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Obstetrics & Gynecology 2003;102:816-822
© 2003 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Quantification of Ovarian Power Doppler Signal With Three-Dimensional Ultrasonography to Predict Response During In Vitro Fertilization

Ilkka Y. Järvelä, MD, Povilas Sladkevicius, MD, Simon Kelly, MD, Kamal Ojha, MD, Stuart Campbell, MD and Geeta Nargund, MD

From the Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland; Diana, Princess of Wales Center for Reproductive Medicine, Academic Department of Obstetrics and Gynecology, St. George’s Hospital Medical School, London, United Kingdom; Department of Obstetrics and Gynecology, Kvinnokliniken, Universitetsjukhuset MAS, Malmö, Sweden; and Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.

Address reprint requests to: Ilkka Y. Järvelä, MD, Oulu University Hospital, Department of Obstetrics and Gynecology, PL 5000, 90014 Oulu, Finland; E-mail: ijarvela{at}cc.oulu.fi.

OBJECTIVE: To evaluate whether power Doppler predicts ovarian response to gonadotrophin stimulation during in vitro fertilization (IVF).

METHODS: Forty-five women were divided into low-reserve (n = 12) and normal-reserve (n = 33) ovarian groups, according to antral follicle count. Transvaginal three-dimensional power Doppler ultrasonographic examinations were performed after pituitary downregulation and after gonadotrophin stimulation. The antral follicle count, ovarian volume, vascularization index, flow index, vascularization flow index, and mean gray value were measured and related to the number of oocytes retrieved and the pregnancy rate.

RESULTS: The number of oocytes retrieved correlated with the antral follicle count (R = .458, P = .004) and ovarian volume (R = .388, P < .016) but not with vascularization index, flow index, vascularization flow index, or mean gray value after pituitary suppression. There was an increase in vascularization index (P < .017), flow index (P < .001), and vascularization flow index (P < .007) during gonadotrophin stimulation in the normal-ovary group but not in the low-ovarian-reserve group.

CONCLUSION: According to our results, quantification of power Doppler signal in the ovaries after pituitary suppression does not provide any additional information to predict the subsequent response to gonadotrophin stimulation during IVF. The increase in ovarian power Doppler signal during gonadotrophin stimulation is related to the antral follicle count observed after pituitary suppression.




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