Antral follicle assessment as a tool for predicting outcome in IVF - Is it a better predictor than age and FSH?

Purpose: The purpose of this study is to determine if baseline antral follicle assessment may serve as additional information in predicting in vitro fertilization outcome. Methods: Prospective, descriptive preliminary study of in vitro fertilization outcome. From July 1998 to July 1999, 224 patients underwent antral follicle assessment (follicle 2-6 mm in diameter) on baseline of the planned, stimulated in vitro fertilization cycle. The outcomes were analyzed with respect to antral follicle assessment (≤6 or >6), basal cycle day 3 follicle stimulated harmone (≤10 or >10 IU/L) and maternal age (≤35 or >35 years). Results: The clinical pregnancy rate was significantly higher in the group with baseline antral follicle >6 compared to that in the group with antral follicle ≤6 (51% vs. 19%, respectively). Controlling for patient age, and basal follicle stimulated harmone, the pregnancy rate was significantly higher in the group with antral follicle >6 compared to that in the group with antral follicle ≤6. The cancellation rate was significantly increased with advancing maternal age, elevated basal follicle stimulated harmone levels, and baseline antral follicle ≤6. The cancellation rate was significantly higher in the group with antral follicle ≤6 compared to that in the group with antral follicle ≥6 (33% vs. 1%, respectively). Conclusions: In vitro fertilization outcome is strongly correlated with both maternal ages, basal cycle, day 3 follicle, stimulated harmone, and antral follicle assessment. Antral follicle assessment was a better predictor of in vitro fertilization outcome than were age or follicle stimulated harmone. Antral follicle assessment may provide a marker for ovarian age that is distinct from chronological age or hormonal markers.