FOLLICULAR VASCULARITY - THE PREDICTIVE VALUE OF TRANSVAGINAL POWER DOPPLER ULTRASONOGRAPHY IN AN IN-VITRO FERTILIZATION PROGRAM - A PRELIMINARY-STUDY

The aim of this prospective study was to investigate the ability of tr ansvaginal power Doppler ultrasonography to assess the relationship be tween follicular vascularity and outcome in women undergoing in-vitro fertilization. Each of 38 subjects underwent a single transvaginal pow er Doppler ultrasound scan on the day of oocyte collection, where the vascularity of individual ovarian follicles was assessed, using a subj ective system, and graded 1 to 4. In addition, conventional pulsatilit y indices (PI) of the uterine and intra-ovarian (stromal) arteries wer e calculated, which showed no significant differences between the preg nant and non-pregnant groups. Using power Doppler ultrasonography, a t otal of 188 follicles was studied. The follicular vascularity grade wa s found to be independent of follicular size and there was no signific ant difference in fertilization rates with different degrees of vascul arity although there was a trend towards higher fertilization rates wi th higher grade vascularity. There were 10 pregnancies, giving a pregn ancy rate of 26.3% per embryo transfer. Pregnancies were confined to t hose women whose embryos were derived from follicles with grade 3 and 4 vascularity (pregnancy rates per embryo transfer of 12.5 and 61.5% r espectively), with only those from grade 4 follicles resulting in live births. This preliminary study suggested that high grade follicular va scularity is associated with increased pregnancy rate and that there i s a possible link between follicular vascularity and implantation pote ntial.