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Antral follicle count in normal (fertility-proven) and infertile Indian women.

Agarwal A, Verma A, Agarwal S, Shukla RC, Jain M, Srivastava A - Indian J Radiol Imaging (2014)

Bottom Line: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility).Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume.Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

ABSTRACT

Background: Antral follicle count (AFC) has been labeled as the most accurate biomarker to assess female fecundity. Unfortunately, no baseline Indian data exists, and we continue using surrogate values from the Western literature (inferred from studies on women, grossly different than Indian women in morphology and genetic makeup).

Aims: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in subfertile Indian women. (2) To establish baseline cut-off AFC values for Indian women.

Settings and design: Prospective observational case-control study.

Materials and methods: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility). The basal ovarian volume and AFC were measured by endovaginal. USG the relevant clinical data and hormonal assays were charted for every patient.

Statistical analysis used: SPSS platform was used to perform the Student's t-test and Mann-Whitney U-test for intergroup comparisons. Correlations were determined by Pearson's ranked correlation coefficient.

Results: Regression analysis revealed the highest correlation of AFC and age in fertile and infertile patients with difference in mean AFC of both the groups. Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume.

Conclusions: AFC has the closest association with chronological age in normal and infertile Indian women. The same is lower in infertile women than in matched controls. Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.

No MeSH data available.


Related in: MedlinePlus

3D-volumetry showing reconstructed true planar images of right ovary (straight arrows) in three orthogonal planes, (A) axial, (B) sagittal, and (C) coronal. The images were obtained using the volumetric data acquisition (by a volume probe) and reconstructing true planes by “VOCAL” software. (D) Surface-rendered image of the right ovary (solid arrow), reconstructed using the same software, was used to assess the gross total volume. Note the healthy antral follicle (curved arrow) as seen in the surface-rendered image
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Figure 1: 3D-volumetry showing reconstructed true planar images of right ovary (straight arrows) in three orthogonal planes, (A) axial, (B) sagittal, and (C) coronal. The images were obtained using the volumetric data acquisition (by a volume probe) and reconstructing true planes by “VOCAL” software. (D) Surface-rendered image of the right ovary (solid arrow), reconstructed using the same software, was used to assess the gross total volume. Note the healthy antral follicle (curved arrow) as seen in the surface-rendered image

Mentions: Transvaginal USG was carried out on the second or third day of the menstrual cycle. All sonographic measurements were performed by the same observer using a 7.5-MHz transvaginal transducer (iU22; Philips Medical System, Andover, MA, USA). Thorough survey of each ovary was done by scanning from the outer to the inner margin.[89] All follicles having adequate morphology as described for a healthy follicle (i.e., 2-10 mm size range of well-defined anechoic cysts with smooth margins and absence of internal septations or nodularity)[10] were measured and counted in each ovary. The sum of both counts was labeled as the AFC. 3-D volume calculations were performed independently, with no access to 2-D results. Virtual organ computer-aided analysis (VOCAL) was used to conduct 3-D rotational measurements of the ovarian volume using incremental rotations in both the longitudinal and coronal planes. The volumes of both ovaries were added to obtain the total ovarian volume (TOV)[10] [Figure 1].


Antral follicle count in normal (fertility-proven) and infertile Indian women.

Agarwal A, Verma A, Agarwal S, Shukla RC, Jain M, Srivastava A - Indian J Radiol Imaging (2014)

3D-volumetry showing reconstructed true planar images of right ovary (straight arrows) in three orthogonal planes, (A) axial, (B) sagittal, and (C) coronal. The images were obtained using the volumetric data acquisition (by a volume probe) and reconstructing true planes by “VOCAL” software. (D) Surface-rendered image of the right ovary (solid arrow), reconstructed using the same software, was used to assess the gross total volume. Note the healthy antral follicle (curved arrow) as seen in the surface-rendered image
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126147&req=5

Figure 1: 3D-volumetry showing reconstructed true planar images of right ovary (straight arrows) in three orthogonal planes, (A) axial, (B) sagittal, and (C) coronal. The images were obtained using the volumetric data acquisition (by a volume probe) and reconstructing true planes by “VOCAL” software. (D) Surface-rendered image of the right ovary (solid arrow), reconstructed using the same software, was used to assess the gross total volume. Note the healthy antral follicle (curved arrow) as seen in the surface-rendered image
Mentions: Transvaginal USG was carried out on the second or third day of the menstrual cycle. All sonographic measurements were performed by the same observer using a 7.5-MHz transvaginal transducer (iU22; Philips Medical System, Andover, MA, USA). Thorough survey of each ovary was done by scanning from the outer to the inner margin.[89] All follicles having adequate morphology as described for a healthy follicle (i.e., 2-10 mm size range of well-defined anechoic cysts with smooth margins and absence of internal septations or nodularity)[10] were measured and counted in each ovary. The sum of both counts was labeled as the AFC. 3-D volume calculations were performed independently, with no access to 2-D results. Virtual organ computer-aided analysis (VOCAL) was used to conduct 3-D rotational measurements of the ovarian volume using incremental rotations in both the longitudinal and coronal planes. The volumes of both ovaries were added to obtain the total ovarian volume (TOV)[10] [Figure 1].

Bottom Line: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility).Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume.Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

ABSTRACT

Background: Antral follicle count (AFC) has been labeled as the most accurate biomarker to assess female fecundity. Unfortunately, no baseline Indian data exists, and we continue using surrogate values from the Western literature (inferred from studies on women, grossly different than Indian women in morphology and genetic makeup).

Aims: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in subfertile Indian women. (2) To establish baseline cut-off AFC values for Indian women.

Settings and design: Prospective observational case-control study.

Materials and methods: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility). The basal ovarian volume and AFC were measured by endovaginal. USG the relevant clinical data and hormonal assays were charted for every patient.

Statistical analysis used: SPSS platform was used to perform the Student's t-test and Mann-Whitney U-test for intergroup comparisons. Correlations were determined by Pearson's ranked correlation coefficient.

Results: Regression analysis revealed the highest correlation of AFC and age in fertile and infertile patients with difference in mean AFC of both the groups. Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume.

Conclusions: AFC has the closest association with chronological age in normal and infertile Indian women. The same is lower in infertile women than in matched controls. Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.

No MeSH data available.


Related in: MedlinePlus