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

Abstract

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.

Dyslipidemia Is Negatively Associated With the Cumulative Live-Birth Rate in Patients Without PCOS Following IVF/ICSI

“…All patients aged 20-38 years, who had a normal ovarian reserve which is generally defined as the basal antral follicular count of more than seven (Christianson et al, 2015). Our criteria for women without PCOS are that all women had a regular menstrual cycle and none had polycystic ovaries on ultrasound.…”

Ultrasound in assisted reproduction: a call to fill the endometrial gap

“…Nomograms for AFC and its percentiles in different age groups have been published (33). A good example for the significance of AFC as a clinical tool arises from a web survey showing that 71.2% of clinicians consider this tool to be a mandatory test in their practice (34). Studies looking at specific subgroups, attempting to determine their reproductive span, are presenting AFC as a nonequivocal instrument in their evaluation (35)(36)(37).…”

Lack of Predictive Value of Ovarian Reserve Tests for Pregnancy Likelihood. The Huge Difference Between Quantity and Quality

“…Antral follicles are responsive to FSH and may be considered a predictor of ovarian response to gonadotropins. Results from literature seem to converge to recognition of the importance of AFC as a predictor of ovarian response [11,13,21].…”

“…Nevertheless, none of the ORT are complete in themselves, either in their sensitivity or their accuracy [8][9][10]. Their goal is to identify women at high risk of having either a poor response or a hyper-stimulation [4,11]. However, such diagnostic tests have been used "predictors of successful full-term pregnancies" or even as "fertility tests" in many ART centers.…”