Oral poster abstractsMethods: Transvaginal 2D and 3D pelvic ultrasound was performed during the early follicular phase of the cycle (day 2 to 5) in 36 women with PCOS, as defined by the Rotterdam guideline, and sub-group analysis conducted based on the subjects' body mass index (BMI), ovulation status, and hirsutism score.

BACKGROUND:The assessment of follicular maturity at the time of human chorionic gonadotropin (hCG) is one of the key factors for the success of all assisted reproductive techniques.AIM:To assess follicles by three dimensional (3D) and 3D power Doppler (PD) before giving hCG to improve pregnancy rates in intrauterine insemination (IUI) cycles.DESIGN:Prospective randomized study.MATERIALS AND METHODS:Ultrasound for pre-hCG follicular assessment was performed over a period of 10 months for all 1000 cycles of IUI. Follicular assessment was performed using a transvaginal multifrequency volume probe. Follicles considered mature by 2D US and color Doppler were assessed by 3D and 3D PD. These values were independently evaluated for the conception and the non-conception groups.RESULTS:Conception rates were 32.3 and 27% respectively and individually when the perifollicular resistance index was < 0.50 and the peak systolic velocity was > 11 cm/s 10-12 h before hCG. Conception rates of 32% were achieved with a follicular volume between 3 and 7 cc. The conception rate was 32.3% in the cumulus group. A perifollicular vascularity index of between six and 20 gave conception rates of 35% and perifollicular flow index of 27-43 gave conception rates of 33%.CONCLUSIONS:3D ultrasound is much more accurate for volume assessment of the follicle. Presence of cumulus increases the surety of the presence of a mature ovum in the follicle. 3D and 3D PD when used with 2D US and color Doppler for pre-hCG follicular assessment would definitely improve pregnancy rates in IUI cycles.

Success of any assisted reproductive technology is dependent on selection of correct stimulation protocol. This is based on prestimulation assessment of female to assess ovarian response and reserve. But, this assessment can also be done by ultrasound scan on 2nd to 3rd day of menstrual cycle, named as 'baseline scan'. This scan is done to categorize ovary into one of the four types: Normal ovaries, low reserve ovaries, poorly responding ovaries and polycystic ovaries. Patients with polycystic ovarian syndrome have variable pictures of ovaries on ultrasound. Understanding the evolution of polycystic ovarian syndrome can explain these variations. Moreover, ultrasound findings can also be correlated with the biochemical and hormonal derangements. This scan also predicts the ovarian reserve and response that can guide to decide the stimulation protocols for ART. This scan includes the use of b mode, Doppler and 3D ultrasound with 3D power Doppler. It consists of assessing ovarian size, antral follicle count (AFC), stromal echogenecity and stromal flow chiefly. Dose calculation is chiefly done based on ovarian volume, AFC and stromal flow.

No abstract

Objective: To assess if the patients with pre hCG high perifollicular PSV values, would benefit with a double IUI, instead of single IUI. Method: A randomized prospective study was done of 350 IUI cycles who were stimulated by either CC or rFSH (recombinant FSH) or Letrozole with rFSH and showed a pre hCG perifolliclular PSV of 15cms/sec. Single IUI was done at 36 -38 hours after hCG injection and in double IUI cases the IUI were done at 12-14 hours and 36-38 hours. Results: With CC stimulated cycles when perifollicular PSV was 15-20, single IUI gave nearly similar conception rates with both single and double IUI. With PSV 20 -25 cms/sec, double IUI showed higher conception rates than single IUI. But when was PSV > 25, conception rates were very low with single IUI than with double IUI. With rFSH cycles with PSV 15-20, conception rates were comparable with both single IUI and double IUI but with PSV > 20, the conception rates were significantly better and with PSV > 25, the pregnancy rates with single IUI were significantly low. Same was the case with letrozole + rFSH cycles. Conclusion: In all cases with PSV > 25 cms/sec on the day of hCG, a double IUI gives better pregnancy rates, but this limit lowers to PSV 20, when it is a rFSH cycle. P20.13Estimation of uterine cavity codition by three-dimensional hysterosonosalpingograpy Background: Congenital and acquired uterine anomalies are relatively often and correlate with infertility and habitual abortions. Objective: To estimate sensitivity and specificity of three-dimensional hysterosonosalpingography (3D HSSG) compared to hysteroscopy. Methods: 60 patients, divided into two groups, were included in this prospective study. In the first group, which consisted of 30 patients, estimates were done by 3D HSSG with negative contrast, and compared to findings of hysteroscopy done on the same patients. The second group, which also consisted of 30 patients, had uterine cavity estimation done by 3D HSSG with hyperechogenic contrast, and compared to finding of hysteroscopy done on these 30 women. Results: Sensitivity and specificity of 3D HSSG with negative contrast was 100% compared to hysteroscopy. Sensitivity of 3D HSSG with hyperechogenic contrast compared to hysteroscopy was 66.6% for synechiae, 94.7% for septum and 100% for other uterine anomalies, while specificity was 100% for all uterine malformations. Conclusion: Results of this study show that 3D HSSG with negative contrast is the best method for uterine cavity vizualisation, and estimation, and it presents precise and minimally invasive alternative, that provides this method to be used in routine ambulatory practice.