The antral follicle count: practical recommendations for better standardization.
OBJECTIVE
To provide recommendations for the standardized use of the Antral follicle count (AFC) which is used to predict ovarian response to gonadotrophin stimulation during assisted reproductive technology treatment. However, the nature of the follicles that are visualized by ultrasound and the competence of the oocytes held within are largely unknown. In addition, there is considerable variability in the clinical definitions and technical methods used to count and measure antral follicles in both published studies and clinical practice.


METHODS
In December 2007, specialist reproductive medicine clinicians and scientists attended a workshop in an effort to address these issues. Literature concerning the physiology and measurement of ovarian antral follicles was reviewed, clinical and technical considerations regarding antral follicle measurement were discussed, and an operational definition of AFC was developed.


METHODS
None.


METHODS
None.


METHODS
Simple recommendations were established for the standardization of AFC assessment in routine clinical practice. The basic clinical and technical requirements required for AFC evaluation were agreed upon, and a systematic method of measuring and counting antral follicles in routine practice was proposed.


CONCLUSIONS
The use of a standardized approach according to the practical recommendations for antral follicle counting as presented is encouraged in future clinical trials and routine practice. The authors also advocate a systematic evaluation of these recommendations as standardized study data become available.
Broekmans
Frank J M
FJ
Department of Reproductive Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
de Ziegler
Dominique
D
Howles
Colin M
CM
Gougeon
Alain
A
Trew
Geoffrey
G
Olivennes
Francois
F
D002138:Calibration; D002452:Cell Count / Q000379:methods / Q000592:standards; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000592:standards; D006287:Health Planning Guidelines; D006801:Humans; D008954:Models, Biological; D006080:Ovarian Follicle / Q000166:cytology* / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods / Q000592:standards