Follicular Blood Flow and Follicular Fluid Concentrations of Vascular Endothelial Growth Factor and Nitric Oxide as Prognostic Factors of IVF Outcome

Oh, Dae Sik; Shin, Byoung Sub; Kim, Ki Hyung; Joo, Boo Sun; Lee, Kyu Sup

Abstract

OBJECTIVE
The aim of this study was 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.
METHODS
In our prospective study, forty-seven cycles who underwent in vitro fertilization with tubal factor (25 cycles) and male factor (22 cycles) at the infertility clinic of Pusan National University Hospital from Feb. 2002 to June 2002 were assessed. Follicular blood flow was estimated on the day of hCG administration. Each follicular fluid was collected at the oocyte retrieval and follicular fluid VEGF and NO concentrations were assessed. According to the age of patients, the cause of infertility, and pregnancy rate, follicular blood flow and follicular fluid VEGF and NO concentrations were measured.
RESULTS
Of 47 cycles, 18 cycles were pregnant (38.3%). Follicular blood flow was significant higher in the pregnant group compared to the nonpregnant group (p<.05), but there was no statistical significantly difference in the age and infertility cause. Follicular fluid concentrations of VEGF and NO were not statistically different in age, infertility cause, and pregnancy outcome. As follicle size increases, the follicular blood flow and follicular fluid VEGF concentrations increased significantly, but follicular fluid NO concentrations decreased. There was no correlation between VEGF and NO concentrations in follicular fluid by linear regression analysis.
CONCLUSION
Our present study showed that follicular blood flow was positively associated with outcome of pregnancy as well as size of follicles, follicular fluid VEGF, but NO had no correlation with patient's age and pregnancy outcome. These results suggest that follicular blood flow might be a more effective prognostic marker of the pregnancy outcome of in vitro fertilization rather than follicular fluid VEGF and NO concentrations.