Vol.13, No 2, 2006 pp. 104 - 108
UC 618.177-089.888.11
COLOR DOPPLER AND COLOR DOPPLER ENERGY
IMAGING AND MEASUREMENTS OF
OVARIAN STROMAL BLOOD FLOW IN CONTROLLED OVARIAN
HYPERSTIMULATION FOR IN VITRO FERTILIZATION
Ranko Kutlešić1, Aleksandar Ljubić2,
Mila Milosavljević1, Milan Stefanović1,
Predrag Vukomanović1
1Clinic of Gynecology and Obstetrics Clinical Center Niš,
Serbia
2Institute of Gynecology and Obstetrics, Clinical Center
Serbia, Belgrade, Serbia
E-mail: kutlesicr@medianis.net
Summary. The aim of this investigation is to determine the correlation
of color Doppler (CD) and color Doppler Energy (CDE) imaging and measurements
of ovarian stromal blood flow prior to controlled ovarian hyperstimulation
(COH), predictors of success of COH and numbers of oocyte retrieved, especially
in group of poor responders. Fifty-two patients on IVF treatment were included
in this prospective clinical trial. The long protocol of controlled ovarian
hyperstimulation was administered in all 52 patients. Prior to COH, at
basal ultrasound examination, the ovarian stromal vascularisation was registered
by color Doppler and color Doppler energy imaging with 6.5 MHz endovaginal
ultrasound probe. In general population of infertile patients submitted
to IVF treatment, CD and CDE imaging and measurements do not correlate
with the result of controlled ovarian hyperstimulation in IVF cycles and
the rate of pregnancy. "Poor responders" during COH with long protocol,
show less expressed and poorer ovarian stromal blood flow on CD and CDE
imaging, associated with higher resistance to blood flow in ovarian stromal
vessels at the beginning of COH. This group of patients should be switched
to some other stimulation protocol, which could spare them from unsuccessful
IVF cycle and give them more chance for pregnancy.
Key words: In vitro fertilization,
controlled ovarian hyperstimulation, Doppler
KOLOR DOPPLER (CD) I KOLOR DOPPLER ENERGIJSKI
PRIKAZ I MERENJA PROTOKA KRVI KROZ STROMU JAJNIKA U
KONTROLISANOJ HIPERSTIMULACIJI TOKOM IN VITRO FERTILIZACIJE
Kratak sadržaj: Cilj ovog istraživanja je da se odredi korelacija
kolor Doppler (CD) i kolor Doppler energijskog (CDE) prikaza i merenja
protoka krvi kroz stromu jajnika pre početka kontrolisane hiperstimulacije
jajnika (KOH) tokom ciklusa in vitro fertilizacije (IVF), prediktora uspeha
KOH i broja dobijenih oocita, posebno u grupi pacijentkinja sa lošim odgovorom
na kontrolisanu hiperstimulaciju jajnika. Ovo prospektivno kliničko istraživanje
je obuhvatilo 52 pacijentkinje, podvrgnute ťdugom protokoluŤ kontrolisane
hiperstimulacije jajnika tokom ciklusa in vitro fertilizacije.Pre početka
KOH kolor Doppler i kolor Doppler energijskim prikazom, na početnom ultrazvučnom
pregledu, je registrovana vaskularizacija strome jajnika, pomoću endovaginalne
sonde od 6.5 MHz. Posmatrano u celini, u populaciji infertilnih pacijentkinja
tokom ciklusa IVF, CD i CDE prikaz i merenja protoka krvi kroz stromu jajnika,
ne koreliraju sa rezultatima kontrolisane hiperstimulacije jajnika tokom
IVF ciklusa, niti sa stopom trudnoća. Pacijentkinje sa lošim odgovorom
na kontrolisanu hiperstimulaciju jajnika ťdugim protokolomŤ u toku IVF
ciklusa, imaju manje izražen protok krvi kroz krvne sudove strome jajnika
na CD i CDE prikazu, što prati i viša rezistenca protoku krvi kroz arteriole
strome jajnika na početku KOH. Pacijentkinje ove grupe bi trebalo prebaciti
na neki drugi protokol stimulacije, što bi ih poštedelo neuspešnog IVF
ciklusa i dalo im više šansi da postignu trudnoću.
Ključne reči:
in vitro fertilizacija, kontrolisana hiperstimulacija jajnika, doppler
