OBJECTIVE: To estimate the probability of live birth, adverse treatment outcome, and extremes of ovarian response at different antral follicle count (AFC) cutoff levels in a large prospective cohort of women undergoing IVF treatment. DESIGN: Prospective study. SETTING: University-based assisted conception unit. PATIENT(S): A total of 1,012 consecutive subjects of all ages undergoing their first cycle of assisted reproductive techniques. INTERVENTION(S): Transvaginal three-dimensional ultrasound assessment and venipuncture in the early follicular phase of the menstrual cycle. MAIN OUTCOME MEASURE(S): Live birth rate, poor ovarian response, and ovarian hyperstimulation syndrome (OHSS). RESULT(S): Analysis was performed in 1,012 subjects. Both age (r = 0.88) and AFC (r = 0.92) thresholds show significant linear relationship with the probability of live birth, but AFC demonstrates a stronger correlation. At AFC quartiles of 3-10, 11-15, 16-22, and ≥23, the mean live birth rates were 23%, 34%, 39%, and 44%, respectively. No live birth was observed in women with AFC <4. Antral follicle count was predictive of ovarian response, with a 67% likelihood of poor ovarian response for AFC ≤4. Although the risk of moderate or severe OHSS is 2.2% with AFC of ≤24, the risk increases to 8.6% at AFC of ≥24. The risk of OHSS increases further to 11% if there are signs and symptoms of polycystic ovary syndrome. CONCLUSION(S): Although age and AFC are significantly correlated with live birth, AFC demonstrates a stronger correlation. Antral follicle count thresholds are useful to predict live birth rates and risks of poor ovarian response and OHSS during IVF treatment.
OBJECTIVE: To estimate the probability of live birth, adverse treatment outcome, and extremes of ovarian response at different antral follicle count (AFC) cutoff levels in a large prospective cohort of women undergoing IVF treatment. DESIGN: Prospective study. SETTING: University-based assisted conception unit. PATIENT(S): A total of 1,012 consecutive subjects of all ages undergoing their first cycle of assisted reproductive techniques. INTERVENTION(S): Transvaginal three-dimensional ultrasound assessment and venipuncture in the early follicular phase of the menstrual cycle. MAIN OUTCOME MEASURE(S): Live birth rate, poor ovarian response, and ovarian hyperstimulation syndrome (OHSS). RESULT(S): Analysis was performed in 1,012 subjects. Both age (r = 0.88) and AFC (r = 0.92) thresholds show significant linear relationship with the probability of live birth, but AFC demonstrates a stronger correlation. At AFC quartiles of 3-10, 11-15, 16-22, and ≥23, the mean live birth rates were 23%, 34%, 39%, and 44%, respectively. No live birth was observed in women with AFC <4. Antral follicle count was predictive of ovarian response, with a 67% likelihood of poor ovarian response for AFC ≤4. Although the risk of moderate or severe OHSS is 2.2% with AFC of ≤24, the risk increases to 8.6% at AFC of ≥24. The risk of OHSS increases further to 11% if there are signs and symptoms of polycystic ovary syndrome. CONCLUSION(S): Although age and AFC are significantly correlated with live birth, AFC demonstrates a stronger correlation. Antral follicle count thresholds are useful to predict live birth rates and risks of poor ovarian response and OHSS during IVF treatment.
Authors: Malinda S Lee; Andrea Lanes; Andrey V Dolinko; Alexandra Bailin; Elizabeth Ginsburg Journal: J Assist Reprod Genet Date: 2020-07-04 Impact factor: 3.412
Authors: Ali Abbara; Channa N Jayasena; Georgios Christopoulos; Shakunthala Narayanaswamy; Chioma Izzi-Engbeaya; Gurjinder M K Nijher; Alexander N Comninos; Deborah Peters; Adam Buckley; Risheka Ratnasabapathy; Julia K Prague; Rehan Salim; Stuart A Lavery; Stephen R Bloom; Matyas Szigeti; Deborah A Ashby; Geoffrey H Trew; Waljit S Dhillo Journal: J Clin Endocrinol Metab Date: 2015-07-20 Impact factor: 5.958