Skip to main content
Log in

The significance of antral follicle count in controlled ovarian stimulation and intrauterine insemination

  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose : This retrospective study evaluated the role of antral follicle count (AFC) in predicting ovarian response and successful outcome of stimulated insemination cycles.

Methods : One-hundred and fifty infertile women with bilateral patent tubes receiving a standard regime of human menopausal gonadotrophin (HMG) in their first cycle were evaluated. Multiple regression analysis was used to evaluate the effects of different parameters on ovarian responses and multiple logistic regression analysis was applied to determine which parameters gave the maximum discrimination to predict clinical pregnancy.

Results : Body mass index was the only significant parameter to predict the number of follicles ≥14 mm whereas AFC was the only significant parameter to predict the HMG duration. Only the number of follicles ≥14 mm significantly improved the chance of clinical pregnancy with an odds ratio of 1.8.

Conclusion : AFC was related to the HMG duration but was not predictive of number of follicles and clinical pregnancy of stimulated insemination cycles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hughes EG: The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis. Hum Reprod 1997;12:1865–1872

    Article  PubMed  Google Scholar 

  2. Scott RT Jr, Hofmann GE: Prognostic assessment of ovarian reserve. Fertil Steril 1995;63:1–14

    PubMed  Google Scholar 

  3. Sharara FI, Scott RT Jr, Seifer DB: The detection of diminished ovarian reserve in infertile women. Am J Obstet Gynecol 1998;179:804–812

    PubMed  Google Scholar 

  4. Cahill DJ, Prosser CJ, Wardle PG, Ford WCL, Hull MGR: Relative influence of serum follicle stimulating hormone, age and other factors on ovarian response to gonadotrophin stimulation. Br J Obstet Gynecol 1994;101:999–1002

    Google Scholar 

  5. Sharif K, Elgendy M, Lashen H, Afnan M: Age and basal follicle stimulating hormone as predictors of in vitro fertilisation outcome. Br J Obstet Gynecol 1998; 105:107–112

    Google Scholar 

  6. Tomás C, Nuojua-Huttunen S, Martikainen H: Pretreatment transvaginal ultrasound examination predicts ovarian responsiveness to gonadotrophins in in-vitro fertilization. Hum Reprod 1997;12:220–223

    Article  PubMed  Google Scholar 

  7. Chang MY, Chiang CH, Hsieh TT, Soong YK, Hsu KH: Use of the antral follicle count to predict the outcome of assisted reproductive technologies. Fertil Steril 1998;69:505–510

    Article  PubMed  Google Scholar 

  8. Ng EHY, Tang OS, Ho PC: The significance of the number of antral follicles prior to stimulation in predicting ovarian responses in an in-vitro fertilization programme. Hum Reprod 2000;15:1937–1942

    Article  PubMed  Google Scholar 

  9. Frattarelli JL, Lauria-Costa DF, Miller B, Bergh PA, Scott RT Jr: Basal antral follicle number and mean ovarian diameter predict cycle cancellation and ovarian responsiveness in assisted reproductive technology cycles. Fertil Steril 2000;74:512–517

    Article  PubMed  Google Scholar 

  10. Hsieh YY, Chang CC, Tsai HD: Antral follicle counting in predicting the retrieved oocyte number after ovarian hyperstimulation. J Assist Reprod Genet 2001;18:320–324

    Article  PubMed  Google Scholar 

  11. Nahum R, Shifren JL, Chang YC, Leykin L, Isaacson K, Toth T: Antral follicle assessment as a tool for predicting outcome in IVF-is it a better predictor than age and FSH? J Assist Reprod Genet 2001;18:151–155

    Article  PubMed  Google Scholar 

  12. Bancsi LF, Broekmans FJ, Eijkemans MJ, de Jong FH, Habbema JD, te Velde ER: Predictors of poor ovarian response in in vitro fertilization: A prospective study comparing basal markers of ovarian reserve. Fertil Steril 2002;77:328–336

    Article  PubMed  Google Scholar 

  13. Kupesic S, Kurjak A: Predictors of IVF outcome by three-dimensional ultrasound. Hum Reprod 2002;17:950–955

    Article  PubMed  Google Scholar 

  14. Popovic-Todorovic B, Loft A, Lindhard A, Bangsboll S, Andersson AM, Andersen AN: A prospective study of predictive factors of ovarian response in ‘standard’ IVF/ICSI patients treated with recombinant FSH. A suggestion for a recombinant FSH dosage normogram. Hum Reprod 2003;18:781–787

    Article  PubMed  Google Scholar 

  15. Chang MY, Chiang CH, Chiu TH, Hsieh TT, Soong YK: The antral follicle count predicts the outcome of pregnancy in a controlled ovarian hyperstimulation/intrauterine insemination program. J Assist Reprod Genet 1998;15:12–17

    Article  PubMed  Google Scholar 

  16. Adams J, Polson DW Franks S: Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. BMJ 1986;293:355–359

    PubMed  Google Scholar 

  17. Makker G, Ng EHY, Yeung WSB, Ho PC: The significance of the acrosome reaction ionophore challenge test in the prediction of successful outcome of controlled ovarian stimulation and intrauterine insemination. Hum Reprod 2003;18:534–539

    Article  PubMed  Google Scholar 

  18. Dickey RP, Olar TT, Taylor SN, Curole DN, Rye PH, Matulich EM: Relationship of follicle number, serum estradiol, and other factors to birth rate and multiparity in human menopausal gonadotropin-induced intrauterine insemination cycles. Fertil Steril 1991;56:89–92

    PubMed  Google Scholar 

  19. Gratton RJ Nisker JA, Daniel S, Toth S, Gunter J, Kaplan BR, Tummon IS, Yuzpe AA: An aggressive philosophy in controlled ovarian stimulation cycles increases pregnancy rates. Hum Reprod 1993;8:528–531

    PubMed  Google Scholar 

  20. Plosker SM, Jacobson W, Amato P: Predicting and optimizing success in an intra-uterine insemination programme. Hum Reprod 1994;9:2014–2021

    PubMed  Google Scholar 

  21. Nuojua HS, Tomás C, Bloigu R, Tuomivaara L, Martikainen H: Intrauterine treatment in subfertility: An analysis of factors affecting outcome. Hum Reprod 1999;14:698–703

    Article  PubMed  Google Scholar 

  22. Dodson WC, Haney AF: Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. Fertil Steril 1991;55:457–467

    PubMed  Google Scholar 

  23. Reuss ML, Kline J, Santos R, Levin B, Timor-Tritsch I: Age and the ovarian follicle pool assessed with transvaginal ultrasonography. Am J Obstet Gynecol 1996;174:624–627

    PubMed  Google Scholar 

  24. Scheffer GJ, Broekmans FJM, Dorland M, Habbema JDF, Looman CWN, te Velde ER: Antral follicle counts by transvaginal ultrasonography are related to age in women with proven natural fertility. Fertil Steril 1991;72:845–851

    Article  Google Scholar 

  25. Kupesic S, Kurjak A, Bjelos D, Vujisic S: Three-dimensional ultrasonographic ovarian measurements and in vitro fertilization outcome are related to age. Fertil Steril 2003;79:190–197

    Article  PubMed  Google Scholar 

  26. Dobbs KE, Dumesic DA, Dumesic JA, Shapiro SS: Differences in serum follicle-stimulating hormone uptake after intramuscular and subcutaneous human menopausal gonadotropin injection. Fertil Steril 1994;62:987–983

    Google Scholar 

  27. Loh S, Wang JX, Matthews CD: The influence of body mass index, basal FSH and age on the response to gonadotrophin stimulation in non-polycystic ovarian syndrome patients. Hum Reprod 2002;17:1207–1211

    Article  PubMed  Google Scholar 

  28. Treloar AE, Boynton RE, Behn BG, Brown BW: Variation of the human menstrual cycle through reproductive life. Int J Fertil1970; 12:77–126

    Google Scholar 

  29. Klein NA, Battaglia DE, Fujimoto VY, Davis GS, Bremner WJ, Soules MR: Reproductive aging: Accelerated ovarian follicular development associated with a monotropic follicle-stimulating hormone rise in normal older women. J Clin Endocrinol Metab 1996;81:1038–1045

    Article  PubMed  Google Scholar 

  30. Klein NA, Harper AJ, Houmard BS, Sluss PM, Soules MR: Is the short follicular phase in older women secondary to advanced or accelerated dominant follicle development? J Clin Endocrinol Metab 2002;87:5746–5750

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ernest Hung Yu Ng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ng, E.H.Y., Yeung, W.S.B. & Ho, P.C. The significance of antral follicle count in controlled ovarian stimulation and intrauterine insemination. J Assist Reprod Genet 22, 323–328 (2005). https://doi.org/10.1007/s10815-005-6785-2

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-005-6785-2

Key Words

Navigation