•Ultrasound Examination (Antral Follicle Count and Ovarian Volume) Versus Serum FSH Measurement in Assessment of Ovarian Reserve

Abstract

aim of study: The current study was designed to compare antral follicle count (A.F.C), ovarian volume & day 3 FSH level, with respect to their ability to predict ovarian response of infertile women to ovulation induction agents (antiestrogens such as clomiphene citrate or tamoxifen, or exogenous gonadotrophins).Material and Methods: Sixty-two patients between the ages of 19 - 43 years participated in this study when attending the infertility clinic of Babylon Hospital for Maternity and Children. All patients underwent a transvaginal sonography on day 3-5 of cycle to measure the ovarian volume and count of basal antral follicle, and basal FSH concentration was determined on day 2-4 of a spontaneous period.Induction of ovulation in next cycle by using antiestrogens or gonadotroohins (pure FSH- gonal- F ) for 3 successive cycles . Patients monitored by using TVS on other days, then on day 12 of cycle TVS was performed to assess the presence of dominant follicle.Results: In this study the results showed that AFC has a higher predictability for successful fertility treatments by assessing ovarian reserve, i.e. when AFC < 10; the success rate was 13.3, while when AFC > 10; the success rate was 58.3.The next predicting factor was ovarian volume, when < 3 ml; the chance of success was very poor (zero), while when volume is 3-9 ml; the success rate was 40.4% & when volume >9 ml; the success rate was 63.6%.While day 3 FSH had the lowest predictability, when FSH < 10 m IU /ml; the success rate was 45.3%, while when FSH > 10 m IU / ml; the success rate was 38.8%Conclusion: A.F.C. performs well as a test for ovarian response being superior to complex and time consuming endocrine tests. It is therefore likely to be the test for general practice.