Le monitorage de l’ovulation : passé, présent et perspectives

The Value of Automated Follicle Volume Measurements in IVF/ICSI

“…With total AFC determination (tAFC), the number of follicles between 2 and 10 mm is counted ( 21 ), usually on the third day of the cycle during the early follicular phase ( 23 ). The tAFC can be estimated using 2D or 3D ultrasound imaging ( 1 , 16 , 23 ). Recent reports have shown that more information can be obtained from observing the antral follicles than from quantification only ( 16 , 24 ).…”

“…The ovarian volume can also be measured via transvaginal ultrasound ( 26 ) in the early follicular phase before any significant follicular dominance occurs ( 1 , 23 , 24 ). Studies by Lass et al ( 3 , 26 ) indicate that patients with very small ovaries (<3.0 cm) have to cancel the treatment cycle more often and have a significantly lower yield of oocytes; therefore, those patients have a lower chance of pregnancy.…”

“…This process is time-consuming, and the reliability of the measurements decreases when the number of follicles increases because it is difficult to check whether each follicle was measured once and only once ( 16 ). Because ovarian follicles often have complex shapes ( 29 ), particularly in stimulated ovaries with “follicular overpopulation” ( 1 , 5 , 12 ), manual determinations of the follicular diameter often offer a weak representation of the follicular volume and might have a negative effect on medical decision-making ( 17 , 30 ). In these cases, volume measurement will provide more reliable information ( 1 ).…”

“…The technology of ultrasound scans has undergone an enormous evolution since the early years of assisted reproductive technology (ART). Endovaginal ultrasound probes were developed during the 1990s and have replaced transabdominal ultrasound scans in ART ( 1 ). In addition to the improved resolution and image quality resulting from the proximity of the ovaries ( 2 , 3 ), endovaginal ultrasound avoids the interruptive influence of abdominal fat, and it reduces the patient’s discomfort because, unlike transabdominal ultrasound, it does require a full bladder.…”

“…The development of three-dimensional (3D) ultrasound imaging in the late 1980s enabled the use and analysis of volume data ( 7 ). The unit constructing the image is now the voxel (defined by axes x, y , and z ) rather than the pixel (defined by axes x and y ) ( 1 ). 3D ultrasound imaging provides more accurate and reproducible volume measurements because the different image reproductions enable the investigator to detect surface irregularities and take corrective measures in the calculations.…”