Relationship of baseline ovarian volume to ovarian response in World Health Organization II anovulatory patients who underwent ovulation induction with gonadotropins.
OBJECTIVE
To assess whether ovarian volume of World Health Organization II anovulatory patients in the early follicular phase predicts the response to ovulation induction with gonadotropins.


METHODS
Retrospective data analysis of two prospective, randomized, multicenter studies.


METHODS
Clinical development unit of biotechnology company.


METHODS
Four hundred sixty-five World Health Organization II anovulatory patients undergoing ovulation induction.


METHODS
Ovarian response to stimulation, ovulation (mid-luteal serum progesterone > 30 nmol/L), cancellation rate, pregnancy rate, and incidence of the ovarian hyperstimulation syndrome (OHSS) according to baseline ovarian volume (day 2-5) before stimulation.


RESULTS
Mean ovarian volume was 11.55 +/- 6.0 cm(3) (range, 0.8-49.3 cm(3)). Small ovarian volume was associated with lower rates of cycle cancellation owing to risk for OHSS (3 vs. 29 patients [2.8% vs. 9%]). Patients with small ovarian volume (<7.25 cm(3)) required fewer ampules of FSH (1373 IU vs. 1629 IU) and shorter duration of stimulation (16 vs. 18.1 days) and had higher ovulation rate than did patients with mid-range and larger ovarian volume (84.3% vs. 69.1% and 68.8%, respectively). The clinical pregnancy rate per cycle of hCG administration was similar in the three groups (25.8%, 28.1%, and 27.5%).


CONCLUSIONS
World Health Organization II anovulatory women with medium-sized or large ovaries who are undergoing low-dose gonadotropin stimulation for ovulation induction may have higher risk for OHSS than do women with small ovaries. Women with small ovaries who meet criteria for administration of hCG respond better to ovulation induction and have a similar likelihood of conceiving compared with women with larger ovaries.
Serono International S.A., Geneva, Switzerland. amir.lass@serono.com
Amir
A
Lass
Anatole
A
Vassiliev
Genevieve
G
Decosterd
David
D
Warne
Ernest
E
Loumaye
D000328:Adult; D000858:Anovulation / Q000503:physiopathology*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D043373:Follicle Stimulating Hormone, Human; D005498:Follicular Phase; D006801:Humans; D008596:Menotropins / Q000627:therapeutic use; D016471:Ovarian Hyperstimulation Syndrome / Q000503:physiopathology; D010053:Ovary / Q000503:physiopathology*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone