Corpus luteum blood flow and pregnancy outcome

Transvaginal color Doppler has made possible to study ovarian perfusion in early pregnancy, thus advancing the understanding of the early human development. The follow up of the luteal blood flow might have a prognostic value in a group of patients with abnormal pregnancy. The aim of this work is to determine whether there is a relationship between Doppler characteristics of the corpus luteum and early pregnancy outcome or not. Two hundred and forty six spontaneous singleton primigravida in their early first trimester [between 6 and 8 week's gestation] were recruited. The corpus luteum site, size, morphological features and vascular pattern was recorded. Both ovaries were examined carefully by colour Doppler and colour flow was used as a guide for pulsed Doppler exploration. The Resistant index was calculated as a function of vascular resistance. The Pulsatility index was also calculated. The pregnancy was followed and fetal losses during the first and early second trimesters were recorded. The candidates were classified according to the fetal outcomes into 2 groups: Group 1: Survirors [204 cases]. Group II: Losses [42 cases]; including the first and early second trimester either spontaneously or missed. Then first trimester's Doppler characteristics of corpus luteum were compared for both survivors and losses. Survivors cases had significantly lower Doppler velocimetry indices for R.1 [0,45 +/- 0.07] compared to losses cases [0.71 +/- 0.06]. On the other hands, survivors cases had lower Doppler velocimetry indices for P.I [0.68 +/- 0.05] compared to losses cases [0.72 +/- 07] but with no significant differences. A high significant negative correlation was observed between the survivors and Doppler velocimetry RI for corpus luterum. The lower the R.I the higher the incidence for fetal survival. However, no significant correlation was found between the survivors and Doppler velocimetry P.I of corpus luteum. A significant positive correlation was observed between the survivors and corpus luteum size. The larger the corpus luteum the higher the incidence for fetal survival. The Doppler characteristics of the corpus luteum [resistant index] have a predictive value for early pregnancy outcome. Also morphological characteristics of the corpus luteum [specially its size] might have a value in predicting early pregnancy outcome. Also, the follow up of the luteal blood flow might have a prognostic value in a group of patients with threatened abortion

Influence of day of embryo transfer on the outcome of ICSI cycle

Since the birth of Louise Brown, implatation rate per embryo is the most important limiting factor in successful ICSI cycle. Blastocyst is claimed to be logic solution for this problem by its high implantation rate. Randomized prospective clinical study. To study benefits and pitfalls of blastocyst transfer. Patients and One hundred and seventeen candidates were divided into 2 groups. Group I [n=58] in whom at least 4 grade I embryos were transferred on day 3. Group II [n=57] in whom two to three blastocyst were transferred. Clinical pregnancy rate per cycle was 27.6% in day 3 group compared to 31.6% in blastocyst group while multiple pregnancy rate was 43.4% and 33.3% respectively. Blastocyst transfer is a reasonable solution for the problem of multiple pregnancy but it is not associated with significant increase in the pregnancy rate