The number of small antral follicles (2-6 mm) determines the outcome of endocrine ovarian reserve tests in a subfertile population

Haadsma, Maaike L.; Bukman, A.; Groen, Henk; Roeloffzen, Ellen M.A.; Groenewoud, Eva R.; Heineman, Maas Jan; Hoek, Annemieke

doi:10.1093/humrep/dem081

Cited by 119 publications

(87 citation statements)

References 47 publications

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“…There is no consensus on identification of the antral follicles (2), however several evidence based studies suggested to select the follicles as antral follicles based on a diameter measurement as 2 to 10 mm. (3)(4)(5)(6)(7)(8)(9)(10). It has been reported that human antral follicles measuring <6 mm express the greatest amount of AMH, and that levels decline with antral follicles increase in size (23).…”

Section: Discussionmentioning

confidence: 99%

“…The antral follicle count (AFC) have been widely used as the ovarian reserve test, due to convenience of the ultrasonographic tools usage. Follicle counts can be performed easily with the help of the high quality resolution of the sonographic systems (2)(3)(4)(5)(6)(7)(8)(9)(10). Although there are well-known difficulties to obtain correct AFC such as high inter-observer differences and anatomical variations (3), it has been suggested that the ability of AFC to predict poor response might be significantly better than basal FSH.…”

Section: Introductionmentioning

confidence: 99%

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The correlation of the antral follicle count and Serum anti-mullerian hormone

Goksedef

Idiş

Görgen

et al. 2010

J Turkish German Gynecol Assoc

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Objective:To compare the value of the basal serum anti-Müllerian hormone (AMH) level with most of the established ovarian reserve tests. Material and Methods:A total of 141 infertile women was studied prospectively. On cycle day 3, serum levels of AMH, inhibin B, estradiol (E), FSH and LH levels were measured, and the number of early antral follicles (2-6 mm in diameter) estimated at ultrasound scanning to compare the strengths of hormonal-follicular correlations. Results:The mean age of the participants was 29.18±5.54. The mean AMH and total AFC on day 3 were 2.23±1.90 ng/ml and 8.35±2.83, respectively. Serum AMH levels were more tightly correlated (p<0.001) with number of the early antral follicle count (r=0.467, p<0.0001) than age and serum levels of FSH (r=-0.400, p<0.001; r=-0.299, p<0.001 respectively). No correlation was detected between serum levels of inhibin B, E 2 , and LH (r=0.154, p=0.06; p=0.31; r=-0.085 and r=0.067, p=0.42) and AFC. Conclusion:Serum AMH levels showed a strong correlation with AFC, and also this correlation is stronger than the other ovarian reserve parameters. (J Turkish-German Gynecol Assoc 2010; 11: 212-5) Key words: Anti-mullerian hormone; ovarian reserve; antral follicle count Received: 9 October, 2010 Accepted: 22 November, 2010 Amaç: Bu çalışmada basal serum bazal anti-Müllerian hormone (AMH) seviyesinin diğer sık kullanılan over rezerv testleri ile karşılaş-tırılması amaçlanmıştır. Gereç ve Yöntemler:

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The correlation of the antral follicle count and Serum anti-mullerian hormone

Goksedef

Idiş

Görgen

et al. 2010

J Turkish German Gynecol Assoc

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“…The number of antral follicles depends on the size of primordial follicle pool from which they are recruited. There are some evidence in the literature that the number of small antral follicles represents the functional ovarian reserve better [18], therefore, small AFC is superior to total AFC in predicting ovarian response. Small AFC is operator-dependent and has intercycle, inter-observer, and intraobserver variability [28,29].…”

Section: Discussionmentioning

confidence: 99%

“…For clinical purpose, some investigators counted the total number of antral follicles with a diameter of 2-10 mm [16], and the others determined the number of antral follicles with a diameter of 2-5 mm [17]. Small antral follicles produce AMH, therefore, they may be better predictors of ovarian reserve and ovarian response than total AFC [18]. Based on these evidence, we preferred to determine the number of small antral follicles with a diameter of 2-6 mm for prediction of high ovarian response in our study.…”

Section: Introductionmentioning

confidence: 99%

Prediction of high ovarian response to controlled ovarian hyperstimulation: anti-Müllerian hormone versus small antral follicle count (2–6 mm)

Aflatoonian

Oskouian

Ahmadi

et al. 2009

J Assist Reprod Genet

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Purpose To evaluate the predictive value of basal serum anti-müllerian hormone level and small antral follicle count for high ovarian response to controlled ovarian hyperstimulation. Methods A total of 159 patients were prospectively included. Basal serum anti-müllerian hormone and small antral follicle count (2-6 mm) were measured. Results Small antral follicle count and anti-müllerian hormone have similar predictive accuracy for high ovarian response with area under curve of 0.961 and 0.922, respectively. The sensitivity and specificity for prediction of high ovarian response were 89% and 92% for small antral follicle count and 93% and 78% for anti-müllerian hormone at the cutoff values of ≥ 16 and ≥ 34.5 pmol/l, respectively. Conclusions Small antral follicle count and anti-müllerian hormone are equally accurate predictors of high ovarian response and facilitate determination of the optimal strategy for controlled ovarian hyperstimulation.

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“…A Blow^AFC ranges from four to ten follicles and is used as a predictor of both low ovarian reserve and a poor response in IVF cycles. Thresholds for AFC prior to starting IVF and for dosing gonadotropins vary among centers [9,10,2,11]. A potential advantage of AFC is that it can be measured readily in the clinic, generating results immediately.…”

Section: Introductionmentioning

confidence: 99%

Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

Christianson

Shoham

Tobler

et al. 2015

J Assist Reprod Genet

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Purpose The purpose of the present study was to identify trends in the therapeutic approaches used to measure antral follicle count (AFC) in patients undergoing in vitro fertilization (IVF) treatment worldwide. Methods A retrospective evaluation utilizing the results of a web-based survey, IVF-Worldwide (www.IVF-Worldwide. com), was performed. Results Responses from 796 centers representing 593,200 cycles were evaluated. The majority of respondents (71.2 %) considered antral follicle count as a mandatory part of their practice with most (69.0 %) measuring AFC in the follicular phase. Most respondents (89.7 %) reported that they would modify the IVF stimulation protocol based on the AFC. There was considerable variation regarding a limit for the number of antral follicles required to initiate an IVF cycle with 46.1 % designating three antral follicles as their limit, 39.9 % selecting either four or five follicles as their limit, and 14.0 % reporting a higher cutoff criteria. With respect to antral follicle size, 61.5 % included follicles ranging between 2 and 10 mm in the AFC. When asked to identify the best predictor of ovarian hyper-response during IVF cycles, AFC was selected most frequently (49.4 %), followed by anti-Mullerian hormone level (42.7 %). Age was selected as the best predictor of ongoing pregnancy rate in 81.7 % of respondents. Conclusions While a large proportion of respondents utilized AFC as part of their daily practice and modified IVF protocol based on the measurement, the majority did not consider AFC as the best predictor of ongoing pregnancy rate.

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The number of small antral follicles (2-6 mm) determines the outcome of endocrine ovarian reserve tests in a subfertile population

Abstract: The number of small antral follicles (2-6 mm) is significantly related to age and also, independent of age, to all endocrine ORTs tested, suggesting the number of small antral follicles represents the functional ovarian reserve.

Cited by 119 publications

References 47 publications

The correlation of the antral follicle count and Serum anti-mullerian hormone

The correlation of the antral follicle count and Serum anti-mullerian hormone

Prediction of high ovarian response to controlled ovarian hyperstimulation: anti-Müllerian hormone versus small antral follicle count (2–6 mm)

Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

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