IMPORTANCE OF PERIFOLLICULAR VASCULARITY IN PREDICTING OUTCOME IN INTRA UTERINE INSEMINATION CYCLES

BACKGROUND Intrauterine insemination (IUI) is usually used in the infertility treatment to get a better pregnancy rate. The common conditions where it is used are unexplained infertility, endometriosis, polycystic ovarian syndrome & male factor infertility. Various approaches have been suggested to increase the pregnancy rate in IUI cycles, e.g. double insemination, identification of conception cycles with use of colour Doppler sonography and prevention of premature LH surge. The capillary network of preovulatory follicles have been found to be more extensive in comparison to other follicles. The use of power Doppler in assessing perifollicular blood flow can be used to determine the quality of the oocyte. This information helps to predict the success of ART cycles. Aims and Objectives- The aim of this study was to assess if we can use perifollicular vascularity in a follicle in IUI cycles to predict treatment outcome. Settings & Design- Prospective Observational study. MATERIALS AND METHODS The study included 178 consecutive IUI cycles. The perifollicular blood flow on the day of HCG was measured. According to the power Doppler signal, the patients were divided into 3 groups. Group A consisted of patients with a perifollicular blood flow of 76% to 100%. Group B with a perifollicular blood flow of 51% to 75% & Group C with a perifollicular blood flow of 0% to 50%. Clinical pregnancy rates were compared. Statistical Analysis- Statistical analysis was done using MEDCALC software. Data was statistically analysed by using by Student's 't' test. Proportions were analysed using the chi-square test.Results were expressed as mean and standard error of the mean. p<0.05 was considered a statistically significant difference. RESULTS In our study, clinical pregnancy occurred in 17 patients in Group A with a clinical pregnancy rate of 21% whereas 4 cases had a clinical pregnancy in Group B with a clinical pregnancy rate of 6.6%. No clinical pregnancy was reported in Group C. There was significant statistical difference between the 3 groups as per the pregnancy rate. CONCLUSION Perifollicular vascularity assessment by transvaginal power Doppler ultrasonography plays a great role in predicting the outcome of stimulated IUI cycles.