The cohort of antral follicles measuring 2-6 mm reflects the quantitative status of ovarian reserve as assessed by serum levels of anti-Müllerian hormone and response to controlled ovarian stimulation.
OBJECTIVE
To evaluate the relationship between serum anti-Müllerian hormone (AMH) and antral follicle size, and to ascertain which cohort of antral follicles is most predictive of the response to controlled ovarian stimulation during assisted reproduction treatment (ART).


METHODS
Prospective study.


METHODS
University-based Assisted Conception Unit.


METHODS
One hundred thirteen women undergoing first cycle of ART.


METHODS
Transvaginal 3D-ultrasound assessment and venipuncture in the early-follicular phase of the menstrual cycle.


METHODS
Serum AMH levels, number of mature oocytes retrieved and poor ovarian response.


RESULTS
The antral follicle cohorts measuring 2 to 3 mm, >3 to 4 mm, >4 to 5 mm, and >5 to 6 mm were most significantly correlated with AMH (r = .30, .27, .30, and .41, respectively) and the number of mature oocytes retrieved (r = .28, .23, .29, and .34, respectively). Although these follicle cohorts of 2-6 mm were significant predictors of the number of mature oocytes retrieved on regression analysis, their discriminative ability (area under the curve [AUC]: 0.829) for the prediction of poor ovarian response was similar to total counts made using cohorts of 2 to 4 mm, 2 to 5 mm, 2 to 8 mm, and 2 to 10 mm (AUCs: 0.794, 0.812, 0.852, and 0.826, respectively).


CONCLUSIONS
The number of antral follicles measuring 2 to 6 mm is most reflective of the quantitative ovarian reserve. However, the ability of this group of antral follicles to predict poor ovarian response appears similar to that of the follicular cohorts of 2 to 4 mm, 2 to 5 mm, 2 to 8 mm, and 2 to 10 mm.
Jayaprakasan
Kannamannadiar
K
Nottingham University Research and Treatment Unit in Reproduction, Division of Human Development, School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom. k.jayaprakasan@nottingham.ac.uk
Deb
Shilpa
S
Batcha
Milhan
M
Hopkisson
James
J
Johnson
Ian
I
Campbell
Bruce
B
Raine-Fenning
Nick
N
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D009865:Oocytes / Q000166:cytology*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging* / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D027724:Reproductive Techniques, Assisted; D014463:Ultrasonography
D015415:Biomarkers; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone