Abstract
Objectives: Oocyte competence is related to perifollicular blood flow supply. We evaluated the correlation between perifollicular vascularization indexes (PVI), cumulus-oocyte complex (COC) assessment during controlled ovarian hyperstimulation (COH) and oocyte competence vs embryo grading. Methods: 75 women undergoing ICSI cycles were enrolled. Women affected by PCO or other ovarian pathologies were excluded. Follicular growth and PVI was monitored by a GE730 Voluson machine equipped with a transvaginal volume transducer. All the stored volumes were off line analyzed by the VOCALTM imaging program to calculate vascularization index (VI), flow index (FI) and vascularization flow index (VFI) and by the Niche TM imaging program in every follicle > 15 mm to evaluate the presence of the COC, assumed when an intrafollicular hyiperechoic mass, separated from the follicular wall, was detected. Ovulation was inducted by hCG. Oocytes were mechanically denuded for ICSI to assess their maturity to the presence of a polar body. Results: There was a progressive increasing in PVI during COH and a total of 336 COC were observed in 397 follicles. 271 mature oocytes were retrieved. There was a significant correlation between the COC detection, PVI and high oocyte scoring, being the most mature oocyte collected from the most vascularized follicles. We selected 150 most mature oocytes for injection obtaining 131 high quality (grade 1/2) embryos. Conclusions: The identification of prognostic biomarkers of oocyte competence could give infertile couples the maximal chance of conception. We have used 3D power Doppler to relate PVI in growing follicles and oocyte maturity to embryo grading, assuming that changes in perifollicular blood flow supplying follicular growing reflect a better oocyte quality, leading to the development of higher quality embryos. PVI and ultrasound detection of the COC seem to be prognostic factors of oocyte maturity and can be used to improve IVF outcome.
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