Limits...
Pre-hCG 3D and 3D power Doppler assessment of the follicle for improving pregnancy rates in intrauterine insemination cycles.

Panchal S, Nagori CB - J Hum Reprod Sci (2009)

Bottom Line: 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%. 3D ultrasound is much more accurate for volume assessment of the follicle.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Dr. Nagori's Institute for Infertility and IVF, Ahmedabad, India.

ABSTRACT

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.

No MeSH data available.


Pre hCG perifollicular 3DPD values
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2800929&req=5

Figure 0002: Pre hCG perifollicular 3DPD values

Mentions: After the volume calculation, the follicle was seen on the rendered image. Using the surface smooth or light gradient mode for rendering with high threshold can show cumulus [Figure 2]. Then, ROI is again edited to select the option for the shell volume. An option for the outside shell with a wall thickness of 2 mm is selected, which has been found to be the most appropriate to include the perifollicular vessels. This is accepted and a volume histogram is switched on. This gives the vascularity index (VI), which calculates the abundance of flow in the selected volume, flow index (FI), which calculates the average intensity of flow in the selected volume and vascular flow index (VFI), which calculates the perfusion of the selected volume. VI indicates the abundance of the color vessels in the given volume, FI indicates the intensity of the color in the given volume and VFI is the ratio of the abundance and intensity, meaning it gives an idea about the general perfusion status of the given volume [Figures 3 and 4].


Pre-hCG 3D and 3D power Doppler assessment of the follicle for improving pregnancy rates in intrauterine insemination cycles.

Panchal S, Nagori CB - J Hum Reprod Sci (2009)

Pre hCG perifollicular 3DPD values
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2800929&req=5

Figure 0002: Pre hCG perifollicular 3DPD values
Mentions: After the volume calculation, the follicle was seen on the rendered image. Using the surface smooth or light gradient mode for rendering with high threshold can show cumulus [Figure 2]. Then, ROI is again edited to select the option for the shell volume. An option for the outside shell with a wall thickness of 2 mm is selected, which has been found to be the most appropriate to include the perifollicular vessels. This is accepted and a volume histogram is switched on. This gives the vascularity index (VI), which calculates the abundance of flow in the selected volume, flow index (FI), which calculates the average intensity of flow in the selected volume and vascular flow index (VFI), which calculates the perfusion of the selected volume. VI indicates the abundance of the color vessels in the given volume, FI indicates the intensity of the color in the given volume and VFI is the ratio of the abundance and intensity, meaning it gives an idea about the general perfusion status of the given volume [Figures 3 and 4].

Bottom Line: 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%. 3D ultrasound is much more accurate for volume assessment of the follicle.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Dr. Nagori's Institute for Infertility and IVF, Ahmedabad, India.

ABSTRACT

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.

No MeSH data available.