title: How reproducible are 2-dimensional ultrasonographic follicular diameter measurements from stored 3-dimensional files of ovarian scanning?
abstract: OBJECTIVE
  To investigate intra- and inter-observer variability in 2-dimensional (2D) follicular measurements among midwives sub-specialized in medically assisted reproduction (MAR), using a new 3D tool imitating real-life ovarian scanning.
  
  
  METHODS
  Six 3D ultrasound volumes from stimulated ovaries were recorded and stored on the ultrasound device (Voluson i, GE Healthcare). Two junior midwives (with 6-36 months' ultrasound scanning experience) and 5 seniors (>36 months' experience) assessed the number of follicles per ovary and the average size of each follicle ≥10 mm off-line. There were 2 time points of measurement by each midwife with a mean interval of 12.7 weeks (±10.7). Intra- and inter-observer variability in the number of follicles, the mean follicle size and the diameter of the largest follicle were investigated using the Wilcoxon signed-rank test and the Kruskal-Wallis test.
  
  
  RESULTS
  There was no significant intra- or inter-observer variability among midwives in the evaluation of the number of follicles, their diameter or the diameter of the largest follicle, even when juniors and seniors were compared.
  
  
  CONCLUSIONS
  These data support the view that well-trained midwives can perform 2D follicle measurements to monitor MAR treatment in a reproducible way, and that prerecorded 3D volumes can also be used for quality control purposes.
authors.affiliation: Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Katja
authors.initials: K
authors.lastname: Servaes
authors.forename: Dominique
authors.initials: D
authors.lastname: Van Schoubroeck
authors.forename: Myriam
authors.initials: M
authors.lastname: Welkenhuysen
authors.forename: Thomas
authors.initials: T
authors.lastname: D'Hooghe
authors.forename: Diane
authors.initials: D
authors.lastname: De Neubourg
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008880:Midwifery; D015588:Observer Variation; D009929:Organ Size; D006080:Ovarian Follicle / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D027724:Reproductive Techniques, Assisted; D014463:Ultrasonography