This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mercé, L. T. Articles by Bajo, J. M. Search for Related Content PubMed PubMed Citation Articles by Mercé, L. T. Articles by Bajo, J. M.

Intraobserver and Interobserver Reproducibility of Ovarian Volume, Antral Follicle Count, and Vascularity Indices Obtained With Transvaginal 3-Dimensional Ultrasonography, Power Doppler Angiography, and the Virtual Organ Computer-Aided Analysis Imaging Program

International Ruber Hospital (L.T.M., S.B.) and University Hospital "Santa Cristina" (B.G., V.E., J.M.B.), Madrid, Spain.

Address correspondence to Luis T. Mercé, MD, Enrique Leyra 17, 28029 Madrid, Spain. e-mail: ltmerce{at}meditex.es

Objectives. The purpose of this study was to assess intraobserver and interobserver reproducibility of the parameters of ovarian response and oocyte ability, studied by 3-dimensional ultrasonography and power Doppler angiography (PDA), and the possible influence of the ovarian functional stage. Methods. Twenty-nine women were included in an in vitro fertilization program. Fourteen women were evaluated after pituitary suppression (basal group), and 15 were scanned on the human chorionic gonadotropin administration day, after gonadotropin ovarian stimulation (stimulated group). A first observer acquired 2 volumes for each ovary. Another observer performed a second analysis of the volumes acquired by the first observer. We analyzed ovarian volume, follicle number in the basal group, vascularization index, flow index, and vascularization-flow index. The volumes were processed by the Virtual Organ Computer-Aided Analysis imaging program using plane A and 15° rotational steps. Results. Ovarian volume showed excellent intraobserver and interobserver agreement, with an intraclass correlation coefficient (Intra-CC) and an interclass correlation coefficient (Inter-CC) close to the unit. The Intra-CC and Inter-CC about the number of follicles were 0.964 and 0.978, respectively. Vascularity indices showed an Intra-CC greater than 0.90. The vascularization index and the vascularization-flow index showed higher interobserver than intraobserver reproducibility (Inter-CC > 0.96 for both). The flow index Inter-CC was 0.898. The reproducibility differences between the basal and stimulated ovary measurements were not significant. Conclusions. There is an excellent intraobserver and interobserver reproducibility of the ovarian volume, follicle counts, and 3-dimensional PDA indices. The ovarian functional stage has no influence on the reliability. Three-dimensional ultrasonography and PDA improve the study of ovarian parameters, and their reliability impels a change in the current clinical routine of performing and interpreting ultrasonography.

Key Words: ovary • reproducibility • 3-dimensional power Doppler angiography • 3-dimensional ultrasonography • vascularity indices • Virtual Organ Computer-Aided Analysis

Abbreviations: CI, confidence interval • FI, flow index • FSH, follicle-stimulating hormone • GnRH, gonadotropin-releasing hormone • Inter-CC, interclass correlation coefficient • Intra-CC, intraclass correlation coefficient • PDA, power Doppler angiography • 3D, 3-dimensional • VFI, vascularization-flow index • VI, vascularization index • VOCAL, Virtual Organ Computer-Aided Analysis

This article has been cited by other articles:

				D. H. M. Lozano, N. Frydman, J. M. Levaillant, S. Fay, R. Frydman, and R. Fanchin The 3D vascular status of the follicle after HCG administration is qualitatively rather than quantitatively associated with its reproductive competence Hum. Reprod., April 1, 2007; 22(4): 1095 - 1099. [Abstract] [Full Text] [PDF]

				L. T. Merce, S. Bau, M. J. Barco, J. Troyano, R. Gay, F. Sotos, and A. Villa Assessment of the ovarian volume, number and volume of follicles and ovarian vascularity by three-dimensional ultrasonography and power Doppler angiography on the HCG day to predict the outcome in IVF/ICSI cycles Hum. Reprod., May 1, 2006; 21(5): 1218 - 1226. [Abstract] [Full Text] [PDF]