Perifollicular vascularity as a potential variable affecting outcome in stimulated intrauterine insemination treatment cycles: by using transvaginal power Doppler

Abstract

The aim of study was to asses any potential relationship between perifollicular vascularity and fetal outcome in an invivo environment following ovarian stimulation and intrauterine insemination. A total of 75 unselected consecutive patients undergoing stimulated intrauterine insemination cycles (with clomid) was recruited where the perifollicular vascularity of the follicles ≥16 mm was studied using subjective grading system by transvaginal power Doppler ultrasonography 24 h after HCG administration. 36 hours after H.C.G administration we did intrauterine insemination and two weeks later we did pregnancy test for our patients. A total 75 mature follicles ( > 16 mm ) was studied. According to the result of Doppler study we found that we had 54.6% of follicles having grade III perfollicular vascularity , 32% having grade II , and 13.3% grade I. The follicles of high grade vascularity were associated with higher pregnancy rate (grade 3= 19.5%) than cycles with low grade vascularity (grade2 =12.5%), with no pregnancy occur in grade 1 vascularity group. Early pregnancy loss rate was significantly higher in grade2 follicular vascularity (33.3%) than grade 3 (12.5%) . The mean age and duration of subfertility were significantly higher (P<0.05), with low follicular vascularity grades compared with grade II, III. These data would suggest that perfollicular vascularity and PI (pulsatility index ) of uterine artery has an important role to play in the outcome of IUI cycles. And that the power Doppler has the potential to refine the management of assisted reproduction treatment cycles.