Innovative Journal Journal of Medical Biomedical and Applied Sciences 2277:4939 10 05 Perifollicular Blood Flow in Controlled Ovarian Hyperstimulation 1 Sharad Prabhakar Rao ARC International Fertility Hospitals And Research Center, Cochin Branch, No 38, KNS Towers, 4010, Old NH 47, Mamangalam, Palarivattom, Kochi, Kerala Mahalaxmi Saravanan ARC International Fertility Hospitals And Research Center, Cochin Branch, No 38, KNS Towers, 4010, Old NH 47, Mamangalam, Palarivattom, Kochi, Kerala Nidhi Sharma Saveetha Medical College And University No.162, Poonamalle High Road, Velappanchavadi, Chennai, Tamil Nadu Priya Senthil ARC International Fertility Hospitals And Research Center, Cochin Branch, No 38, KNS Towers, 4010, Old NH 47, Mamangalam, Palarivattom, Kochi, Kerala Sargunadevi ARC International Fertility Hospitals And Research Center, Cochin Branch, No 38, KNS Towers, 4010, Old NH 47, Mamangalam, Palarivattom, Kochi, Kerala Neenu Sugesh ARC International Fertility Hospitals And Research Center, Cochin Branch, No 38, KNS Towers, 4010, Old NH 47, Mamangalam, Palarivattom, Kochi, Kerala Journal Article https://doi.org/10.15520/ijmhs.v10i03.282 Abstract Background: The aim of this study was to investigate the association of perifollicular blood flow with oocyte quality , metaphase 2 conversion and embryo quality after controlled ovarian hyperstimulation in antagonist cycles . Objective: The primary aim was to measure the perifollicular Doppler blood flow indices in graffian follicle and correlate it with number of mature oocytes retrieved in women undergoing intracytoplasmic sperm injection (ICSI) in controlled ovarian hyperstimulation with gonadotropins in antagonist cycles .The secondary aim was to assess the blastocysts obtained from these oocytes. Results: Antagonist protocol was used for controlled ovarian stimulation with sequential gonadotropin protocol . Peripheral Vascularity, pulsatility Index (PI) and resistive index (RI) of perifollicular perfusion were assessed on day 10 for 65 follicles. After oocyte retrieval the count of metaphase stage 2 oocytes, and day 5 embryos obtained were evaluated. RI and PI indices had a positive correlation with age (p value nonsignificant). Follicles with ≥18 mm diameter and >75% of circumferential perfusion (p value= 0.04, significant ), Follicle with > 75% circumferential vascularity with low PI and RI were associated with high number of metaphse 2 oocytes (p value significant). Follicles with >75% of vasculaity with low PI and RI were associated high number of Day 5 blastocyst (p value significant). Conclusion: In our study, the Doppler indices of perifollicular blood flow provided a reliable prediction of the number and quality of metaphase 2 oocytes and day 5 embryos. Hence perifollicular blood flow is a simple, non-invasive and economical marker to predict response to gonadotropins in controlled ovarian hyperstimulation. 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