Combining cycle day 7 follicle count with the basal antral follicle count improves the prediction of ovarian response.
OBJECTIVE
To analyze the predictive value of cycle day 7 follicle count (CD7-FC) for poor ovarian response during IVF in women down-regulated with a luteal start of GnRH analogue (long protocol).


METHODS
A retrospective analysis.


METHODS
University hospital.


METHODS
Ninety-one consecutive IVF cycles of 82 subjects.


METHODS
Basal levels of FSH and E2 were determined in the spontaneous cycle before the IVF cycle. During the IVF cycle, the number of basal and CD7 follicles and CD7 endometrial thickness were determined by ultrasound, and CD7 serum E2 levels were measured.


METHODS
Ovarian response determined according to the number of mature oocytes retrieved.


RESULTS
On receiver operating characteristic analysis, CD7-FC had the highest combination of sensitivity and specificity to detect women with poor ovarian response when compared with the basal ovarian reserve tests. When a combined basal antral FC and CD7-FC evaluation was used with the optimum cutoff values of 6.5 and 7.5, respectively, sensitivity and specificity improved to 85% and 90%, respectively.


CONCLUSIONS
Cycle day 7 follicle count during a long IVF protocol is helpful in predicting ovarian response in combination with the antral FC. This combination has high positive and negative predictive values. This may help clinicians and women to cancel cycles earlier and decrease the psychological, financial, and medical burden of a later cancellation.
Durmusoglu
Fatih
F
Center for ART, Department of Obstetrics and Gynecology, Marmara University School of Medicine, Istanbul, Turkey. fatihdurmusoglu@superonline.com
Elter
Koray
K
Yoruk
Pinar
P
Erenus
Mithat
M
D000328:Adult; D019540:Area Under Curve; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D008597:Menstrual Cycle; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D010053:Ovary / Q000187:drug effects / Q000503:physiopathology*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D012372:ROC Curve; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography
D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone