ASSOCIATIONS BETWEEN ULTRASOUND INDEXES OF FOLLICULAR BLOOD-FLOW, OOCYTE RECOVERY AND PREIMPLANTATION EMBRYO QUALITY

The aim of this study was to elucidate possible relationships between ultrasound indices of follicular blood flow, oocyte recovery and the s ubsequent production and morphological quality of preimplantation embr yos, A total of 27 women with bilateral tubal occlusion, undergoing tr eatment for infertility by in-vitro fertilization and embryo transfer, contributed data from 29 cycles, Transvaginal ultrasonography with co lour Doppler imaging and pulsed Doppler spectral analysis was used to obtain indices of blood flow for each follicle immediately before it w as aspirated, The main outcome measures for each follicle were the pul satility index, peak systolic velocity, recovery or non-recovery of an oocyte and the subsequent production or non-production of an embryo, A total of 126 follicles were studied, 102 oocytes were recovered and 58 embryos (49 at grades I or II) were produced. There were six clinic al pregnancies (pregnancy rate 27.3% per embryo transfer, 22.2% per pa tient), There was a significant correlation (P < 0.0001, chi(2) test) between whether or not follicular blood how was detected and whether o r not an oocyte was recovered, The sensitivity of a test based on the presence of detectable blood flow and the subsequent recovery of an oo cyte was 74% and the positive predictive value was 93%, The peak systo lic velocity (PSV, measured in cm/s, mean +/- SD) in follicles with de tectable blood flow was significantly higher in follicles that were as sociated with the production of a preimplantation embryo (19.7 +/- 10. 8) compared with those that were not (9.9 +/- 5.3, P < 0.0001, Student 's t-test). There was a 70% chance of producing a grade I or II embryo if the follicular blood velocity was greater than or equal to 10 cm/s , compared with 14% if the PSV was <10 cm/s, or 18% if no blood flow w as detected, We conclude that there is a physiological relationship be tween follicular blood velocity, oocyte recovery and the production of a high-grade preimplantation embryo, which may form the basis of a us eful clinical test.