Value of ovarian stromal blood flow velocity measurement after pituitary suppression in the prediction of ovarian responsiveness and outcome of in vitro fertilization treatment

Objective: To evaluate whether ovarian stromal blood Bow velocity after pituitary suppression is predictive of ovarian response and the outcome of IVF treatment in patients with normal basal serum FSH levels and to compare the predictive value of this test with age, early follicular phase serum FSH level, E-2 level, and FSH:LH ratio. Design: Prospective observational study of women undergoing IVF treatment. Setting: A tertiary referral center for assisted reproduction. Patient(s): Eighty-eight women who received the long buserelin acetate treatment protocol. Intervention(s): Transvaginal color and pulsed Doppler measurement of the ovarian stromal peak systolic velocity (PSV) after pituitary suppression and measurement of the basal serum FSH level, E-2 level, and FSH:LH ratio. Main Outcome Measure(s): Number of mature oocytes retrieved and pregnancy rate. Result(s): Ovarian stromal PSV was the most important single independent predictor of ovarian response in patients with a normal basal serum FSH level, when compared with age, basal FSH level, E-2 level, or FSH:LH ratio. Patients in group 2 (PSV greater than or equal to 10 cm/s) had a significantly higher median number of mature oocytes retrieved (11 versus 5.5) and a higher clinical pregnancy rate (35.3% versus 11.3%) than patients in group 1 (PSV <10 cm/s), even after controlling for age. Conclusion(s): Ovarian stromal blood flow velocity, after pituitary suppression is confirmed, is predictive of ovarian responsiveness and the outcome of IVF treatment. (C) 1998 by American Society for Reproductive Medicine.