S. Huey et al., Perifollicular blood flow Doppler indices, but not follicular pO(2), pCO(2), or pH, predict oocyte developmental competence in in vitro fertilization, FERT STERIL, 72(4), 1999, pp. 707-712
Objective: To assess the relationships among perifollicular blood how; foll
icular fluid pO(2), pCO(2), and pH; oocyte developmental capacity; preimpla
ntation embryo quality.
Design: Prospective study.
Setting: Academic, tertiary care institution.
Patient(s): Unselected, gonadotropin-stimulated IVF cycles.
Intervention(s): Color, pulsed Doppler analysis of perifollicular blood flo
w, and follicular pO(2), pCO(2), and pH determinations of randomly designat
ed, mapped ovarian follicles.
Main Outcome Measure(s): Fertilization and day 3 embryo cleavage and morpho
logy.
Result(s): Perifollicular vascularity indices were significantly and negati
vely correlated with day 3 embryo cleavage. Pulsatility index and S-D ratio
also were significantly and negatively correlated with follicular pO(2). T
he same correlation was found between resistance index and the fertilizatio
n rate of preovulatory oocytes. No relationship existed between follicular
metabolic analysis and fertilization or embryo quality. The resistance inde
x had a sensitivity of 0.57 and a specificity of 0.71 for the prediction of
advanced embryo cleavage status.
Conclusion(s): Results confirm and extend previous reports demonstrating th
at color, pulsed Doppler ultrasound analysis of individual preovulatory fol
licles during IVF therapy may provide an indirect index of the developmenta
l competence of the corresponding oocyte. Although these methods may provid
e means to select embryos for transfer with the highest implantation potent
ial, the moderate predictive power showed so far may limit their clinical a
pplicability. (Fertil Steril(R) 1999;72.707-12. (C) 1999 by American Societ
y for Reproductive Medicine.).