A prospective assessment of the predictive value of basal antral follicles in in vitro fertilization cycles.
OBJECTIVE
To determine the predictive value and define threshold values for basal antral follicle count in patients undergoing IVF.


METHODS
Prospective cohort analysis. Tertiary care center. Two hundred eighty-nine patients. Transvaginal ultrasonography before starting gonadotropin administration.


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


RESULTS
Pregnant patients had significantly more antral follicles (13.8 +/- 7.5 vs. 12.4 +/- 10.0). Patients in whom cycles were canceled had significantly fewer antral follicles (7.6 +/- 4.8 vs. 13.7 +/- 8.8). Antral follicle count significantly correlated with most prestimulation and poststimulation IVF variables. Threshold analysis demonstrated a lower pregnancy rate (23.5% vs. 57.6%) and a higher cancellation rate (41% vs. 6.4%) associated with having four or fewer antral follicles.


CONCLUSIONS
The basal antral follicle count identified patients who responded poorly to IVF stimulation. Having four or fewer antral follicles was associated with a high cancellation rate (41%) and, in patients without a cancelled cycle, a low pregnancy rate (23%). However, no antral follicle count absolutely predicted pregnancy or cycle cancellation.
Frattarelli
John L
JL
Tripler Army Medical Center, Honolulu, Hawaii 96859-5000, USA. john.fratarelli@amedd.army.mil
Levi
Andrew J
AJ
Miller
Bradley T
BT
Segars
James H
JH
D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D017211:Treatment Failure; D014463:Ultrasonography