Follicular Monitoring

ABSTRACT Assessment of the follicular maturity and endometrial receptivity and the time of hCG is one of the key factors for success of all ART procedures. Maturation of the follicle and the endometrium, ovulation and leutinization is a process of multiple biochemical, morphological and vascular changes. The vascular changes are reflection of the biochemical changes and can be studied by color Doppler. 3D ultrasound gives a better assessment of the follicular and endometrial size, that is the anatomical maturity, than 2D ultrasound and 3D power Doppler gives not only qualitative but also quantitative idea of global vascularity, that is the reflection of functional/physiological maturity. Follicular vascularity distribution and flow indices can be better parameters of follicular quality and can be more reliable parameters to decide the time of hCG and IUI. Endometrial assessment can be more meaningful if its morphology is studied more in detail along with abundance of its vascularity as well as flow indices. Thus, deciding correct time of hCG can improve conception rates in ART cycles. How to cite this article Panchal S, Nagori CB. Follicular Monitoring. Donald School J Ultrasound Obstet Gynecol 2012; 6(3):300-312.

Engineering as a Tool in Assisted Reproduction: An Investigation Using Mathematical Modelling of Oxygen Transport in the Ovarian Follicle

The key objective of any Assisted Reproductive Technology (ART) is to provide infertile couples with the maximal chance of producing healthy offspring and there is a large body of research within this field directed toward this objective. However, despite this volume of research attention, the success rates of many procedures such as In-Vitro fertilization (IVF) have improved little since their inception. Engineering principles have not been widely applied to ART and, as a result, it appears that there is great potential for engineering to make a contribution to this field. The objectives of this work were to demonstrate the usefulness of engineering principles in this field via the example of modelling oxygen transport in the preovulatory human ovarian follicle. The results show mathematical relationships between follicular fluid dissolved oxygen levels, follicular vascularity and the developmental potential of the oocyte can be described. These relationships are shown to be consistent with findings reported in the literature. Significant results include the emergence of cut off levels of both follicular vascularity and follicle size below which all eggs will be starved of oxygen. Based on current model parameters these cut off levels are predicted to range from 22–40% and 3.5–4.3 ml (19.0–20.3 mm follicle diameter) for follicle vascularity and volume respectively. These results serve to highlight the potential contribution of engineering in general to ART. The implications of these findings are also discussed as are future improvements for modelling mass transport in the ovarian follicle.