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Objective: To investigate the effect of uterine adenomyosis diagnosed by transvaginal ultrasound on IVF/ICSI treatment outcome., Study Design: A retrospective cohort study of all women aged ≤ 42 years with infertility who underwent IVF/ICSI treatment at IVF Australia-East between January 2000 and June 2006. Patients were divided into two groups according to findings on a baseline pre-treatment transvaginal pelvic ultrasound: group A consisted of women with adenomyosis and group NA consisted of women without adenomyosis. The primary outcome measure was live birth rate per patient (cycle)., Results: A total of 201 patients (37 patients in Group A, 164 patients in group NA) undergoing a single stimulated cycle of IVF/ICSI were included in the data analysis. There was no difference in live birth rate per patient (cycle) between the two groups with both raw and logistic regression adjusted data (29.7%V 26.1%; p=0.395; OR 1.45 with 95% CI 0.61-3.43). There were no other differences in ovarian response, embryological parameters or clinical outcomes between the two groups., Conclusions: The presence of transvaginal ultrasound diagnosed adenomyosis did not adversely affect outcome in women undergoing IVF/ICSI treatment at our unit. However, the results are not conclusive and further large, well-designed prospective cohort studies are required in order to confirm our findings., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To examine the relationship between age and ovarian perifollicular blood flow (PFBF) in women undergoing IVF., Methods: Serial transvaginal power Doppler ultrasound (PDU) scans to assess ovarian PFBF were performed prospectively throughout the follicular phase of ovarian stimulation in women undergoing IVF. The ultrasound assessment days were categorized according to day of hCG trigger., Results: A total of 1050 ovarian follicles from 34 women undergoing one IVF treatment cycle were used for data analysis. The median age of the women was 38.5 years, ranging from 28 years to 44 years. There was a significant negative correlation between age and ovarian PFBF on the day of hCG trigger or trigger day minus 1, but not beforehand during the follicular phase., Conclusions: There was a significant negative correlation between age and ovarian PFBF in women undergoing IVF which was only observed very late in the follicular phase of ovarian stimulation.

Objective: To determine whether ovarian perifollicular blood flow (PFBF) in the early follicular phase (EFP) was associated with treatment outcome., Design: Retrospective longitudinal cohort study., Setting: Tertiary referral centre/university hospital., Patients: Thirty-four women underwent 37 IVF cycles, which resulted in 35 embryo transfers., Interventions: Serial transvaginal scans using power Doppler ultrasound during the follicular phase. Ovarian PFBF of follicles > or =5 mm was subjectively assessed using a modified grading system (grades 0-4)., Main Outcome Measures: Ovarian PFBF and pregnancy., Results: Treatment cycles were retrospectively divided into two groups: Group 1 (n=20) had cycles with at least one small (5-10 mm) or medium (11-14 mm) size follicle(s) of high grade (2-4) PFBF on cycle day 5 or 6 or 7; and Group 2 (n=17), had cycles that did not. Group 1 had a significantly higher proportion of high grade large follicles in the late follicular phase (35% vs. 21%) (OR 2.0; 95% CI 1.1-3.7) and higher clinical pregnancy rate (47% vs. 12%) (OR 6.3; CI 1.1-35.7) compared to Group 2., Conclusion: High grade ovarian PFBF in the EFP during IVF is associated with both high grade PFBF in the late follicular phase and a higher clinical pregnancy rate.

Objective: To evaluate whether ovarian perifollicular blood flow (PFBF) varies by ultrasound among women with polycystic and normal ovaries undergoing in vitro fertilization (IVF)., Design: Prospective observational cohort study of women undergoing IVF treatment., Setting: Department of reproductive medicine at a university teaching hospital., Patient(s): Thirty four women with regular spontaneous ovulatory menstrual cycles undergoing IVF divided into two groups according to findings on a baseline transvaginal ultrasound scan: group 1 consisted of 20 women with ultrasound-evident normal ovaries (USNO group), and group 2 consisted of 14 women with ultrasound-evident polycystic ovaries (USPCO group)., Intervention(s): Serial transvaginal power Doppler ultrasound assessments throughout the follicular phase of ovarian stimulation., Main Outcome Measure(s): Ovarian PFBF and ovarian stromal artery pulsatility index., Result(s): Women with USPCO had a significantly lower ovarian stromal artery pulsatility index at the time of the first ultrasound assessment before starting the FSH injections compared with USNO women. However, there was no difference in ovarian PFBF between women with USPCO and USNO during the follicular phase of ovarian stimulation for IVF., Conclusion(s): There is no difference in ovarian follicular vascularity between women with polycystic and normal ovaries during ovarian stimulation at IVF treatment.

Purpose: This longitudinal study aimed to compare ovarian perifollicular and endometrial blood flow (PFBF and EBF, respectively) during the follicular phase in pregnant and non-pregnant IVF cycles., Methods: Serial transvaginal scans were performed in 15 subjects undergoing IVF treatment. Both PFBF and EBF were subjectively graded (grades 0-4 for PFBF and grades 1-3 for EBF). After confirmation of clinical pregnancy, the treatment cycles were grouped into 'Pregnant' and 'Non-pregnant' cycles. Ovarian PFBF and EBF were retrospectively compared between the two groups., Results: In pregnant cycles, the proportion of large (> or = 15 mm) follicles with high (24) grade PFBF increased with time throughout the follicular phase, and the proportion of large follicles with poor (0-1) grade PFBF decreased. In non-pregnant cycles these trends were reversed. There was no difference in EBF between the two groups., Conclusion: The pattern of ovarian PFBF but not EBF may be predictive of treatment outcome.