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Sharma, N., Saravanan, M., Saravanan, L., & Narayanan, S. (2019). The role of color doppler in assisted reproduction: A narrative review. International Journal of Reproductive BioMedicine (IJRM), 17(10), 779–788. https://doi.org/10.18502/ijrm.v17i10.5484
https://doi.org/10.18502/ijrm.v17i10.5484
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authors
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Nidhi Sharma
Nidhi Sharma
Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Mahalakshmi Saravanan
Mahalakshmi Saravanan
Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Lakshmanan Saravanan
Lakshmanan Saravanan
Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Sindujhaa Narayanan
Sindujhaa Narayanan
Department of Obstetrics and Gynecology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
Published Date
- Nov 28, 2019
The role of color doppler in assisted reproduction: A narrative review
Abstract
Color Doppler of perifollicular vascularity is a useful assessment tool to predict the growth potential and maturity of Graafian follicles. Power Angio is independent of the angle of insonation and morphometry and provides reliable clues to predict the implantation window of the endometrium. Color Doppler can be used for the prediction of ovarian hyperstimulation syndrome. It can also be used to identify the hyper responder and gonadotropin-resistant type of polycystic ovaries. The secretory scan of corpus luteum can accurately predict its vascularity and functional status. A corpus luteum with decreased blood flow is a very sensitive and specific indicator of threatened and missed abortions. Color Doppler and Power Angio need to be standardized and identical settings should be maintained if different patients, or if changes over time within the same patient are to be compared.
Key words: Diagnostic imaging, Ultrasonography, Doppler ultrasound imaging.
References
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[2] European IVF-Monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE), Calhaz-Jorge C, de Geyter C, Kupka MS, de Mouzon J, Erb K, et al. Assisted reproductive technology in Europe, 2012: results generated from European registers by ESHRE. Hum Reprod 2016; 31: 1638–1652.
[3] Vural F, Vural B, Doğer E, Çakıroğlu Y, Çekmen M. Perifollicular blood flow and its relationship with endometrial vascularity, follicular fluid EG-VEGF, IGF-1, and inhibin-a levels and IVF outcomes. J Assist Reprod Genet 2016; 33: 1355–1362.
[4] Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod 2013; 28: 2318–2331.
[5] Panchal S, Nagori CB. Pre-hCG 3D and 3D power Doppler assessment of the follicle for improving pregnancy rates in intrauterine insemination cycles. J Hum Reprod Sci 2009; 2: 62–67. [6] Revelli A, Martiny G, Delle Piane L, Benedetto C, Rinaudo P, Tur-Kaspa I. A critical review of bidimensional and three-dimensional ultrasound techniques to monitor follicle growth: do they help improving IVF outcome? Reprod Biol Endocrinol 2014; 12: 107.
[7] Mishra VV, Agarwal R, Sharma U, Aggarwal R, Choudhary S, Bandwal P. Endometrial and subendometrial vascularity by three-dimensional (3D) power doppler and its correlation with pregnancy outcome in frozen embryo transfer (FET) cycles. J Obstet Gynaecol India 2016; 66 (Suppl.): 521–527.
[8] Malhotra N, Bahadur A, Singh N, Kalaivani M, Mittal S. Role of perifollicular Doppler blood flow in predicting cycle response in infertile women with genital tuberculosis undergoing in vitro fertilization/intracytoplasmic sperm injection. J Hum Reprod Sci 2014; 7: 19–24.
[9] Singh N, Yadav A, Vanamail P, Kumar S. Roy KK, Sharma JB. Can endometrial volume assessment predict the endometrial receptivity on the day of hCG trigger in patients of fresh IVF cycles: a prospective observational study. Int J Reprod Contracept Obstet Gynecol 2018; 7: 1523–1526.
[10] Baena V, Terasaki M. Three-dimensional organization of transzonal projections and other cytoplasmic extensions in the mouse ovarian follicle. Sci Rep 2019; 9: 1262.
[11] Turkgeldi E, Urman B, Ata B. Role of three-dimensional ultrasound in gynecology. J Obstet Gynaecol India 2015; 65: 146–154.
[12] Vlaisavljević V, Borko E, Radaković B, Zazula D, Dosen M. Changes in perifollicular vascularity after administration of human chorionic gonadotropin measured by quantitative three-dimensional power Doppler ultrasound. Wien Klin Wochenschr 2010; 122 (Suppl.): 85–90.
[13] Allahbadia GN. Intrauterine insemination: Fundamentals revisited. J Obstet Gynecol India 2017; 67: 385–392. [14] Engels V, Sanfrutos L, Perez-Medina T, Alvarez P, Zapardiel I, Godoy-Tundidor S, et al. Periovulatory follicular volume and vascularization determined by 3D and power Doppler sonography as pregnancy predictors in intrauterine insemination cycles. J Clin Ultrasound 2011; 39: 243–247.
[15] Yaman C, Mayer R. Three-dimensional ultrasound as a predictor of pregnancy in patients undergoing ART. J Turk Ger Gynecol Assoc 2012; 13: 128–134.
[16] Kim A, Jung H, Choi WJ, Hong SN, Kim HY. Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles. Taiwan J Obstet Gynecol 2014; 53: 360–365.
[17] Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC. Relationship between uterine blood flow and endometrial and subendometrial blood flows during stimulated and natural cycles. Fertil Steril 2006; 85: 721– 727.
[18] Jarvela IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 2005; 26: 765–769.
[19] Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC. Endometrial and sub endometrial vascularity is higher in pregnant patients with live birth following ART than in those who suffer a miscarriage. Hum Reprod 2007; 22: 1134–1141. [20] Hajiahmadi S, Alikhani F, Adibi A. Comparative study of corpus luteum ultrasonographic findings in normal and abnormal pregnancies of the first trimester in patients referred to the hospital. Ann Med Health Sci Res 2018; 8: 397–400.
[21] Ahmad RA, Sadek SM, Abdelghany AM. 3D power Doppler ultrasound characteristics of the corpus luteum and early pregnancy outcome. Middle East Fertility Society Journal 2015; 20: 280–283.
[22] Alcazar JL. Three-dimensional power Doppler-derived vascular indices: what are we measuring and how are we doing it? Ultrasound Obstet Gynecol 2008; 32: 485–487.
[23] Tamura H, Takasaki A, Taniguchi K, Matsuoka A, Shimamura K, Sugino N. Changes in blood-flow impedance of the human corpus luteum throughout the luteal phase and during early pregnancy. Fertil Steril 2008; 90: 2334–2339.
[24] Pareja Oda S, Urbanetz AA, Urbanetz LA, de Carvalho NS, Piazza MJ. [Echographic characteristics of the corpus luteum in early pregnancy: morphology and vascularization]. Rev Bras Ginecol Obstet 2010; 32: 549–555.
[25] Miyamoto A, Shirasuna K, Hayashi KG, Kamada D, Awashima C, Kaneko E, et al. A potential use of color ultrasound as a tool for reproductive management: new observations using color ultrasound scanning that were not possible with imaging only in black and while. J Reprod Dev 2006; 52: 153–160.
[26] Ammar T, Sidhu PS, Wilkins CJ. Male infertility: the role of imaging in diagnosis and management. Br J Radiol 2012; 85: S59–68. [27] Aflatoonian A, Mashayekhy M. Transvaginal ultrasonography in female infertility evaluation. Donald School Journal of Ultrasound in Obstetrics and Gynecology 2011; 5: 311–316.
[28] Seyhan A, Ata B, Son WY, Dahan MH, Tan SL. Comparison of complication rates and pain scores after transvaginal ultrasound-guided oocyte pickup procedures for in vitro maturation and in vitro fertilization cycles. Fertil Steril 2014; 101: 705–709.
[29] Ozdemir O, Sari ME, Kalkan D, Koc EM, Ozdemir S, Atalay CR. Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic. Gynecol Endocrinol 2015; 31: 322–326.
[30] Sahu A, Tripathy P, Mohanty J, Nagy A. Doppler analysis of ovarian stromal blood flow changes after treatment with metformin versus ethinyl estradiolcyproterone acetate in women with polycystic ovarian syndrome: A randomized controlled trial. J Gynecol Obstet Hum Reprod 2019; 48: 335–339.
[31] Pascual MA, Graupera B, Hereter L, Tresserra F, Rodriguez I, Alcázar JL. Assessment of ovarian vascularization in the polycystic ovary by three-dimensional power Doppler ultrasonography. Gynecol Endocrinol 2008; 24: 631–636.
[32] Nardo LG, Gelbaya TA. Evidence-based approach for the use of ultrasound in the management of polycystic ovary syndrome. Minerva Ginecol 2008; 60: 83–89.
[33] Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, Norman RJ, et al. Definition and significance of polycystic ovarian morphology: a task force report from the androgen excess and polycystic ovary syndrome society. Hum Reprod Update 2014; 20: 334–352.
[34] Jayaprakasan K, Jayaprakasan R, Al-Hasie HA, Clewes JS, Campbell BK, Johnson IR, et al. Can quantitative three-dimensional power Doppler angiography be used to predict ovarian hyper stimulation syndrome? Ultrasound Obstet Gynecol 2009; 33: 583–591.
[35] Nastri CO, Teixeira DM, Moroni RM, Leitão VM, Martins WP. Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention. Ultrasound Obstet Gynecol 2015; 45: 377–393.
[36] Jayaprakasan K, Jayaprakasan R, Al-Hasie HA, Clewes JS, Campbell BK, Johnson IR, et al. Can quantitative three-dimensional power Doppler angiography be used to predict ovarian hyper stimulation syndrome? Ultrasound Obstet Gynecol 2009; 33: 583–591.
[37] Kwan I, Bhattacharya S, McNeil A, van Rumste MM. Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI). Cochrane Database Syst Rev 2008; 2: CD005289.
[2] European IVF-Monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE), Calhaz-Jorge C, de Geyter C, Kupka MS, de Mouzon J, Erb K, et al. Assisted reproductive technology in Europe, 2012: results generated from European registers by ESHRE. Hum Reprod 2016; 31: 1638–1652.
[3] Vural F, Vural B, Doğer E, Çakıroğlu Y, Çekmen M. Perifollicular blood flow and its relationship with endometrial vascularity, follicular fluid EG-VEGF, IGF-1, and inhibin-a levels and IVF outcomes. J Assist Reprod Genet 2016; 33: 1355–1362.
[4] Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod 2013; 28: 2318–2331.
[5] Panchal S, Nagori CB. Pre-hCG 3D and 3D power Doppler assessment of the follicle for improving pregnancy rates in intrauterine insemination cycles. J Hum Reprod Sci 2009; 2: 62–67. [6] Revelli A, Martiny G, Delle Piane L, Benedetto C, Rinaudo P, Tur-Kaspa I. A critical review of bidimensional and three-dimensional ultrasound techniques to monitor follicle growth: do they help improving IVF outcome? Reprod Biol Endocrinol 2014; 12: 107.
[7] Mishra VV, Agarwal R, Sharma U, Aggarwal R, Choudhary S, Bandwal P. Endometrial and subendometrial vascularity by three-dimensional (3D) power doppler and its correlation with pregnancy outcome in frozen embryo transfer (FET) cycles. J Obstet Gynaecol India 2016; 66 (Suppl.): 521–527.
[8] Malhotra N, Bahadur A, Singh N, Kalaivani M, Mittal S. Role of perifollicular Doppler blood flow in predicting cycle response in infertile women with genital tuberculosis undergoing in vitro fertilization/intracytoplasmic sperm injection. J Hum Reprod Sci 2014; 7: 19–24.
[9] Singh N, Yadav A, Vanamail P, Kumar S. Roy KK, Sharma JB. Can endometrial volume assessment predict the endometrial receptivity on the day of hCG trigger in patients of fresh IVF cycles: a prospective observational study. Int J Reprod Contracept Obstet Gynecol 2018; 7: 1523–1526.
[10] Baena V, Terasaki M. Three-dimensional organization of transzonal projections and other cytoplasmic extensions in the mouse ovarian follicle. Sci Rep 2019; 9: 1262.
[11] Turkgeldi E, Urman B, Ata B. Role of three-dimensional ultrasound in gynecology. J Obstet Gynaecol India 2015; 65: 146–154.
[12] Vlaisavljević V, Borko E, Radaković B, Zazula D, Dosen M. Changes in perifollicular vascularity after administration of human chorionic gonadotropin measured by quantitative three-dimensional power Doppler ultrasound. Wien Klin Wochenschr 2010; 122 (Suppl.): 85–90.
[13] Allahbadia GN. Intrauterine insemination: Fundamentals revisited. J Obstet Gynecol India 2017; 67: 385–392. [14] Engels V, Sanfrutos L, Perez-Medina T, Alvarez P, Zapardiel I, Godoy-Tundidor S, et al. Periovulatory follicular volume and vascularization determined by 3D and power Doppler sonography as pregnancy predictors in intrauterine insemination cycles. J Clin Ultrasound 2011; 39: 243–247.
[15] Yaman C, Mayer R. Three-dimensional ultrasound as a predictor of pregnancy in patients undergoing ART. J Turk Ger Gynecol Assoc 2012; 13: 128–134.
[16] Kim A, Jung H, Choi WJ, Hong SN, Kim HY. Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles. Taiwan J Obstet Gynecol 2014; 53: 360–365.
[17] Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC. Relationship between uterine blood flow and endometrial and subendometrial blood flows during stimulated and natural cycles. Fertil Steril 2006; 85: 721– 727.
[18] Jarvela IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 2005; 26: 765–769.
[19] Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC. Endometrial and sub endometrial vascularity is higher in pregnant patients with live birth following ART than in those who suffer a miscarriage. Hum Reprod 2007; 22: 1134–1141. [20] Hajiahmadi S, Alikhani F, Adibi A. Comparative study of corpus luteum ultrasonographic findings in normal and abnormal pregnancies of the first trimester in patients referred to the hospital. Ann Med Health Sci Res 2018; 8: 397–400.
[21] Ahmad RA, Sadek SM, Abdelghany AM. 3D power Doppler ultrasound characteristics of the corpus luteum and early pregnancy outcome. Middle East Fertility Society Journal 2015; 20: 280–283.
[22] Alcazar JL. Three-dimensional power Doppler-derived vascular indices: what are we measuring and how are we doing it? Ultrasound Obstet Gynecol 2008; 32: 485–487.
[23] Tamura H, Takasaki A, Taniguchi K, Matsuoka A, Shimamura K, Sugino N. Changes in blood-flow impedance of the human corpus luteum throughout the luteal phase and during early pregnancy. Fertil Steril 2008; 90: 2334–2339.
[24] Pareja Oda S, Urbanetz AA, Urbanetz LA, de Carvalho NS, Piazza MJ. [Echographic characteristics of the corpus luteum in early pregnancy: morphology and vascularization]. Rev Bras Ginecol Obstet 2010; 32: 549–555.
[25] Miyamoto A, Shirasuna K, Hayashi KG, Kamada D, Awashima C, Kaneko E, et al. A potential use of color ultrasound as a tool for reproductive management: new observations using color ultrasound scanning that were not possible with imaging only in black and while. J Reprod Dev 2006; 52: 153–160.
[26] Ammar T, Sidhu PS, Wilkins CJ. Male infertility: the role of imaging in diagnosis and management. Br J Radiol 2012; 85: S59–68. [27] Aflatoonian A, Mashayekhy M. Transvaginal ultrasonography in female infertility evaluation. Donald School Journal of Ultrasound in Obstetrics and Gynecology 2011; 5: 311–316.
[28] Seyhan A, Ata B, Son WY, Dahan MH, Tan SL. Comparison of complication rates and pain scores after transvaginal ultrasound-guided oocyte pickup procedures for in vitro maturation and in vitro fertilization cycles. Fertil Steril 2014; 101: 705–709.
[29] Ozdemir O, Sari ME, Kalkan D, Koc EM, Ozdemir S, Atalay CR. Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic. Gynecol Endocrinol 2015; 31: 322–326.
[30] Sahu A, Tripathy P, Mohanty J, Nagy A. Doppler analysis of ovarian stromal blood flow changes after treatment with metformin versus ethinyl estradiolcyproterone acetate in women with polycystic ovarian syndrome: A randomized controlled trial. J Gynecol Obstet Hum Reprod 2019; 48: 335–339.
[31] Pascual MA, Graupera B, Hereter L, Tresserra F, Rodriguez I, Alcázar JL. Assessment of ovarian vascularization in the polycystic ovary by three-dimensional power Doppler ultrasonography. Gynecol Endocrinol 2008; 24: 631–636.
[32] Nardo LG, Gelbaya TA. Evidence-based approach for the use of ultrasound in the management of polycystic ovary syndrome. Minerva Ginecol 2008; 60: 83–89.
[33] Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, Norman RJ, et al. Definition and significance of polycystic ovarian morphology: a task force report from the androgen excess and polycystic ovary syndrome society. Hum Reprod Update 2014; 20: 334–352.
[34] Jayaprakasan K, Jayaprakasan R, Al-Hasie HA, Clewes JS, Campbell BK, Johnson IR, et al. Can quantitative three-dimensional power Doppler angiography be used to predict ovarian hyper stimulation syndrome? Ultrasound Obstet Gynecol 2009; 33: 583–591.
[35] Nastri CO, Teixeira DM, Moroni RM, Leitão VM, Martins WP. Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention. Ultrasound Obstet Gynecol 2015; 45: 377–393.
[36] Jayaprakasan K, Jayaprakasan R, Al-Hasie HA, Clewes JS, Campbell BK, Johnson IR, et al. Can quantitative three-dimensional power Doppler angiography be used to predict ovarian hyper stimulation syndrome? Ultrasound Obstet Gynecol 2009; 33: 583–591.
[37] Kwan I, Bhattacharya S, McNeil A, van Rumste MM. Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI). Cochrane Database Syst Rev 2008; 2: CD005289.