The three-dimensional ultrasonographic ovarian vascularity of women developing poor ovarian response during assisted reproduction treatment and its predictive value

Fertil Steril. 2009 Dec;92(6):1862-9. doi: 10.1016/j.fertnstert.2008.09.031. Epub 2008 Oct 29.


Objective: To test the hypothesis that ovarian vascularity is decreased in women who demonstrate poor ovarian response to controlled ovarian stimulation as part of assisted reproduction treatment.

Design: Prospective study.

Setting: University-based Assisted Conception Unit.

Patient(s): One hundred forty-one women undergoing their first cycle of assisted reproduction treatment (ART).

Intervention(s): Transvaginal 3D ultrasound assessment and venepuncture in the early follicular phase of the menstrual cycle immediately before ART.

Main outcome measure(s): Ovarian vascularity indices (VI, FI, and VFI), ovarian volume (OV), and antral follicle count (AFC).

Results: The ovarian VI (7.5 +/- 5.3 vs. 8.6 +/- 7.3), FI (38.9 +/- 6.9 vs. 38.0 +/- 5.5), and VFI (3.2 +/- 2.6 vs. 3.5 +/- 3.1) were similar in both poor and normal responders. AFC and OV were significantly lower in women who developed poor response (9 +/- 3.3 and 6.3 +/- 3.5 cm(3), respectively) than in normal responders (19.2 +/- 9.9 and 8.9 +/- 4.8 cm(3), respectively). Antral follicle count and basal FSH were the only significant predictors of poor ovarian response on multiple regression analysis.

Conclusion(s): Ovarian blood flow, as measured by 3D ultrasound, is not decreased in women who demonstrate a poor response to ovarian stimulation and is not predictive of poor response during IVF treatment. The AFC is the single best predictor of poor ovarian response.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Female
  • Follicular Phase
  • Humans
  • Imaging, Three-Dimensional
  • Infertility, Female / diagnostic imaging*
  • Infertility, Female / therapy*
  • Logistic Models
  • Ovarian Follicle / blood supply*
  • Ovarian Follicle / diagnostic imaging*
  • Predictive Value of Tests
  • Pregnancy
  • Prospective Studies
  • ROC Curve
  • Regional Blood Flow
  • Reproductive Techniques, Assisted*
  • Treatment Outcome
  • Ultrasonography, Doppler / methods*