Doppler Index of Ovarian Stromal Artery: Clinical Significance as a Predictor of Ovarian Response and Pregnancy in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer.

Kim,  Seok Hyun; Ku,  Seung Yup; Jee,  Byung Chul; Suh,  Chang Suk; Choi,  Young Min; Kim,  Jung Gu; Moon,  Shin Yong; Lee,  Jin Yong

Journal of Korean Society of Medical Ultrasound 2001;20(1): 49-57.

Seok Hyun Kim, Seung Yup Ku, Byung Chul Jee, Chang Suk Suh, Young Min Choi, Jung Gu Kim, Shin Yong Moon, Jin Yong Lee

¹Department of Obstetrics and Gynecology, College of Medicine, Seoul National University
²Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, Korea

Published online: March 1, 2001.

ABSTRACT

PURPOSE: To assess whether the doppler index of ovarian stromal artery predicts the outcomes of controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET) such as ovarian response and pregnancy. MATERIALS and METHODS : Pulsatility index (PI) was measured using transvaginal Doppler ultrasonography in 99 infertile patients undergoing IVF-ET. PI was obtained from bilateral ovarian stromal arteries on the starting day of COH (PI1 ) and the day of hCG administration (PI2 ). The outcomes of IVF-ET were analyzed and correlated with PI values. RESULTS : Patients were divided into three groups using PI1 of 1.3 and 2.3, PI2 of 1.0 and 2.0, and delta PI (PI2 -PI1 ) of 0.2 and 0.4, respectively. There were no significant differences in the outcomes of COH among three groups. The pregnancy rate was significantly higher in group of PI1 value below 1.3 (61.4%) than in group of PI1 value above 2.3 (33.3%), in group of PI2 value below 1.0 (61.0%) than in group of PI2 value above 2.0 (34.3%), and in group of delta PI value below 0.2 (60.0%) than in group of delta PI value above 0.4 (34.1%) (p<0.05). Significant positive correlations were found between PI1 or PI2 and 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). CONCLUSION : The lower PI of ovarian stromal artery during COH, the higher the pregnancy rate and the smaller the amount of gonadotropin was needed for effective COH. This study suggests that the pulsatility index of ovarian stromal artery during COH may be useful in predicting the success of IVF-ET.

Keywords: Infertility; In vitro fertilization and embryo transfer(IVF-ET); Controlled ovarian hyperstimulation(COH); Ovary; Ultrasound(US), Doppler studies