P20.08: Power Doppler ultrasound assessment of follicular vascularization: prospective clinical interest evaluation for IVF management—preliminary results

Abstract

Average live birth rate in Europe remains ∼28% per transfer despite advances in in-vitro fertilization (IVF). Factors such as maternal age, ovarian reserve, serum estradiol concentrations, follicular number and size are being investigated as possible prognostic factors of success. In regard to the oocyte quality at the time of retrieval, a relationship between follicular vascularization and the IVF outcome has been established. Conventional pulsatility indices of intra-ovarian arteries are very difficult to use routinely. The aim of this study was to investigate the accuracy of power Doppler ultrasonography for assessment of follicular vascularization during IVF attempts, as well as a prognostic factor of IVF outcome. 35 patients undergoing IVF treatment were prospectively recruited. Using power Doppler ultrasound, we assessed individual follicular vascularization of about three follicules in each ovary, by a subjective graduation, at the time of oocyte collection. Using a validated system, follicles were determined to be at high or low grade on regard with the extension of vascularization. Subsequent follicular and oocyte quality parameters were collected: mean follicular diameter, presence and maturity of the corresponding oocyte, quality of zygotes and cleaved embryos whether transferred or not. A total of 187 follicles were studied. The assessment of perifollicular vascularization, although highly subjective, was feasible in 92.51% of cases. Vascularization grade was not dependent on follicular size. There was no significant difference in any of the analysed follicular and oocyte quality parameters between high and low grade follicles. Power Doppler assessment of perifollicular vascularization does not seem to be a useful procedure to evaluate follicular and oocyte quality.