Antral follicle count as a predictor of ovarian responsiveness in women with endometriomas or with a history of surgery for endometriomas

Capsule:
The capacity of antral follicule count to predict ovarian responsiveness during in vitro fertilization is similar among unaffected ovaries, ovaries with endometriomas, and previously operated ovaries.

Authors:
Laura Benaglia, M.D., Giorgio Candotti, M.D., Andrea Busnelli, M.D., Alessio Paffoni, M.Sc., Paolo Vercellini, M.D., Edgardo Somigliana, M.D., Ph.D.

Volume 103, Issue 6, Pages 1544-1550

Abstract:

Objective:
To evaluate the accuracy of antral follicular count (AFC) in predicting ovarian responsiveness in ovaries with endometriomas or with a past history of surgical excision of endometriomas.

Design:
Retrospective review.

Setting:
Academic hospital.

Patient(s):
Eighty-three women for a total of 166 gonads.

Intervention(s):
None.

Main Outcome Measure(s):
Total number of developing follicles.

Result(s):
The ovaries were characterized as four groups: [1] unoperated gonads without endometriomas (n = 42, control group), [2] unoperated gonads with endometriomas (n = 46), [3] operated gonads without endometriomas (n = 55), and [4] operated gonads with endometriomas (n = 23). The analyses subsequently considered all ovaries with endometriomas (groups 2 + 4, n = 69) and all operated ovaries (groups 3 + 4, n = 78). The capacity of AFC to predict low response (≤2 follicles) or hyperresponsiveness (≥7 follicles) was evaluated using receiver operating characteristic curves. We used a linear regression model to calculate the adjusted B coefficients. The adjusted B coefficients in unaffected ovaries, in all ovaries with endometriomas, and in all operated ovaries were 0.55 (95% confidence interval [CI], 0.07–1.03), 0.76 (95% CI, 0.54–0.98), and 0.51 (95% CI, 0.26–0.76), respectively. The area under the curve (AUC) for the prediction of low response was 0.83 (95% CI, 0.68–0.99), 0.83 (95% CI, 0.73–0.93), and 0.74 (95% CI, 0.63–0.85), respectively. The AUC for the prediction of hyperresponse was 0.84 (95% CI, 0.70–0.97), 0.74 (95% CI, 0.63–0.85), and 0.77 (0.60–0.94), respectively.

Conclusion(s):
The accuracy of AFC for predicting ovarian response is similar in unaffected ovaries, ovaries with endometriomas and ovaries with a history of surgery for endometriomas.

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