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Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

  • Assisted Reproduction Technologies
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Abstract

Purpose

The purpose of the present study was to identify trends in the therapeutic approaches used to measure antral follicle count (AFC) in patients undergoing in vitro fertilization (IVF) treatment worldwide.

Methods

A retrospective evaluation utilizing the results of a web-based survey, IVF-Worldwide (www.IVF-Worldwide.com), was performed.

Results

Responses from 796 centers representing 593,200 cycles were evaluated. The majority of respondents (71.2 %) considered antral follicle count as a mandatory part of their practice with most (69.0 %) measuring AFC in the follicular phase. Most respondents (89.7 %) reported that they would modify the IVF stimulation protocol based on the AFC. There was considerable variation regarding a limit for the number of antral follicles required to initiate an IVF cycle with 46.1 % designating three antral follicles as their limit, 39.9 % selecting either four or five follicles as their limit, and 14.0 % reporting a higher cutoff criteria. With respect to antral follicle size, 61.5 % included follicles ranging between 2 and 10 mm in the AFC. When asked to identify the best predictor of ovarian hyper-response during IVF cycles, AFC was selected most frequently (49.4 %), followed by anti-Mullerian hormone level (42.7 %). Age was selected as the best predictor of ongoing pregnancy rate in 81.7 % of respondents.

Conclusions

While a large proportion of respondents utilized AFC as part of their daily practice and modified IVF protocol based on the measurement, the majority did not consider AFC as the best predictor of ongoing pregnancy rate.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Mindy S. Christianson & Yulian Zhao

  2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Gon Shoham

  3. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Womack Army Medical Center, Fort Bragg, NC, USA

    Kyle J. Tobler

  4. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Christina N. Cordeiro

  5. The Women’s Clinic, Hong Kong, SAR, China

    Milton Leong

  6. Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, 76100, Israel

    Zeev Shoham

Authors
  1. Mindy S. Christianson
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  2. Gon Shoham
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  3. Kyle J. Tobler
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  4. Yulian Zhao
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  5. Christina N. Cordeiro
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  6. Milton Leong
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  7. Zeev Shoham
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Corresponding author

Correspondence to Mindy S. Christianson.

Additional information

Capsule

A worldwide survey of IVF centers demonstrates most utilize antral follicle count as part of their practice but most do not consider it the best predictor of ongoing pregnancy rate.

Appendix: Question stems pertaining to antral follicle count used for analysis in this study with responses as percentages of units and cycles

Appendix: Question stems pertaining to antral follicle count used for analysis in this study with responses as percentages of units and cycles

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Christianson, M.S., Shoham, G., Tobler, K.J. et al. Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey. J Assist Reprod Genet 32, 1435–1440 (2015). https://doi.org/10.1007/s10815-015-0555-6

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  • DOI: https://doi.org/10.1007/s10815-015-0555-6

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