Perifollicular blood flow Doppler indices, but not follicular pO(2), pCO(2), or pH, predict oocyte developmental competence in in vitro fertilization

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.).