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

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.

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


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.

Retrospective review.

Academic hospital.

Eighty-three women for a total of 166 gonads.


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

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.

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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