Follicular blood flow is a better predictor of the outcome of in vitro fertilization–embryo transfer than follicular fluid vascular endothelial growth factor and nitric oxide concentrations

Kim, Ki Hyung; Oh, Dae Sik; Jeong, Jae Heok; Shin, Byung Sub; Joo, Bo Sun; Lee, Kyu Sup

doi:10.1016/j.fertnstert.2004.02.120

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Volume 82, Issue 3 , Pages 586-592, September 2004

Follicular blood flow is a better predictor of the outcome of in vitro fertilization–embryo transfer than follicular fluid vascular endothelial growth factor and nitric oxide concentrations

Presented in part as a poster (P-346) at the 19th Annual Meeting of the European Society of Human Reproduction and Embryology, Madrid, Spain, June 29–July 2, 2003.

Ki Hyung Kim, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Pusan National University, Busan, Korea
Dae Sik Oh, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Pochon CHA University, Women CHA Hospital, Daegu, Korea
Jae Heok Jeong, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Pusan National University, Busan, Korea
Byung Sub Shin, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Pusan National University, Busan, Korea
Bo Sun Joo, Ph.D.
- Center for Reproductive Medicine and Infertility, Moonhwa Hospital, Busan, Korea
Kyu Sup Lee, M.D.
- Department of Obstetrics and Gynecology, College of Medicine, Pusan National University, Busan, Korea
- Reprint requests: Kyu Sup Lee, M.D., Department of Obstetrics and Gynecology, College of Medicine, Pusan National University, 1-10 Amidong, Seoku, Busan 602-739, Korea (FAX: 82-51-248-2384)

Received 23 September 2003; received in revised form 9 February 2004; accepted 9 February 2004.

Objective

To investigate the relationship between follicular blood flow and the follicular fluid vascular endothelial growth factor (VEGF) and nitric oxide (NO) concentrations and to determine which factor might be a better predictor of the outcome of IVF-ET.

Design

Prospective study.

Setting

Academic research laboratory.

Patient(s)

Forty-seven cycles of IVF (tubal factor, 25 cycles; male factor, 22 cycles) at the infertility clinic of Pusan National University Hospital from February 2002 to June 2002.

Intervention(s)

Follicular blood flow was estimated on the day of hCG administration. Each follicular fluid sample was collected at oocyte retrieval, and follicular fluid VEGF and NO concentrations were assessed.

Main outcome measure(s)

Follicular blood flow and follicular fluid VEGF and NO concentrations according to the age of patients, the cause of infertility, and pregnancy rate.

Result(s)

Of 47 cycles, 18 (38.3%) cycles resulted in a pregnancy. Follicular blood flow was significantly higher in the pregnant group compared with the nonpregnant group, but there was no statistically significant difference in age and infertility cause. Follicular fluid concentrations of VEGF and NO did not show statistically significant differences in age, infertility cause, or pregnancy outcome. As the follicle size increases, the follicular blood flow and follicular fluid VEGF concentrations increased significantly but the follicular fluid NO concentrations decreased. There was no correlation between VEGF and NO concentrations in the follicular fluid by linear regression analysis.

Conclusion(s)

Our study showed that follicular blood flow was positively associated with the outcome of pregnancy. This is the first study to investigate the direct association of the follicular blood flow with pregnancy outcome after IVF-ET. These results suggest that follicular blood flow might be a more effective prognostic marker of the pregnancy outcome of IVF than follicular fluid VEGF or NO concentrations.

Key words: Follicular blood flow , VEGF , NO , pregnancy outcome