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Int J Clin Exp Pathol 2013;6(2):258-266
Original Article
The significance of antral follicle size prior to
stimulation in predicting ovarian response in
a multiple dose GnRH antagonist protocol
Qiaohong Lai, Cai Chen, Zhijun Zhang, Shu Zhang, Qilin Yu, Ping Yang, Jun Hu, Cong-Yi Wang
The Center for Biomedical Research; Center of Ophthalmology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan 430030, China; The Center for
Biotechnology and Genomic Medicine, Department of Pathology, Georgia Health Sciences University, 1120 15th
Street, CA4098, Augusta, GA 30912, USA
Received November 16, 2012; Accepted December 7, 2012; Epub January 15, 2013; Published February 1, 2013
Abstract: Prediction of ovarian responses prior to stimulation is not only useful for patient counseling, but also
important in tailoring the optimal dosage of gonadotrophin for individual patients. By prospectively study of 214
women undergoing in vitro fertilization and embryo transfer (IVF-ET) treatment, we obtained data supporting that
antral follicle size could be an additional valuable predictive marker other than the antral follicle count (AFC) in predicting
ovarian response. Our studies revealed that AFC achieved the best predictive value in relation to the number
of oocyte obtained, followed by antral follicle size, basal follicle stimulating hormone (FSH) and body mass index
(BMI). Unlike AFC, antral follicle size was noted to be negatively correlated with the dosage (R = -0.493) and duration
(R = -0.465) of rFSH stimulation. Antral follicle size was also found with higher negative regression coefficient (B
= -0.661) as compared with that of basal FSH concentration (B = -0.326) and BMI (b = -0.281). More importantly,
women with antral follicle size 6-7mm showed significantly higher AFC, oocytes retrieved, fertilized oocytes and
grade I/II embryos along with much lower transfer cycle cancellation rate (7.5% vs. 16-17%). Together, our data
suggest that basal antral follicle size could be a valued predictive marker in women with IVF-ET treatment, in which
women with antral follicle size 6-7mm are likely predisposed to better IVF-ET outcomes. (IJCP1211017).
Keywords: IVF-ET, antral follicle count, antral follicle size, ovarian response, oocytes
Address all correspondence to:
Dr. Cong-Yi Wang
The Center for Biomedical Research, Tongji Hospital
Tongji Medical College
Huazhong University of Science and Technology
1095 Jiefang Ave, Wuhan 430030, China.
Tel: 86-27-8366-3485
E-mail: cwang@georgiahealth.edu
Original Article
The significance of antral follicle size prior to
stimulation in predicting ovarian response in
a multiple dose GnRH antagonist protocol
Qiaohong Lai, Cai Chen, Zhijun Zhang, Shu Zhang, Qilin Yu, Ping Yang, Jun Hu, Cong-Yi Wang
The Center for Biomedical Research; Center of Ophthalmology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan 430030, China; The Center for
Biotechnology and Genomic Medicine, Department of Pathology, Georgia Health Sciences University, 1120 15th
Street, CA4098, Augusta, GA 30912, USA
Received November 16, 2012; Accepted December 7, 2012; Epub January 15, 2013; Published February 1, 2013
Abstract: Prediction of ovarian responses prior to stimulation is not only useful for patient counseling, but also
important in tailoring the optimal dosage of gonadotrophin for individual patients. By prospectively study of 214
women undergoing in vitro fertilization and embryo transfer (IVF-ET) treatment, we obtained data supporting that
antral follicle size could be an additional valuable predictive marker other than the antral follicle count (AFC) in predicting
ovarian response. Our studies revealed that AFC achieved the best predictive value in relation to the number
of oocyte obtained, followed by antral follicle size, basal follicle stimulating hormone (FSH) and body mass index
(BMI). Unlike AFC, antral follicle size was noted to be negatively correlated with the dosage (R = -0.493) and duration
(R = -0.465) of rFSH stimulation. Antral follicle size was also found with higher negative regression coefficient (B
= -0.661) as compared with that of basal FSH concentration (B = -0.326) and BMI (b = -0.281). More importantly,
women with antral follicle size 6-7mm showed significantly higher AFC, oocytes retrieved, fertilized oocytes and
grade I/II embryos along with much lower transfer cycle cancellation rate (7.5% vs. 16-17%). Together, our data
suggest that basal antral follicle size could be a valued predictive marker in women with IVF-ET treatment, in which
women with antral follicle size 6-7mm are likely predisposed to better IVF-ET outcomes. (IJCP1211017).
Keywords: IVF-ET, antral follicle count, antral follicle size, ovarian response, oocytes
Address all correspondence to:
Dr. Cong-Yi Wang
The Center for Biomedical Research, Tongji Hospital
Tongji Medical College
Huazhong University of Science and Technology
1095 Jiefang Ave, Wuhan 430030, China.
Tel: 86-27-8366-3485
E-mail: cwang@georgiahealth.edu
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