Can Doppler study of the ovarian artery predict the fertility outcome of intrauterine insemination?

J Clin Ultrasound. 2014 Jul-Aug;42(6):331-5. doi: 10.1002/jcu.22140. Epub 2014 Feb 13.

Abstract

Background: To test the velocimetric pattern of the ovarian artery as a routine ovarian reserve test.

Methods: We enrolled 317 consecutive patients from January 2011 to June 2012. At the second day of the menstrual cycle, a transvaginal ultrasound was performed to evaluate the antral follicle count and ovarian volume, and Doppler of both ovarian arteries was also performed. Controlled ovarian stimulation was performed and the patients were divided in two groups according to the result of the intrauterine insemination: group A (nonpregnant women) and group B (pregnant women).

Results: Ovarian velocimetric pattern was similar between the two groups. Follicle stimulating hormone value had a significant correlation with the ultrasound markers; however, the multiple regression linear analysis showed that the only independent variables were the antral follicle count (t = -2.74, p = 0.008) and the systolic/diastolic ratio (t = 3.95, p = 0.0005). The best parameters in predicting the pregnancy were the mean ovarian volume, total and partial antral follicle count between 7 and 10 mm, and the mean resistance index (area under the curve: 0.744, 0.671, 0.667, 0.573, respectively).

Conclusions: The Doppler study of the ovarian arteries did not add significant information about the ovarian reserve status. Only the mean resistance index had a significant diagnostic accuracy, but its specificity (53%) is too low to consider it a screening test.

Keywords: Doppler; follicle stimulating hormone; in vitro fertilization; insemination; ovary; ultrasonography.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Arteries / diagnostic imaging
  • Confidence Intervals
  • Female
  • Humans
  • Infertility, Female / diagnostic imaging
  • Infertility, Female / therapy
  • Insemination, Artificial / methods*
  • Multivariate Analysis
  • Ovary / blood supply*
  • Ovulation Induction / methods*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Rate
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Ultrasonography, Doppler / methods
  • Ultrasonography, Interventional / methods