The Role of 3D Ultrasound in Assessment of Endometrial Receptivity and Follicular Vascularity to Predict the Quality Oocyte

The success of human and embryo implantation depends on maternal and embryonic factors and their interactions. To asses uterine receptivity one must take various factors into account. Current advances in transvaginal 3D ultrasonography have allowed us to examine in detail and visualize pelvic organ structures to analyse their volumes with great accuracy (Alcazar et al., 2006 ),(Raga et al., 1999 ). It is reasonable to believe that an analysis of power Doppler signals in a volume better reflects the overall vascularization in an organ than analysis of a two-dimensional (2D) ultrasound image or measurement of blood flow velocity in a single or a few vessels. Using 3D Power Doppler Angiography we can assess both arterial and venous circulation also the whole architecture of the vascular net into a volumetric image with the posibility of an overall evaluation of blood flows , and computer analysis makes this assessment objective (Jokubkiene et al., 2006). The VOCAL (Virtual Organ Computer – aided Analysis) and volume calculation is semi-authomatic type of calculating volumes starting from the rotation of the organ target of study. Allows to calculate partial volumes and at the same time the of vascular system and flows into the region of interest. Two dimensional Doppler sonography provides a subjective estimation of uterine and ovarian vascularity. Is it limited, however, by providing flow depiction in a single plane as opposed to the sample volume as obtained by free dimensional imaging. Therefore, three dimensional ultrasound and power Doppler angiography (3D US-PDA) have advantage of assessing simultaneously both the endometrial blood flow and endometrial volume (EV) (Merce et al., 2008 ) and improves better traditional ultrasound scanning imaging with the posibility of storing information for further analysis or share datasets through telemedicine. The follicular blood flow seems to play a major role during the growth and development of the follicle containing the oocyte (Chui et al. ,1997 ),(Coulam et al.,1999). The surge in perifolicullar angiogenesis during selection of dominant follicles and following the LH surge or HCG can be detected by measurment of perifolicular flow/velocities. This allows identification of those follicles likely to produce high quality eggs and embryos. 3D surface