Basal antral follicle number and mean ovarian diameter predict cycle cancellation and ovarian responsiveness in assisted reproductive technology cycles

Objective: To determine the predictive value and define threshold levels for basal antral follicle number and mean ovarian diameter in patients undergoing ART cycles. Design: Retrospective, Setting: Tertiary care center. Patients: Two hundred seventy-eight patients who had ovarian measurements performed an cycle day 3 before beginning treatment with gonadotropins. Intervention: Pretreatment ovarian ultrasound measurements. Main Outcome Measure: Number of oocytes retrieved, hormone levels, and cycle outcomes. Results: A direct linear correlation was observed between mean ovarian diameter and basal follicle number. Roth measures demonstrated a positive linear correlation with recovered oocytes, basal E-2, and peak E-2. Both demonstrated a negative lineal correlation with ampules of gonadotropins administered, days of stimulation, patient age. cycle day 3 FSH, and FSH:LH ratio. An antral follicle count of less than or equal to 10 or a mean ovarian diameter of <20 mm was associated with an increased risk of cycle cancellation. Conclusions: Ovarian diameter and basal antral follicle number identify patients who may respond poorly to ART stimulation. These ovarian measures con-elate well with ART screening and stimulation parameters. This knowledge allows physicians to evaluate and counsel patients immediately before an ART stimulation and to optimize stimulation protocols. (Fertil Steril(R) 2000:74:512-17. (C) 2000 by American Society for Reproductive Medicine.).