Clinical significance of transvaginal color Doppler ultrasonography of the ovarian artery as a predictor of ovarian response in controlled ovarian hyperstimulation for in vitro fertilization and embryo transfer.

Abstract

Our purpose was to verify whether the blood flow impedance of the ovarian stromal artery in transvaginal color Doppler ultrasonography can predict the in vitro fertilization and embryo transfer (IVF-ET) outcomes. Transvaginal color Doppler ultrasonographic examinations were performed in 99 patients undergoing controlled ovarian hyperstimulation (COH) for IVF-ET. The pulsatility index (PI) was evaluated in the bilateral ovarian stromal arteries on the starting day of COH (PI1) and the day of hCG administration (PI2). The patients were classified into three groups by the mean PI1, PI2, and API (PI1 - PI2), respectively, and the IVF-ET outcomes were analyzed and compared. There were no significant differences in the duration of COH, the total dosage of gonadotropins used for COH, the serum E2 concentration on day of hCG administration, the number of follicles on the day of hCG administration, the number of oocytes retrieved or fertilized in vitro, and the number of embryos transferred between their respective PI1, PI2, and API values. However, the pregnancy rate was significantly lower in the higher PI1 and PI2 groups than in the lower groups (p < 0.05, p < 0.05). Significant positive correlations were also found between PI1 and PI2 and the total dosage of gonadotropins for COH (Y= 0.483X + 27.1, r = 0.052, p < 0.05; Y = 0.877X + 26.6, r = 0.075, p < 0.05). Our results showed that the lower PI in the ovarian stromal artery during COH is associated with the higher the pregnancy rate and the smaller amount of gonadotropins used for effective COH. This study suggests that the color Doppler ultrasonographic index (PI) of the ovarian stromal artery during COH may be useful for predicting the success of IVF-ET in infertile patients.