Perifollicular Doppler flow and follicular fluid vascular endothelial growth factor concentrations in poor responders

Objective: To prospectively evaluate follicular fluid levels of vascular en dothelial growth factor in women undergoing IVF cycles and to investigate t he correlation of these levels with ovarian response to gonadotropins and w ith uterine or ovarian Doppler findings. Design: Prospective study. Setting: University hospital. Patient(s): 41 patients undergoing ART were divided into two groups accordi ng to response to ovarian stimulation protocols: poor responders (n = 18) a nd normoresponders (n = 23). Intervention(s): Doppler analysis of perifollicular arteries and assay of f ollicular fluid vascular endothelial growth factor. Main Outcome Measure(s): During ovarian stimulation, patients underwent hor monal (E2), ultrasonographic (follicular number and diameter, endometrial t hickness) and Doppler (uterine and perifollicular arteries) evaluation. Ser um and follicular fluid concentrations of vascular endothelial growth facto r were assayed in each female patient. Result(s): Compared with poor responders, more oocytes were collected and m ore embryos were transferred but follicular fluid levels of vascular endoth elial growth factor levels were lower in normoresponders. Follicular fluid levels of vascular endothelial growth factor were inversely correlated with number of oocytes retrieved. Poor responders had significantly higher uter ine and perifollicular Doppler flow resistances. The pregnancy rate per cyc le was significantly higher in normoresponders (26%) than poor responders ( 6%). Conclusion(s): Elevated follicular fluid levels of vascular endothelial gro wth factor concentrations are associated with poor ovarian response and a v ery low pregnancy rate. (Fertil Steril (R) 2000;74:809-12. (C) 2000 by Amer ican Society for Reproductive Medicine.).