Antral follicle count as a predictor of ovarian responsiveness in women with endometriomas or with a history of surgery for endometriomas.
OBJECTIVE
To evaluate the accuracy of antral follicular count (AFC) in predicting ovarian responsiveness in ovaries with endometriomas or with a past history of surgical excision of endometriomas.


METHODS
Retrospective review.


METHODS
Academic hospital.


METHODS
Eighty-three women for a total of 166 gonads.


METHODS
None.


METHODS
Total number of developing follicles.


RESULTS
The ovaries were characterized as four groups: [1] unoperated gonads without endometriomas (n = 42, control group), [2] unoperated gonads with endometriomas (n = 46), [3] operated gonads without endometriomas (n = 55), and [4] operated gonads with endometriomas (n = 23). The analyses subsequently considered all ovaries with endometriomas (groups 2 + 4, n = 69) and all operated ovaries (groups 3 + 4, n = 78). The capacity of AFC to predict low response (≤ 2 follicles) or hyperresponsiveness (≥ 7 follicles) was evaluated using receiver operating characteristic curves. We used a linear regression model to calculate the adjusted B coefficients. The adjusted B coefficients in unaffected ovaries, in all ovaries with endometriomas, and in all operated ovaries were 0.55 (95% confidence interval [CI], 0.07-1.03), 0.76 (95% CI, 0.54-0.98), and 0.51 (95% CI, 0.26-0.76), respectively. The area under the curve (AUC) for the prediction of low response was 0.83 (95% CI, 0.68-0.99), 0.83 (95% CI, 0.73-0.93), and 0.74 (95% CI, 0.63-0.85), respectively. The AUC for the prediction of hyperresponse was 0.84 (95% CI, 0.70-0.97), 0.74 (95% CI, 0.63-0.85), and 0.77 (0.60-0.94), respectively.


CONCLUSIONS
The accuracy of AFC for predicting ovarian response is similar in unaffected ovaries, ovaries with endometriomas and ovaries with a history of surgery for endometriomas.
Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: laurabenaglia@hotmail.it.
Laura
L
Benaglia
Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Giorgio
G
Candotti
Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Università degli Studi di Milano, Milan, Italy.
Andrea
A
Busnelli
Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Alessio
A
Paffoni
Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Università degli Studi di Milano, Milan, Italy.
Paolo
P
Vercellini
Department of Obstetrics and Gynecology, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Università degli Studi di Milano, Milan, Italy.
Edgardo
E
Somigliana
D000328:Adult; D002452:Cell Count / Q000379:methods*; D004715:Endometriosis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006080:Ovarian Follicle / Q000473:pathology*; D065851:Ovarian Reserve / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
AFC; controlled ovarian hyperstimulation; endometrioma