A prospective analysis of the changes in ovarian morphology during hormonal pituitary suppression before in vitro fertilization.
OBJECTIVE
To assess the change in ovarian morphology at three specific times integral to an IVF cycle, and to evaluate the factors associated with a change in ovarian morphology after pituitary desensitization.


METHODS
Prospective cohort analysis.


METHODS
Academic IVF center.


METHODS
Infertile patients undergoing 85 IVF cycles.


METHODS
Eighty-five patients had a transvaginal ultrasound to assess ovarian morphology on unstimulated menstrual day 3, 21 days after starting oral contraceptives (OCs), and 14 days after starting GnRH agonist (GnRH-a).


METHODS
Ovarian morphology.


RESULTS
Compared with the basal total ovarian volume, ovarian volume was significantly decreased after 21 days of OCs and after 14 days of GnRH-a. A significant decrease was noted in the total number of antral follicles from the basal state to after 21 days of OCs and after 14 days of GnRH-a treatment. There was no significant effect on pregnancy outcome rates. Univariate analysis showed a significant correlation between ovarian morphology and IVF stimulation parameters.


CONCLUSIONS
Hormonal suppression significantly alters ovarian morphology. If the use of ovarian morphology is to be used to counsel patients and predict IVF success as suggested by some studies, it should be standardized for the day the ovarian morphology is evaluated.
Frattarelli
John L
JL
Tripler Army Medical Center, Honolulu, Hawaii, USA. jfrattarelli@rmanj.com
D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000494:pharmacology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects; D009929:Organ Size; D010053:Ovary / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000187:drug effects; D010902:Pituitary Gland / Q000187:drug effects*; D011247:Pregnancy; D011446:Prospective Studies; D014463:Ultrasonography
D003278:Contraceptives, Oral, Hormonal