published Online: 01-12-2009

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: Ovarian blood flow plays a vital role in ovarian follicular development in In Vitro fertilization (IVF) cycle. Perifollicular color mapping with three-dimensional (3D) power Doppler angiography (PDA) is a reliable technique for predicting IVF success. Objective: Single-center prospective study, with an aim to investigate correlation between 3D PDA parameters and success of IVF cycles. Methods: Ovulation induction was done using a long protocol with gonadotrophins and GnRH agonist in 94 infertile women. With the help of 3D PDA, on the day of HCG administration, ovarian volume (OV), number of follicles (NF), vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated. The success of IVF outcome in these patients was noted. Results: The OV, VI, FI, VFI, and NF were significantly higher in women who conceived following IVF. IVF outcome can be presumed by NF and VI. NF was the only independent parameter predicting a number of retrieved oocytes, mature oocytes, fertilized oocytes and number of grade 4 embryos. Conclusion: Three-dimensional USG and PDA is an easy and quick modality for ovarian blood flow assessment and prediction of success of IVF cycle. Positive correlation was identified between 3D PDA parameters and IVF laboratory parameters along with subsequent IVF success.

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  1. Kupesic S, Kurjak A. Predictors of IVF outcome by threedimensional ultrasound. Human Reprod. 2002;17(4):950.
  2. Linda G. Ovarian markers of implantation potential in assisted reproduction. Human Reprod. 1998; 13: Supp 4.
  3. Abulafia O, Sherer DM. Angiogenesis of the ovary. Am J Obstet Gynecol. 2000;182: 240-246.
  4. Augustin HG. Vascular morphogenesis in the ovary. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14: 867-882.
  5. Nargund G, Doyle PE, Bourne TH, Parsons JH, Cheng WC, Campbell S, Collins WP. Ultrasound derived indices of follicular blood flow before HCG administration and the prediction of oocyte recovery and preimplantation embryo quality. Human Reprod. 1996;11(11):2512-2517.
  6. Coulam CB, Goodman C, Rinehart JS. Colour Doppler indices of follicular blood flow as predictors of pregnancy after invitro fertilizationand embryo transfer. Human Reprod. 1999; 14:1979-1982.
  7. Vieli A. Ultrasonic Doppler and duplex systems: possibilities and limitations. Urol. 1990; 45: 251-257.
  8. Nelson TR, Pretorius DH. The Doppler signal: where does it come from and what does it mean? AJR Am J Roentgenol. 1988; 151:439-447.
  9. Raine-Fenning NJ, Campbell BK, Clewes JS, Kendall NR, Johnson IR. The reliability of virtual organ computer-aided analysis(VOCAL) for the semiquantification of ovarian, endometrialandsubendometrial perfusion. Ultrasound Obstet Gynecol. 2003; 22: 633-639.
  10. Jarvela IY, Sladkevicius P, Tekay AH, Campbell S, Nagund G. Intraobserver and interobserver variability of ovarian volume, gray-scale and color flow indices obtained usingtransvaginal three-dimensional power doppler ultrasonography. Ultrasound Obstet Gynecol. 2003; 21:277-282.
  11. 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. Human Reprod. 1999;14:939-945.
  12. Chui DK, Pugh ND, Walker SM, Gregory L, Shaw RW. Follicular vascularity – The predictive value of transvaginal power doppler ultrasonography in an in-vitro fertilization programme: a preliminary study. Human Reprod. 1997;12: 191-196.
  13. N. J. Raine-Fenning, B. K. Campbell, J. S. Clewes, N. R. Kendall and I. R. Johnson, The interobserver reliability of three-dimensional power Doppler data acquisition within the female pelvis, Ultrasound Obstet Gynecol 2004;23:501-508.
  14. Raine-Fenning NJ, Campbell BK, Collier J, Brincat MB, Johnson IR. The reproducibility of endometrial volume acquisitionand measurement with the VOCAL-imaging program. Ultrasound Obstet Gynecol. 2002;19:69-75.
  15. Bordes A, Bory AM, Benchaib M, Rudigoz RC, Salle B. Reproducibility of transvaginal three-dimensional endometrial volume measurements with virtual organ computer-aided analysis(VOCAL) during ovarian stimulation. Ultrasound Obstet Gynecol. 2002;19:76-80.
  16. Merce LT, Santiago B, María JB, Juan T, Rosina G, Florencia S, Amelia V. Assessment of the ovarian volume, number and volume of follicles and ovarian vascularity by three-dimensional ultrasonography and power doppler angiography on the HCG day to predict the outcome in IVF/ICSI cycle. Human Reprod. 2006;21(5):1218-1226.
  17. Merce LT, Gomez B, Engels V, Bau S, Bajo JM. Intraobserver and interobserver reproducibility of ovarian volume, antral follicle count and vascularity indices obtained with transvaginal 3-dimensional ultrasonography, power dopplerangiography and virtual organ computer-aided imaging program. J Ultrasound Med. 2005;24:1279-1287.
  18. Anita K, Ernest Hung Yu Ng1, William BY, Pak CH. Perifollicular vascularity in poor ovarian responders during IVF. Human Reprod. 2006;21(6): 539-544.
  19. Pan HA, Wu MH, Cheng YC, Li CH, Chang FM. Quantification of doppler signal in PCOS using three-dimensional power doppler ultrasonography: A possible new marker for diagnosis. Human Reprod. 2002;17:201-206.
  20. Cutting et al. Modified for UK NEQAS Embryo Morphology Scheme 2010 – Elective Single Embryo Transfer: Guidelines for Practice. British Fertility Society and Association of Clinical Embryologists. Human Fertility. 2008;11(3):131-146.
  21. Balakier H, Stronell R. Colour Doppler assessment of the GnRHa – The RI value seems to reflect this sensitivity: Folliculogenesis in invitro fertilization patients. Fertil Steril.1994;62:1211-1216.
  22. Wu MH, Tang HH, Hsu CC, Wang ST, Huang KE. The role of three-dimensional ultrasonographic images in ovarian measurement. Fertil Steril.1998;69:1152-1155.
  23. Dolz M, Osborne NG, Blanes J, Raga F, Abad-Velasco L, Villalobos A, Pellicer A, Bonilla-Musoles F. Polycystic ovarian syndrome: Assessment with color doppler angiography and three-dimensional ultrasonography. J Ultrasound Med. 1999;18:303-313.
  24. Pairleitner H, Steiner H, Hasenoehrl G, Staudach A. Threedimensional power doppler sonography: Imaging and quantifying blood flow and vascularization. Ultrasound Obstet Gynecol. 1999;14:139-143.
  25. Wittmaack FM, Kreger DO, Blasco L, Tureck RW, Mastroianni L, Lessey BA. Effect of follicular size on oocyte retrieval, fertilization, cleavage and embryo quality in invitro fertilization cycles: A 6-year data collection. Fertil Steril. 1994;62:1205-1210.
  26. Dubey AK, Wang HA, Duffy P, Penzias AS. The correlationbetween follicular measurements, oocyte morphology and fertilization ratesin an invitro fertilization program. Fertil Steril. 1995;64:787-790.
  27. Bergh C, Broden H, Lundin K, Hamberger L. Comparison of fertilization, cleavage and pregnancy rates of oocytes from large and small follicles. Human Reprod.1998;13:1912-1915.
  28. Kupesic S, Kurjak A, Bjelos D, Vujisic S. Three-dimensional ultrasonographic ovarian measurements and invitrofertilization outcome are related to age. Fertil Steril. 2003;79:1.
  29. Jarvela IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Comparison of follicular vascularization in normal versus polycystic ovaries duringinvitro fertilization as measured using 3D PDA. Fertil Steril. 2004;82:5.
  30. Terriou P, Sapin C, Giorgetti C, Hans E, Spach JL, Roger R. Embryo score is a better predictor ofpregnancy than the number of transferredembryos or female age. Fertil Steril. 2001;75:3.
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