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The prognostic value of perifollicular blood flow in the outcome after assisted reproduction: a systematic review
Results: A total of 14 articles were included in the current review. The results are very heterogeneous, though there is evidence that measuring PFBF could be a good prognostic marker for oocyte and embryo quality, but even more for pregnancy rate after IVF/ICSI. This finding is not observed in studies concerning IUI.
www.ncbi.nlm.nih.gov/pmc/articles/PMC5819322/
219. Can perifollicular blood flow [PFBF] influence embryo quality and pregnancy? [Forum/Discussion]
from: Administrator (office@fertaid.com), Australia on 1/04/2018 9:24:54 AM Profession:
Comment: A review of a limited number of papers on perifollicular blood flow argue that it is associated with better embryo quality and pregnancy.
Submission: The authors have reviewed several aged papers on PFBF based upon small in-house studies, nad found that while follicular blood flow was not associated with oocyte numbers and quality it was associated with improved embryo quality and with pregnancy.// Measuring PFBF is not easy and there have been no reports of it being used dynamically during egg collection because of the difficult logistically issues of using the colour Doppler while trying to aspirate follicles. It is a shame that this area of study has been neglected since vascularisation of follicles is thought to be a key component of early follicle growth and development. One may ask how follicles could continue to grow if they are not vascularised since how else can they gain access to FSH and effect negative feedback if estrogen cannot be adsorbed into the peripheral blood system.// Yet in the age of hyperstimulation, FSH is in such high concentrations that it appears that even in the poorly vascularised region of the ovarian cortex, FSH is available to all follicles regardless of whether they have been able to develop a perifollicular blood flow. As a result, many follicles are induced to grow without a PFBF leading to hypoxic follicles. It is the hypoxic environment that is thought to lead to diminished embryo quality and reduced implantation. It appears that in some cases, women may proceed to egg collection with no or few healthy follicles and little chance of pregnancy.// It seems an opportunity for enterprising clinics may exist to offer enhanced follicle scanning services to include follicle Doppler studies leading to better prognostic advice prior to collection.//
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