title: Intracycle variation in number of antral follicles stratified by size and in endocrine markers of ovarian reserve in women with normal ovulatory menstrual cycles.
abstract: OBJECTIVE
  To quantify the intracycle variation in markers of ovarian reserve measured by antral follicle counts stratified by size using three-dimensional (3D) ultrasound and anti-Müllerian hormone (AMH) in women with normal menstrual cycles.
  
  
  METHODS
  Healthy volunteers with normal menstrual cycles were prospectively recruited. Three-dimensional (3D) ultrasound examination and blood test were performed in early (F1) and mid-follicular (F2) phases and in periovulatory (PO) and luteal (LU) phases of one menstrual cycle. Antral follicles were measured using 'sonography-based automated volume calculation' with post processing (SonoAVC) and ovarian volume was measured using Virtual Organ Computer-aided AnaLysis (VOCAL). Blood serum was processed for hormonal assays including AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol. Repeated-measures analysis was used to examine the variance in markers of ovarian reserve in different phases of one menstrual cycle.
  
  
  RESULTS
  A total of 36 volunteers were included in the final analysis, of whom 34 attended all four visits. Repeated-measures analysis showed a significant variation in total antral follicle count (AFC) (P < 0.001). However, on stratifying the antral follicles according to size using SonoAVC, a non-significant variation (P = 0.382) was seen in small AFC (≤ 6.0 mm) and a significant variation (P < 0.001) was seen in large AFC (> 6.0 mm). The ovarian volume showed a significant intracycle variation (P < 0.001). A small but significant intracycle variation was noted in AMH (P = 0.041) and a significant variation was seen in levels of serum FSH, LH and estradiol (P < 0.05).
  
  
  CONCLUSIONS
  Small antral follicles (≤ 6.0 mm) measured using 3D ultrasound and AMH show little intracycle variation and perhaps should be evaluated when predicting ovarian reserve independent of menstrual cycle.
authors: Nottingham University Hospitals NHS Trust, Nottingham, UK. shilpadeb@nottingham.ac.uk
authors: S
authors: S
authors: Deb
authors: B K
authors: BK
authors: Campbell
authors: J S
authors: JS
authors: Clewes
authors: C
authors: C
authors: Pincott-Allen
authors: N J
authors: NJ
authors: Raine-Fenning
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008597:Menstrual Cycle / Q000097:blood / Q000502:physiology*; D009929:Organ Size; D006080:Ovarian Follicle / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D010053:Ovary / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone