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Antral follicle size in the downregulated cycle and its relation to in vitro fertilization outcome.

Padhy N, Latha M, Sathya B, Varma TR - J Hum Reprod Sci (2009)

Bottom Line: A P-value < 0.05 (Fisher exact test) was taken to be significant.There was no significant difference in basal estradiol and FSH levels among the three groups.Accelerated growth of follicles (zooming) was significantly associated with bigger antral follicles ( P < 0.001) whereas poor quality oocytes were significantly higher in Group 1.

View Article: PubMed Central - PubMed

Affiliation: Department of Reproductive Medicine, Institute of Reproductive Medicine, Madras Medical Mission, Chennai - 37, India.

ABSTRACT

Aim: In this study, we have attempted to relate the antral follicle size on day 3 of downregulation to the in vitro fertilization (IVF) outcome and hence test its predictive value for IVF outcome.

Settings and design: Teaching hospital, prospective double-blinded cohort study. The sonographer was blinded toward the patient profile whereas the follicular size on day 3 was concealed from the clinicians.

Materials and methods: Two hundred and twenty-eight patients undergoing the long protocol programme for IVF/intracytoplasmic sperm injection at the Institution are included in this study. The antral follicle size on day 3 of the downregulated cycle was measured for all patients and, based on the size, they were divided into three groups: Group I (0-3 mm), Group II (3-6 mm), and Group III (6-9 mm), Various outcome measures taken into account were amount and number of days of gonadotropin required, basal estradiol and follicle-stimulating hormone (FSH) level, zooming of follicles, and quality of oocytes.

Statistical analysis used: Data were analyzed using the Graphpad software with a microsoft excel spread sheet. A P-value < 0.05 (Fisher exact test) was taken to be significant. Multinomial regression tests were used as appropriate.

Results: A significant number of follicles were in the 3-6 mm group whereas the population below 35 years constituted the majority. There was no significant difference in basal estradiol and FSH levels among the three groups. Accelerated growth of follicles (zooming) was significantly associated with bigger antral follicles ( P < 0.001) whereas poor quality oocytes were significantly higher in Group 1.

Conclusion: The significant number of poor quality of oocytes produced by such follicles whereas zooming of follicles among the bigger antral follicle group suggest their accelerated development potential and hence the dose of gonadotropin should be adjusted accordingly, indicating evidence of intrinsic abnormality of folliculogenesis in very small follicles.

No MeSH data available.


Related in: MedlinePlus

PCOS vs endometriosis – antral follicle size Note: In polycystic ovary syndrome, antral follicles more than 6 mm are abundant whereas in endometriosis, a majority are 3-6 mm in size
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Figure 0001: PCOS vs endometriosis – antral follicle size Note: In polycystic ovary syndrome, antral follicles more than 6 mm are abundant whereas in endometriosis, a majority are 3-6 mm in size

Mentions: Of 220 patients, 176 (80%) were less than 35 years of age and constituted the majority in all three groups, whereas 178 (80.6%) had primary subfertility. Male factor infertility accounted for 26% of the cases [Table 1]. 51.3% of the patients had 3-6 mm follicles, whereas only 18% had follicles less than 3 mm. Very small follicles as well as larger antral follicles were found in younger age groups, which signify that follicle size does not change with age [Table 2]. Majority of PCOS patients had larger antral follicles (P < 0.001) whereas in patients with endometriosis, follicle size was not significantly correlated with any group (P = 0.06) [Figure 1]. There was no significant difference in basal estradiol and FSH levels among the three groups [Table 3]. Also, there was no difference in the amount of gonadotropin used, as this study was double blinded, and there was a difference in the median days of gonadotropin therapy (Group 1, P = 0.02). Accelerated growth of follicles (zooming) was significantly associated with bigger antral follicles (P < 0.005) [Table 4]. Poor quality oocytes were significantly high in Group 1.


Antral follicle size in the downregulated cycle and its relation to in vitro fertilization outcome.

Padhy N, Latha M, Sathya B, Varma TR - J Hum Reprod Sci (2009)

PCOS vs endometriosis – antral follicle size Note: In polycystic ovary syndrome, antral follicles more than 6 mm are abundant whereas in endometriosis, a majority are 3-6 mm in size
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2800930&req=5

Figure 0001: PCOS vs endometriosis – antral follicle size Note: In polycystic ovary syndrome, antral follicles more than 6 mm are abundant whereas in endometriosis, a majority are 3-6 mm in size
Mentions: Of 220 patients, 176 (80%) were less than 35 years of age and constituted the majority in all three groups, whereas 178 (80.6%) had primary subfertility. Male factor infertility accounted for 26% of the cases [Table 1]. 51.3% of the patients had 3-6 mm follicles, whereas only 18% had follicles less than 3 mm. Very small follicles as well as larger antral follicles were found in younger age groups, which signify that follicle size does not change with age [Table 2]. Majority of PCOS patients had larger antral follicles (P < 0.001) whereas in patients with endometriosis, follicle size was not significantly correlated with any group (P = 0.06) [Figure 1]. There was no significant difference in basal estradiol and FSH levels among the three groups [Table 3]. Also, there was no difference in the amount of gonadotropin used, as this study was double blinded, and there was a difference in the median days of gonadotropin therapy (Group 1, P = 0.02). Accelerated growth of follicles (zooming) was significantly associated with bigger antral follicles (P < 0.005) [Table 4]. Poor quality oocytes were significantly high in Group 1.

Bottom Line: A P-value < 0.05 (Fisher exact test) was taken to be significant.There was no significant difference in basal estradiol and FSH levels among the three groups.Accelerated growth of follicles (zooming) was significantly associated with bigger antral follicles ( P < 0.001) whereas poor quality oocytes were significantly higher in Group 1.

View Article: PubMed Central - PubMed

Affiliation: Department of Reproductive Medicine, Institute of Reproductive Medicine, Madras Medical Mission, Chennai - 37, India.

ABSTRACT

Aim: In this study, we have attempted to relate the antral follicle size on day 3 of downregulation to the in vitro fertilization (IVF) outcome and hence test its predictive value for IVF outcome.

Settings and design: Teaching hospital, prospective double-blinded cohort study. The sonographer was blinded toward the patient profile whereas the follicular size on day 3 was concealed from the clinicians.

Materials and methods: Two hundred and twenty-eight patients undergoing the long protocol programme for IVF/intracytoplasmic sperm injection at the Institution are included in this study. The antral follicle size on day 3 of the downregulated cycle was measured for all patients and, based on the size, they were divided into three groups: Group I (0-3 mm), Group II (3-6 mm), and Group III (6-9 mm), Various outcome measures taken into account were amount and number of days of gonadotropin required, basal estradiol and follicle-stimulating hormone (FSH) level, zooming of follicles, and quality of oocytes.

Statistical analysis used: Data were analyzed using the Graphpad software with a microsoft excel spread sheet. A P-value < 0.05 (Fisher exact test) was taken to be significant. Multinomial regression tests were used as appropriate.

Results: A significant number of follicles were in the 3-6 mm group whereas the population below 35 years constituted the majority. There was no significant difference in basal estradiol and FSH levels among the three groups. Accelerated growth of follicles (zooming) was significantly associated with bigger antral follicles ( P < 0.001) whereas poor quality oocytes were significantly higher in Group 1.

Conclusion: The significant number of poor quality of oocytes produced by such follicles whereas zooming of follicles among the bigger antral follicle group suggest their accelerated development potential and hence the dose of gonadotropin should be adjusted accordingly, indicating evidence of intrinsic abnormality of folliculogenesis in very small follicles.

No MeSH data available.


Related in: MedlinePlus