Document Detail

Can quantitative three-dimensional power Doppler angiography be used to predict ovarian hyperstimulation syndrome?
MedLine Citation:
PMID:  19402100     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test the hypothesis that ovarian vascularity is increased in women developing ovarian hyperstimulation syndrome (OHSS) and to assess its value as a predictor of OHSS during in-vitro fertilization (IVF). METHODS: 118 subjects undergoing their first cycle of IVF had a three-dimensional (3D) transvaginal ultrasound scan in the early follicular phase of the menstrual cycle preceding IVF treatment. 18 of them developed moderate or severe OHSS and 100 subjects had normal ovarian response. Antral follicle count, ovarian volume, and ovarian vascularity (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)) were compared between OHSS and control groups. Multiple regression analysis was used to assess the predictive value of these variables against age, body mass index and basal follicle-stimulating hormone level for the development of OHSS. RESULTS: The ovarian blood flow indices VI (11.1 +/- 11.6 vs. 8.6 +/- 7.3%; P = 0.23), FI (38.0 +/- 4.8 vs. 38.0 +/- 5.5; P = 0.95) and VFI (4.2 +/- 3.3 vs. 3.5 +/- 3.1; P = 0.40) were similar in the OHSS group and the normal responders. While antral follicle count was significantly higher in women developing OHSS (33.0 +/- 15.1) than in the control group (19.2 +/- 9.9, P < 0.001), ovarian volume did not differ between the two groups (10.6 +/- 3.8 vs. 8.9 +/- 4.8 cm(3), respectively, P = 0.11). On multiple regression analysis, antral follicle count was the only significant predictor of OHSS (P < 0.01). CONCLUSIONS: Women developing OHSS during IVF do not demonstrate an increased ovarian blood flow as measured by 3D ultrasound but do have a significantly higher antral follicle count, which is the only significant predictor of OHSS.
K Jayaprakasan; R Jayaprakasan; H A Al-Hasie; J S Clewes; B K Campbell; I R Johnson; N J Raine-Fenning
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  33     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-04     Completed Date:  2010-04-27     Revised Date:  2010-08-24    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  583-91     Citation Subset:  IM    
Nottingham University Research and Treatment Unit in Reproduction (NURTURE), Division of Human Development, School of Clinical Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
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MeSH Terms
Blood Vessels / ultrasonography
Fertilization in Vitro / adverse effects*
Follicular Phase / drug effects,  physiology
Imaging, Three-Dimensional / methods
Infertility, Female / therapy,  ultrasonography*
Logistic Models
Ovarian Follicle / blood supply*,  physiology,  ultrasonography
Ovarian Hyperstimulation Syndrome / pathology,  physiopathology,  ultrasonography*
Predictive Value of Tests
Prospective Studies
Regional Blood Flow / physiology
Regression Analysis
Ultrasonography, Doppler
Erratum In:
Ultrasound Obstet Gynecol. 2009 Oct;34(4):489

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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