Abstract
Purpose: The purpose of this study is to determine if baseline antral follicle assessment may serve as additional information in predicting in vitro fertilization outcome.
Methods: Prospective, descriptive preliminary study of in vitro fertilization outcome. From July 1998 to July 1999, 224 patients underwent antral follicle assessment (follicle 2–6 mm in diameter) on baseline of the planned, stimulated in vitro fertilization cycle. The outcomes were analyzed with respect to antral follicle assessment (≤6 or >6), basal cycle day 3 follicle stimulated harmone (≤10 or >10 IU/L) and maternal age (≤35 or >35 years).
Results: The clinical pregnancy rate was significantly higher in the group with baseline antral follicle >6 compared to that in the group with antral follicle ≥6 (51% vs. 19%, respectively). Controlling for patient age, and basal follicle stimulated harmone, the pregnancy rate was significantly higher in the group with antral follicle >6 compared to that in the group with antral follicle ≤6. The cancellation rate was significantly increased with advancing maternal age, elevated basal follicle stimulated harmone levels, and baseline antral follicle ≤6. The cancellation rate was significantly higher in the group with antral follicle ≤6 compared to that in the group with antral follicle ≥6 (33% vs. 1%, respectively).
Conclusions: In vitro fertilization outcome is strongly correlated with both maternal ages, basal cycle, day 3 follicle, stimulated harmone, and antral follicle assessment. Antral follicle assessment was a better predictor of in vitro fertilization outcome than were age or follicle stimulated harmone. Antral follicle assessment may provide a marker for ovarian age that is distinct from chronological age or hormonal markers.
Keywords: antral follicle, IVF outcome, pregnancy rate, cancellation rate
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REFERENCES
- 1.Pellicer A, Lightman A, Diamond MP, et al. Outcome of in vitro fertilization in women with low response to ovarian stimulation. Fertil Steril. 1987;47:812–815. doi: 10.1016/s0015-0282(16)59170-5. [DOI] [PubMed] [Google Scholar]
- 2.Scott RT, Toner JP, Muasher SJ, Oehninger SC, Robinson S, Rosenwaks Z. Follicle stimulating hormone levels on cycle day 3 are predictive of in vitro fertilization outcome. Fertil Steril. 1989;51:651–654. doi: 10.1016/s0015-0282(16)60615-5. [DOI] [PubMed] [Google Scholar]
- 3.Muasher SJ, Oehninger S, Simonetti S, Matta J, Ellis LM, Liu HC, Jones GS, Rosenwaks Z. The level of basal and/or stimulated serum gonadotropin levels in prediction of stimulation response and in vitro fertilization outcome. Fertil Steril. 1988;50:298–307. doi: 10.1016/s0015-0282(16)60077-8. [DOI] [PubMed] [Google Scholar]
- 4.Toner JP, Philput CB, Jones GS, et al. Basal follicle-stimulating hormone level is a better predictor of in vitro fertilization performance than age. Fertil Steril. 1991;55:784–791. doi: 10.1016/s0015-0282(16)54249-6. [DOI] [PubMed] [Google Scholar]
- 5.Nahum RT, Shifren JL, ChangY-C, Leykin L, Isaacson K, Toth TL. Age, follicle-stimulating hormone and estradiol-which is a better predictor for ovarian response in IVF. Assist Reprod. 1999;9:176–180. [Google Scholar]
- 6.Scott RT, Hofmann GE. Prognostic assessment of ovarian reserve. Fertil Steril. 1995;63:1–11. [PubMed] [Google Scholar]
- 7.Andolf E, Jorgensen C, Svalenius E, Sunden B. Ultrasound measurment of the ovarian volume. Acta Obstet Gynecol Scand. 1987;66:387–389. doi: 10.3109/00016348709022039. [DOI] [PubMed] [Google Scholar]
- 8.Syrop CH, Willhoite A, Van Voorhis BJ. Ovarian Volume: A novel predictor for assisted reproduction. Fertil Steril. 1995;64:1167–1171. doi: 10.1016/s0015-0282(16)57979-5. [DOI] [PubMed] [Google Scholar]
- 9.Lass A, Skull J, McVeigh E, Margara R, Winston RM. Measurement of ovarian volume by transvaginal sonography before ovulation induction with human menopausal gonadotropin for in-vitro fertilization can predict poor response. Hum Reprod. 1997;12:294–297. doi: 10.1093/humrep/12.2.294. [DOI] [PubMed] [Google Scholar]
- 10.Sharara FI, McClanrock HD. The effect of aging on ovarian volume measurements in infertile women. Obstet Gynecol. 1999;94:57–60. doi: 10.1016/s0029-7844(99)00242-2. [DOI] [PubMed] [Google Scholar]
- 11.Reuss ML, Kline J, Santos R, levin B, Timor-Tritsch I. Age and the ovarian follicle pool assessed with transvaginal ultrasonography. Am J Obstet Gynecol. 1997;174:624–627. doi: 10.1016/s0002-9378(96)70439-8. [DOI] [PubMed] [Google Scholar]
- 12.Tomas C, Nuojua-Huttunen S, Martikainen H. Pretreatment transvaginal ultrasound examination predicts ovarian responsiveness to gonadotropins in in-vitro fertilization. Hum Reprod. 1997;12:220–223. doi: 10.1093/humrep/12.2.220. [DOI] [PubMed] [Google Scholar]
- 13.Chang M-Y, Chiang C-H, Hsieh T-T, Soong Y-K, Hsu K-H. Use of the antral follicle count to predict the outcome of assisted reproductive technologies. Fertil Steril. 1998;69:505–510. doi: 10.1016/s0015-0282(97)00557-8. [DOI] [PubMed] [Google Scholar]
- 14.Adashi EY, Rock JA, Rosenwaks Z: Reproductive Endocrinology, Surgery, and Technology, Chapter 10:The Ovarian Follicle. Lippincott-Raven Publishers, 1996
- 15.Jacobs SL, Metzger DA, Dodson WC, et al. Effect of age on response to human menopausal gonadotropin stimulation. J Clin Endocrinol Metab. 1990;71:1525–1530. doi: 10.1210/jcem-71-6-1525. [DOI] [PubMed] [Google Scholar]
- 16.Pellicer A, Ardiles G, Neuspiller F, Remohi J, Simon C, Bonilla-Musoles F. Evaluation of the ovarian reserve in young low responders with normal levels of follicle-stimulating hormone using three-dimensional ultrasonography. Fertil Steril. 1998;70:671–675. doi: 10.1016/s0015-0282(98)00268-4. [DOI] [PubMed] [Google Scholar]
