Prediction of in vitro fertilization outcome at different antral follicle count thresholds in a prospective cohort of 1,012 women

Capsule:
While AFC and age are predictive of live birth following IVF treatment, AFC demonstrates a stronger positive correlation. This study illustrates post-test probabilities of live birth at individual AFC thresholds.

Authors:
Kannamannadiar Jayaprakasan, Ph.D., YeeYin Chan, M.B.B.S., Rumana Islam, M.B.B.S., Zeina Haoula, M.R.C.O.G., James Hopkisson, M.D., Arri Coomarasamy, M.D., Nick Raine-Fenning, Ph.D.

Volume 98, Issue 3, Pages 657-663, September 2012

Abstract:

Objective:
To estimate the probability of live birth, adverse treatment outcome, and extremes of ovarian response at different antral follicle count (AFC) cutoff levels in a large prospective cohort of women undergoing IVF treatment.

Design:
Prospective study.

Setting:
University-based assisted conception unit.

Patient(s):
A total of 1,012 consecutive subjects of all ages undergoing their first cycle of assisted reproductive techniques.

Intervention(s):
Transvaginal three-dimensional ultrasound assessment and venipuncture in the early follicular phase of the menstrual cycle.

Main Outcome Measure(s):
Live birth rate, poor ovarian response, and ovarian hyperstimulation syndrome (OHSS).

Result(s):
Analysis was performed in 1,012 subjects. Both age (r = 0.88) and AFC (r = 0.92) thresholds show significant linear relationship with the probability of live birth, but AFC demonstrates a stronger correlation. At AFC quartiles of 3–10, 11–15, 16–22, and ≥23, the mean live birth rates were 23%, 34%, 39%, and 44%, respectively. No live birth was observed in women with AFC

Conclusion(s):
Although age and AFC are significantly correlated with live birth, AFC demonstrates a stronger correlation. Antral follicle count thresholds are useful to predict live birth rates and risks of poor ovarian response and OHSS during IVF treatment.

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