Lukasz T. Polanski

Assessing repeatability of 3D Doppler indices obtained by static 3D and STIC power Doppler: a combinedin-vivo/in-vitroflow phantom study: Static 3D and STIC power Doppler indices

To compare the variability in vascularization flow index (VFI) seen in serial acquisitions obtained using spatiotemporal image correlation (STIC) and using conventional static three‐dimensional (3D) power Doppler (PD), for both in‐vitro and in‐vivo models, and to evaluate whether the curves formed by VFI values obtained from successive ‘frames’ in a STIC dataset are consistent and resemble the waveforms obtained by spectral Doppler analysis.

Time‐lapse embryo imaging for improving reproductive outcomes: systematic review and meta‐analysis

To identify, appraise and summarize the available evidence regarding the effectiveness and safety of time‐lapse embryo monitoring on the main outcomes of assisted reproductive techniques.

Do dopamine agonists prevent or reduce the severity of ovarian hyperstimulation syndrome in women undergoing assisted reproduction? A systematic review and meta-analysis

Abstract Controlled ovarian stimulation is an integral part of assisted reproduction treatment. This can result in ovarian hyperstimulation syndrome (OHSS), which is associated with significant morbidity and potentially mortality. Recent approaches to ovarian stimulation have led to a reduction in the prevalence of OHSS but it still occurs. Dopamine agonists (DAs) have been used with some success during the ovarian stimulation phase when there are early signs of OHSS but there is no consensus on when to start and stop treatment or on the dose and specific agonist to use. EMBRASE, MEDLINE and Cochrane were searched using the following terms: ovarian hyperstimulation syndrome, controlled ovarian hyperstimulation, DAs, cabergoline, quinagolide, bromocriptide, pergolide, talipexole, ropinirole and pranipexole. The search yielded 20 publications. In total 1646 woman were included and 914 received a DA. In the treated group 86 (9.41%) developed OHSS, compared with 157 (21.45%) in the non-treated group. Nine studies were suitable for meta-analysis. This showed a benefit to the use of DAs (RR 0.51 [0.33, 0.78], Chi2 = 16.07). The use of DAs appears to be effective for the prevention of OHSS. DAs are useful but less effective for the treatment of OHSS. No conclusions can be made regarding the most effective drug, the optimal dose or the most appropriate drug regimen.

Influence of Gain Adjustment on 3-Dimensional Power Doppler Indices and on Spatiotemporal Image Correlation Volumetric Pulsatility Indices Using a Flow Phantom

Spatiotemporal image correlation can be used to acquire 3‐dimensional power Doppler information across a single cardiac cycle. Assessment and comparison of the systolic and diastolic components of the data sets allow measurement of the recently introduced “volumetric pulsatility index” (vPI) through algorithms comparable with those used in 2‐dimensional Doppler waveform analysis. The vPI could potentially overcome the dependency on certain machine settings, such as power, color gain, pulse repetition frequency, and attenuation, since these factors would affect the power Doppler signal equally throughout the cardiac cycle. The objective of this study was to compare the effect of color gain on the vascularization index (VI), vascularization‐flow index (VFI), and vPI using an in vitro flow phantom model. We separated gains into 3 bands: −8 to −1 (no noise), −1 to +5 (low noise), and +5 to +8 (obvious noise). The vPI was determined from the 3‐dimensional VI or VFI using the formula vPI = (maximum − minimum)/mean. Using no‐noise gains, we observed that although the VI and VFI increased linearly with gain, the vPI was substantially less dependent on this adjustment. The VI and VFI continued to increase linearly with gain, whereas the vPI decreased slightly using low‐noise gains. When gain was increased above the lower limit of obvious noise (+5), the VI and VFI increased noticeably, and there were marked reductions in both vPI values. We conclude that the vPI is less affected by changes in color gain than the VI and VFI at no‐noise gains.

4-D Assessment of Endometrial Vascularity Using Spatiotemporal Image Correlation: A Study Comparing Spherical Sampling and Whole-Tissue Analysis

Our aim in the study described here was to assess the feasibility of spatiotemporal image correlation power Doppler quantification of the endometrium with two techniques: spherical samples and whole tissue. We scanned 51 women in the midluteal phase of the menstrual cycle: STIC assessment of the whole endometrium was not possible in 10% of cases, whereas spherical analysis was possible in all. The time taken for data set analysis was much longer for the whole endometrium compared with spherical analysis (1478.9 ± 291 s vs. 266.8 ± 39.3 s, p < 0.05). Intra-class correlation coefficients for the vascularization flow index (VFI) were similar for both methods. Volumetric vascularity indices were higher when spherical sampling was conducted. Significant cycle-to-cycle variability in the vascularity indices was present, with coefficients of variation exceeding 20% for both techniques. We found that STIC power Doppler quantification of the whole endometrium is possible in the majority of cases, however, it is time consuming and limited by significant cycle-to-cycle variability.

Endometrial scratching for women with repeated implantation failure

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Outcome of assisted reproduction in women with congenital uterine anomalies: a prospective observational study

To assess the prevalence of congenital uterine anomalies, including arcuate uterus, and their effect on reproductive outcome in subfertile women undergoing assisted reproduction.

Reproductive outcome of women with congenital uterine anomalies after assisted reproduction: A prospective observational study

To assess the prevalence of congenital uterine anomalies, including arcuate uterus, and their effect on reproductive outcome in subfertile women undergoing assisted reproduction.

Endometrial spatio-temporal image correlation (STIC) and prediction of outcome following assisted reproductive treatment

OBJECTIVE The aim of this study was to correlate manual and spherical endometrial spatio-temporal image correlation (STIC) vascularity indices with assisted reproductive treatment (ART) outcomes. STUDY DESIGN STIC ultrasound assessments of the endometrium were carried out at three time-points in 127 women in a prospective observational study. RESULTS Biochemical pregnancy rate was 69% (88/127), with a biochemical and clinical pregnancy loss of 17%. Endometrial STIC vascularity indices in the assessed time-points did not differ between subjects who achieved a clinical pregnancy and those who did not (P>0.05). For first trimester miscarriage, minimal manual vascularization index (VI) at oocyte collection (cut-off value ≥0.7; sensitivity 80.0% and specificity 68.1%) demonstrated the highest area under the curve (AUC) of 0.8. CONCLUSION In summary, STIC modality is not a useful tool to predict ART outcome, however manual STIC analysis of endometrial vascularity seems to be more accurate in predicting first trimester pregnancy loss.

Outcome of assisted reproduction in women with congenital uterine anomalies: a prospective observational study: Reproductive outcome in women with congenital uterine anomaly

To assess the prevalence of congenital uterine anomalies, including arcuate uterus, and their effect on reproductive outcome in subfertile women undergoing assisted reproduction.