Antral follicle responsiveness to follicle-stimulating hormone administration assessed by the Follicular Output RaTe (FORT) may predict in vitro fertilization-embryo transfer outcome

Gallot, V.; Silva, A.L. Berwanger da; Genro, Vanessa Krebs; Grynberg, Michaël; Frydman, Nelly; Fanchin, Rénato

doi:10.1093/humrep/der479

Cited by 90 publications

(102 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 In this study it is observed that effect of ovarian aging on FORT is negligible as compared to PFC, basal E2 and FSH levels and antral follicles continue to respond to FSH irrespective of ovarian aging which is supported by other studies. 11,24 The present study reflected that high peak E2 (at the time of OI) is associated with greater number of oocytes maturity, retrieval, fertilization, cleavage and the number of top quality embryos which enhance chances of clinical pregnancy as observed in other studies 14,25 The suggested high peak E2 for improvement of oocyte and embryo quality was observed in high FORT group of our study, similar results were shown in another study. 26,27 The increased E2 produced by growing follicles in the window of implantation, increases endometrial receptivity by apposition, attachment and apposition for the encroaching blastocyst.…”

Section: Discussionsupporting

confidence: 90%

“…Gallot et al has established FORT as a qualitative reflector of ovarian follicle potential and quality of embryos obtained for ICSI treatment cycles as it was observed in our study that high FORT had highest number of fertilized oocytes comparable to other groups. 11,18 The present study showed that cleaved embryos were significant in high FORT group as compared to low and medium FORT groups as in another study. 38 This innovative index gives an insight to re-examine the usual criteria of abandonment of cycle just on the basis of number of growing follicles in agreement with Genro et al 18 Failure of implantation may occur in any cycle irrespective of transfer of healthy and morphologically normal embryos.…”

Section: Discussionsupporting

confidence: 77%

“…The FORT was calculated by the ratio between PFC on dhCG × 100/AFC at baseline. 11 To interpret the possible relationship between follicle responsiveness to COS and ICSI outcome, study population was stratified into three distinct FORT groups on the basis of tertile values; low, medium and high. FORT values were under the 33 rd percentile (<47%, in the low FORT group) between the 33 rd and the 67 th percentile (42-58%, in the medium FORT group), or above the 67 th percentile (>58%, in the high FORT group).…”

Section: Treatment Protocolmentioning

confidence: 99%

“…[8][9][10] The number of preovulatory follicles obtained at the end of COS at the same time is not a reliable reflection of antral follicle sensitivity to FSH, since it is subject to a number of small antral follicles available before treatment. 11 In this context, follicular output rate (FORT) has proved itself to be a qualitative reflector of ovarian follicular competence in terms of percentage of antral follicles that effectively respond to FSH after COS in ICSI patients. 11 The need for estimation of FORT is hypothesized from the fact that follicle and oocyte dysfunction limit the sensitivity of antral follicles to exogenous FSH with the role of FORT as an important predictor of antral follicle responsiveness.…”

Section: Introductionmentioning

confidence: 99%

“…11 In this context, follicular output rate (FORT) has proved itself to be a qualitative reflector of ovarian follicular competence in terms of percentage of antral follicles that effectively respond to FSH after COS in ICSI patients. 11 The need for estimation of FORT is hypothesized from the fact that follicle and oocyte dysfunction limit the sensitivity of antral follicles to exogenous FSH with the role of FORT as an important predictor of antral follicle responsiveness. This is especially useful to ignore 40% atretic follicles that might give false results to the expected stimulation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Rehman

Mustafa

Hoor

et al. 2015

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: We aimed to estimate pregnancy outcome after ICSI in terms of oocyte parameters, embryo quality, endometrial thickness, hormone and cytokine levels in women stratified on the basis of follicular output rate (FORT). Methods: Quasi experimental design was carried out after approval from "Ethical review board of Islamabad clinic serving infertile couples" from July 2010 to August 2013. One thousand and fifty females were selected with the criteria of age between 21-40 years, infertility of more than 2 years, body mass index of 18-35 kg/m 2 , menstrual cycle of 25 ± 7 days, both ovaries present with normal uterine cavity, serum FSH levels less than 8 IU/ml and normal thyroid-stimulating hormone levels. Females on short agonist or antagonist protocol with diagnosis of polycystic ovarian syndrome, fibroids or in their male partner sperms retrieved by testicular biopsy were excluded from the study. Down regulation of ovaries was followed by controlled ovarian stimulation, Ovulation Induction (OI), oocyte pick up, in vitro fertilization, Embryo Transfer (ET) and confirmation of pregnancy was done by serum beta hCG of more than 25 mIU/ml and cardiac activity on trans vaginal scan. Enzyme linked immuno sorbent assay was used for peak and mid luteal estradiol (E2), progesterone (P) and interleukin I-β estimation on OI and ET days respectively. FORT (ratio of preovulatory follicle count to antral follicle count × 100 on OI day) stratified females into low under the 33 rd percentile, medium between the 33 rd and the 67 th percentile and high above the 67 th percentile. Characteristics of groups were compared by one way analysis of variance. Results: Females 276 (33%), 288 (34%) and 282 (33%) comprised of low, medium and high FORT groups respectively. The number of retrieved, mature and fertilized oocytes, cleaved embryos, endometrial thickness and number of gestational sacs in the high FORT group was significantly high (P <0.001). High peak and midluteal E2 (P = 0.0025, 0.0001), low P (P = 0.0001) and high peak interleukin-1β (P = 0.0001) was observed in high FORT in comparison with medium FORT with resultant greater number of clinical pregnancies 183 (65%). Conclusions: The FORT in non PCOS patients may reflect good reproductive outcome after ICSI with maximum clinical pregnancies in high FORT group.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 77%

Section: Treatment Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Rehman

Mustafa

Hoor

et al. 2015

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

Comparison of stimulation protocols for dose determination of gonadotropins: A systematic review and Bayesian network meta‐analysis based on randomized controlled trials

Peng,

Ma,

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

BackgroundTo date, evidence regarding the effectiveness and safety of individualized controlled ovarian stimulation (COS) compared with standard dose COS has been inadequate.ObjectivesTo evaluate the updated evidence from published randomized controlled trials (RCTs) about the efficacy and safety of individualized COS with different ovarian reserve test biomarkers or clinical experience versus standard dose COS.Search StrategyTerms and descriptors related to COS, individualized or standard, and RCT were combined to search, and only English language studies were included. Conference abstracts and comments were excluded.Selection CriteriaRCTs with comparison between different individualized COS strategies and standard starting dose strategy were included.Data Collection and AnalysisTwo reviews independently assessed the eligibility of retrieved citations in a predefined standardized manner. Relative risk (RRs) and the weighted mean difference (WMD) with 95% confidence intervals (CIs) were pooled using a random‐effects model on R software version 4.2.2.Main ResultsCompared with the standard dose COS strategy in pairwise meta‐analysis, the individualized COS strategy was associated with a notable lower risk of ovarian hyperstimulation syndrome (OHSS; 174/2384 [7.30%] vs 114/2412 [4.73%], RR 0.66, 95% CI: 0.47–0.93, I2 = 46%), a significantly lower risk of hyperresponse to stimulation (hyperresponse; 476/2402 [19.82%] vs 331/2437 [13.58%], RR 0.71, 95% CI: 0.57–0.90, I2 = 61%), and a slightly longer ovarian stimulation days (duration of stimulation; WMD 0.20, 95% CI: 0.01–0.40, I2 = 66%). Bayesian network meta‐analysis also found that biomarker‐tailored strategy had a significantly lower risk of OHSS than standard dose strategy (OHSS; RR 0.63, 95% CI: 0.41–0.97, I2 = 47.5%).ConclusionCompared with standard dose COS strategy, individualized COS strategy could significantly reduce the risks of OHSS and hyperresponse to stimulation, but the duration of stimulation was slightly longer.Trial RegistrationPROSPERO: CRD42023358439.

show abstract

Comparison of antral follicle count and serum anti‐Müllerian hormone level for determination of gonadotropin dosing in in‐vitro fertilization: randomized trial

Lee

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Objective To compare the proportion of women achieving a desired ovarian response following ovarian stimulation when gonadotropin dosing was determined based on antral follicle count (AFC) vs serum anti‐Müllerian hormone (AMH) level, in women undergoing in‐vitro fertilization (IVF) using the gonadotropin‐releasing hormone (GnRH) antagonist protocol. Methods This was a randomized double‐blind trial carried out in a university‐affiliated assisted reproduction unit. A total of 200 women undergoing their first IVF cycle using the GnRH‐antagonist protocol between April 2016 and February 2018 were randomized to determination of gonadotropin dosing based on either AFC or serum AMH level measured in the pretreatment cycle 1 month before the IVF cycle. Patients underwent IVF as per our center's standard protocol. The proportion of subjects achieving a desired ovarian response, defined as retrieval of six to 14 oocytes, was compared between the two study arms. Subgroup analysis of patients with baseline AFC > 5 and those with baseline AFC ≤ 5 was performed. Concordance in AFC and AMH categorization between the pretreatment cycle and the ovarian‐stimulation cycle was assessed using Cohen's kappa (κ). Results There was no significant difference in the proportion of patients achieving a desired ovarian response between the AFC (54%) and AMH (49%) groups (P = 0.479). The median number of oocytes retrieved was nine vs seven (P = 0.070), and the median follicular output rate was 0.54 vs 0.55 (P = 0.764) in the AFC and AMH groups, respectively. Similar findings were observed on subgroup analysis of subjects with AFC ≤ 5 and AFC > 5 at the start of ovarian stimulation (P > 0.05 for all comparisons). There was moderate concordance between AFC and AMH measured in the pretreatment cycle and the stimulation cycle (κ = 0.478 and 0.587, respectively). Conclusion The proportion of women achieving a desired ovarian response following ovarian stimulation using the GnRH‐antagonist protocol is similar when the gonadotropin‐dosing algorithm used is based on AFC or serum AMH level. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

Antral follicle responsiveness to follicle-stimulating hormone administration assessed by the Follicular Output RaTe (FORT) may predict in vitro fertilization-embryo transfer outcome

Cited by 90 publications

References 21 publications

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Importance of estimation of Follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Comparison of stimulation protocols for dose determination of gonadotropins: A systematic review and Bayesian network meta‐analysis based on randomized controlled trials

Comparison of antral follicle count and serum anti‐Müllerian hormone level for determination of gonadotropin dosing in in‐vitro fertilization: randomized trial

Contact Info

Product

Resources

About