Color Doppler and Color Doppler Energy Imaging and Measurements of Ovarian Stromal Blood Flow in Controlled Ovarian Hyperstimulation for in Vitro Fertilization

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.