Day3最大基礎濾泡AF大小可能與IVF懷孕率有關
AF大小6-7mm可達最佳懷孕率
AF大小2-6mm需較高之排卵針劑量與療程
AF大小8-10mm需較少之排卵針劑量與療程但懷孕率較低
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544237/
The significance of antral follicle size prior to stimulation in predicting ovarian response in a multiple dose GnRH antagonist protocol
Abstract
Prediction of ovarian responses prior to stimulation is not only useful for patient counseling, but also important in tailoring the optimal dosage of gonadotrophin for individual patients. By prospectively study of 214 women undergoing in vitro fertilization and embryo transfer (IVF-ET) treatment, we obtained data supporting that antral follicle size could be an additional valuable predictive marker other than the antral follicle count (AFC) in predicting ovarian response. Our studies revealed that AFC achieved the best predictive value in relation to the number of oocyte obtained, followed by antral follicle size, basal follicle stimulating hormone (FSH) and body mass index (BMI). Unlike AFC, antral follicle size was noted to be negatively correlated with the dosage (R = -0.493) and duration (R = -0.465) of rFSH stimulation. Antral follicle size was also found with higher negative regression coefficient (B = -0.661) as compared with that of basal FSH concentration (B = -0.326) and BMI (b = -0.281). More importantly, women with antral follicle size 6-7mm showed significantly higher AFC, oocytes retrieved, fertilized oocytes and grade I/II embryos along with much lower transfer cycle cancellation rate (7.5% vs. 16-17%). Together, our data suggest that basal antral follicle size could be a valued predictive marker in women with IVF-ET treatment, in which women with antral follicle size 6-7mm are likely predisposed to better IVF-ET outcomes.
Table 5
Comparison of IVF-ET outcomes of subjects with different antral follicle size
| Antral Follicle Size | 2-6mm | 6-7mm | 7-8mm | 8-10mm |
|---|---|---|---|---|
| Cycles | 52 | 53 | 61 | 48 |
| Age (years) | 34.6±5.5 | 34.7±4.7 | 34.4±4.6 | 34.5±5.2 |
| BMI | 21.6±2.4 | 22.1±2.7 | 21.7±2.6 | 21.2±2.5 |
| Basal FSH (IU/l) | 7.6±2.2 | 7.7±3.6 | 6.7±3.0 | 7.0±2.5 |
| Antral follicle count | 6.8±3.7b | 10.2±5.2b | 8.9±4.5 | 7.1±3.3b |
| rFSH duration (days) | 8.8±1.6 | 8.5±1.6 | 7.5±1.2 | 6.9±1.2 |
| rFSH dosage(amp) | 31.7±12.1b | 27.8±11.1 | 23.7±8.7b | 19.9±6.3b |
| HCG day | ||||
| Oestradiol (pmol/l) | 1513.4±1247.9 | 1700.2±1154.6a | 1323.0±705.8 | 1149.9±590.2a |
| Progesterone(ng/ml) | 1.3±0.5 | 1.4±0.8 | 1.2±0.5 | 1.2±0.6 |
| Endometrial thickness(mm) | 9.9±2.2 | 10.7±2.2 | 11.1±2.7 | 9.9±2.1 |
| ≥14mm follicles | 5.7±3.8 | 6.6±3.8a | 5.3±2.8 | 4.4±3.1a |
| Oocytes retrieved | 7.2±5.8 | 10.3±9.4b | 7.1±4.7 | 5.3±4.1b |
| Fertilized oocytes | 4.5±4.1a | 6.0±5.7b | 3.9±2.8 | 2.6±2.4a b |
| Fertilization rate (%) | 245/391 (62.7) | 320/543 (58.9) | 249/455 (54.7) | 132/266 (49.6) |
| Embryos transferred no. | 1.9±1.0 | 2.3±0.9b | 1.8±1.0 | 1.7±1.0b |
| Grade I/II embryos | 2.4±2.6 | 3.1±3.1b | 1.8±2.0 | 1.4±1.6b |
| Transfer cycles cancelled (%) | 9(17.3) | 4(7.5) | 10(16.4) | 8(16.7) |
| Implantation rate (%) | 18/101(17.8) | 24/121(19.8) | 27/117(23.1) | 11/83(13.3) |
| Clinical pregnancy (%) | 14/45(33.3) | 16/49(32.7) | 21/54(38.9) | 8/42(19.0) |
ap < 0.05;
bp < 0.01.
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