Is it possible to predict a fertile cycle? Uteroovarian blood flow parameters in conception versus nonconception cycles

ObjectiveTo compare uterine and ovarian blood flow, measured by Doppler ultrasound, in the follicular phase of the menstrual cycle, in women who conceived to women who did not conceive during that cycle.DesignA prospective study of 192 women looking at markers of ovarian reserve between August 2000 and September 2002.SettingA fertility clinic.Patient(s)A cross-section of women attending for fertility advice and treatment.Intervention(s)Each woman was monitored during a natural cycle and then during a clomiphene challenge cycle (100 mg clomiphene given for 5 days from days 3–7 of the cycle). Doppler ultrasound scans were performed on days 3 and 12 of the natural cycle and day 11 of the clomiphene challenge cycle.Main Outcome Measure(s)Cycles in which women conceived were compared with those in which women did not conceive to see whether there were differences in uteroovarian blood flow parameters as measured by Doppler ultrasound scan in the follicular phase of the cycle.Result(s)In the 15 natural conception cycles there was an increased uterine artery peak systolic velocity at day 12 compared with 131 natural nonconception cycles (in which there was an opportunity to conceive). There were no differences in any uteroovarian blood flow parameters at day 3, and no differences in ovarian blood flow parameters (dominant follicle blood flow, dominant follicle pulsatility index), endometrial thickness or pulsatility at day 12. No differences were seen in any blood flow parameters in 10 clomiphene conception cycles compared with 116 clomiphene nonconception cycles.Conclusion(s)In the late follicular phase of natural conception cycles there is an increased uterine artery peak systolic velocity compared with nonconception cycles. This was not seen in clomiphene cycles in which conception occurred. There is very little in the literature comparing natural or clomiphene conception with nonconception cycles.