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Number and size of antral follicles as predictive factors in vitro fertilization and embryo transfer.

Zusammenfassung: IVF-Patientinnen mit einer höheren Anzahl an Follikeln zu Zyklusbeginn zeigten eine höhere Schwangerschaftsrate. Patientinnen mit einem dominanten Follikel tendierten zu vermindertem Ansprechen auf die hormonelle Stimulation.

J Assist Reprod Genet. 2000 Jul;17(6):315-8.

Pöhl M(1), Hohlagschwandtner M, Obruca A, Poschalko G, Weigert M, Feichtinger W.

PURPOSE: The purpose of the study was to evaluate whether number and size of antral follicles can predict the outcome of in vitro fertilization-embryo transfer.

METHODS: A total of 113 patients were prospectively included into this study.
After 19 days of down-regulation, number and size of follicles were determined by using recent three-dimensional transvaginal ultrasound technology. Before application of gonadotropin, all follicles had been defined as antral follicles.
According to size, antral follicles were categorized into four different groups: group I included antral follicles < 5 mm, group II follicles 5-10 mm; group III 11-20 mm; and group IV > 20 mm. Pregnant and non-pregnant patients were compared in terms of their number of antral follicles of group I-IV. These four groups were then compared regarding implantation rate, number of retrieved oocytes, endometrium thickness, and age.

RESULTS: Pregnant patients showed an significant higher number of follicles with the size between 5 and 10 mm (P = 0.04). A significant correlation was found between number of retrieved oocytes and antral follicle size of 5-10 mm (P = 0.0001). Antral follicles with a diameter between 5 and 10 mm decreased significantly with age (P = 0.008). In group III and IV, a significant correlation was found between antral follicle size (P = 0.016) and serum estradiol level after gonadotropin-releasing hormone-agonist down-regulation (P = 0.011).

CONCLUSIONS: We demonstrated that patients with a higher number of follicles between 5 and 10 mm showed a significantly higher pregnancy rate, whereas patients with a dominant number of antral follicles > 11 mm have a higher cancellation rate due to ovarian low response.