Basal antral follicle number and mean ovarian diameter predict cycle cancellation and ovarian responsiveness in assisted reproductive technology cycles.
OBJECTIVE
To determine the predictive value and define threshold levels for basal antral follicle number and mean ovarian diameter in patients undergoing ART cycles.


METHODS
Retrospective.


METHODS
Tertiary care center.


METHODS
Two hundred seventy-eight patients who had ovarian measurements performed on cycle day 3 before beginning treatment with gonadotropins.


METHODS
Pretreatment ovarian ultrasound measurements.


METHODS
Number of oocytes retrieved, hormone levels, and cycle outcomes.


RESULTS
A direct linear correlation was observed between mean ovarian diameter and basal follicle number. Both measures demonstrated a positive linear correlation with recovered oocytes, basal E(2), and peak E(2). Both demonstrated a negative linear correlation with ampules of gonadotropins administered, days of stimulation, patient age, cycle day 3 FSH, and FSH:LH ratio. An antral follicle count of </=10 or a mean ovarian diameter of <20 mm was associated with an increased risk of cycle cancellation.


CONCLUSIONS
Ovarian diameter and basal antral follicle number identify patients who may respond poorly to ART stimulation. These ovarian measures correlate well with ART screening and stimulation parameters. This knowledge allows physicians to evaluate and counsel patients immediately before an ART stimulation and to optimize stimulation protocols.
Frattarelli
J L
JL
Combined Federal Program for Reproductive Endocrinology at Walter Red Army Medical Center, National Naval Medical Center, Uniformed Services University for the Health Sciences, Bethesda, Maryland, USA. jfratt@yahoo.com
Lauria-Costab
D F
DF
Miller
B T
BT
Bergh
P A
PA
Scott
R T
RT
D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D017063:Outcome Assessment, Health Care; D006080:Ovarian Follicle / Q000502:physiology*; D010053:Ovary / Q000502:physiology*; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone