Establishing the intercycle variability of three-dimensional ultrasonographic predictors of ovarian reserve.
OBJECTIVE
To estimate the intercycle variability of antral follicle counts (AFCs) and ovarian volume, as measured by using three-dimensional ultrasound, and to compare these to the variation in basal FSH levels.


METHODS
Prospective study.


METHODS
University-based assisted conception unit.


METHODS
One hundred women undergoing two cycles of assisted reproductive technology.


METHODS
Transvaginal three-dimensional ultrasound assessment and venepuncture in the early follicular phase of the menstrual cycle, immediately before assisted reproductive technology.


METHODS
Intercycle variability of AFC, ovarian volume, and basal FSH.


RESULTS
The limits of agreement between cycles were +4.03 and -3.71 for AFC, +2.67 and -3.03 cm(3) for ovarian volume, and +4.36 and -4.52 IU/L for FSH levels. The AFC showed the least degree of variation, with a range of 0.48 times its own mean, in contrast to corresponding values of 0.73 and 1.29 for ovarian volume and basal FSH levels, respectively. The intraobserver variability for AFC and ovarian volume and the intraassay variability for FSH were 0.37, 0.17, and 0.42 times the mean of those respective variables.


CONCLUSIONS
The AFC demonstrates a lower intercycle variability than do ovarian volume and basal FSH level. The observed intercycle variability of the AFC may primarily be caused by observer variability, and the true biological variation may be minimal.
Jayaprakasan
Kannamannadiar
K
Academic Division of Reproductive Medicine and Surgery, Nottingham University Research and Treatment Unit, School of Human Development, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom. k.jayaprakasan@nottingham.ac.uk
Campbell
Bruce
B
Hopkisson
James
J
Clewes
Jeanette
J
Johnson
Ian
I
Raine-Fenning
Nick
N
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007246:Infertility / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D015588:Observer Variation; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D010050:Ovarian Function Tests; D010053:Ovary / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography
D015415:Biomarkers; D043373:Follicle Stimulating Hormone, Human