Abstract
Ovarian angiogenesis and subsequent intrafollicular O2 content is a critical point in determining oocyte competence and IVF outcome.We wanted to evaluate the differences in ovarian perifollicular blood flow (PFBF) in normal and PCOS ovaries during IVF by using three-dimensional power Doppler (3D pD). 80 unexplained infertile women and 74 women with US evidence of PCOS were enrolled.Controlled ovarian hyperstimulation was induced by long or short protocol + rFSH(alpha-follitropin). A GE 730Voluson machine with a transvaginal volume transducer was used. 3DpD was used to assess total follicle number per ovary (FNPO),ovarian volume (OV) and ovarian vascularization indexes (OVI). Stored volumes were analyzed by the VOCAL program.Mean greyness-MG, vascularization index, flow index and vascularization flow index were serially calculated throughout the follicular phase of ovarian stimulation.Serum FSH, LH and insulin were also checked.Ovulation was induced by hCG administration. We observed conflicting results in PCOS women as OVI appeared positively related to FNPO rather than OV or FSH /LH levels.In the presence of FNPO > 20 OVI were all significantly higher in PCOS women,than in normal ones,in every step of stimulated cycles independently from pituitary down regulation, whereas in the presence of FNPO > 12 but < 20 (consensus standard) OVI were lower in PCOS women following pituitary suppression.MG values were similar in both groups but total stromal area was significantly increased in PCOS.Normoandrogenic ovulatory women needed a higher amount of α-follitropin to get the same PFBF vascularization indexes than the PCOS ones.Insulin resistance appeared positively related with OVI increasing. PCOS is a heterogeneous disease.FNPO better relate with ovarian vascularization and angiogenesis during COH than FSH/LH levels or OV.Women with a total FNPO > 20 are at higher risk of ovarian hyperstimulation.Insulin resistance may play a role in ovarian hyper response in PCOS.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
