Intraovarian arterial blood flow resistance in oligomenorrheal infertile women

Abstract

Purpose:Intraovarian arterial blood flows before and after follicular rupture in ovulation induced cycles were examined by transvaginal color flow Doppler imaging. The changes observed in the intraovarian arterial resistance before and after ovulation in relation to the regularity of menstruation and several other parameters were analyzed. Methods: In a prospective study, 22 patients undergoing infertility treatment in our center were recruited. Patients were divided into two subgroups, according to their menstrual regularity (regular menstrual group and oligomenorrheal group) and 42 cycles were studied. All patients received the same FSH low-dose stimulation treatment. The relationship between the post and preovulatory arterial pulsatility indexes (PI) was analyzed. Cycles that showed a decrease in their PI after ovulation of 10% or more were considered "profoundly decreased cycles." Cycles from the same patients without ovulatory stimulation (natural cycles) were used as control. Results: In the regular menstrual group the rate of profoundly decreased cycles during FSH stimulation was 63.2%, which was similar to the rate observed in natural cycles. In the oligomenorrheal group the rate of profoundly decreased cycles during natural cycles was 14.3%, but in FSH ovulation induction cycles this rate was significantly increased (47.6%, p < 0.05). In addition, the pregnancy rate per cycle in the oligomenorrheal group was significantly higher than that in the regular menstrual group (p = 0.03). Conclusions: Oligomenorrheal patients presented a higher rate in the decrease of their PI values after FSH stimulation, which is essential to achieve pregnancy. This elevated rate of reduction implies that oligomenorrheal patients have increased incidence of disturbance in their ovulatory process when compared to normal cycling patients. Thus, ovulation induction with FSH, in oligomenorrheal patients resulted in a higher pregnancy rate in this group.

Reduction of perifollicular arterial blood flow resistance after hCG administration is a good indicator of the recovery of mature oocytes in ART treatment

“…Moreover, we also indicated that oligomenorrheal patients showed a disturbance in the ovulation process during the peri-ovulatory period with respect to intraovarian arterial blood flow resistance [13]. The induction of ovulation with a FSH low-dose step-up regimen improved the ovulation process of the oligomenorrheal patients with a deep decrease in intraovarian arterial blood flow resistance, and consequently, the pregnancy rate was also increased [13]. From these results, we conclude that mature oocytes with good quality develop and are ovulated when a substantial decrease in intraovarian arterial blood flow resistance occurs during the ovulation process.…”

“…This parameter is noninvasive and one of the available methods for evaluating the follicular environment during ovulation. Moreover, we also indicated that oligomenorrheal patients showed a disturbance in the ovulation process during the peri-ovulatory period with respect to intraovarian arterial blood flow resistance [13]. The induction of ovulation with a FSH low-dose step-up regimen improved the ovulation process of the oligomenorrheal patients with a deep decrease in intraovarian arterial blood flow resistance, and consequently, the pregnancy rate was also increased [13].…”

Elevated basal FSH levels, if it is under 15 IU/L, will not reflect poor ART outcomes

“…This was found to be useful in the evaluation of both the quality of the oocytes and in the developmental competence of the corresponding oocytes [5][6][7].…”