Evaluation of diagnostic ultrasound as a parameter of follicular development in an in vitro fertilization program.

The ultrasound results in 141 patients through 203 cycles stimulated with clomiphene citrate prior to oocyte collection and in vitro fertilization are analyzed. A wide range in the size and number of follicles was seen. Bivariate analysis of the size of the largest follicle, compared with the time of the spontaneous luteinizing hormone (LH) surge, has shown a highly significant correlation (r = 0.720; P less than 0.001) between these two variables, but the accuracy of prediction of the LH surge in a specific cycle, as expressed by the standard error of estimate, was 34.3 hours. As an isolated observation, ultrasound results are no better than the menstrual history in predicting the time of the LH surge in stimulated cycles. Multiparameter assessment of follicular development is required.