窦卵泡计数与辅助生殖后的活产率强烈相关，还与多囊卵巢综合征女性患者的良好治疗结局相关

Objective:

To evaluate the association of antral follicle count (AFC) with in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) outcome in a large unselected cohort of patients covering the entire range of AFC.

Design:

Prospective observational study.

Setting:

University-affiliated private infertility center.

Patient(s):

2,092 women undergoing 4,308 IVF-ICSI cycles.

Intervention(s):

AFC analyzed for associations with treatment outcome and statistically adjusted for repeated treatments and age.

Main Outcome Measure(s):

Pregnancy rate, live-birth rate, and stimulation outcome parameters.

Result(s):

The AFC was log-normally distributed. Pregnancy rates and live-birth rates were positively associated with AFC in a log-linear way, leveling out above AFC ∼30. Treatment outcome was superior among women with polycystic ovaries, independent from ovulatory status. The findings were significant also after adjustment for age and number of oocytes retrieved.

Conclusion(s):

Pregnancy and live-birth rates are log-linearly related to AFC. Polycystic ovaries, most often excluded from studies on ovarian reserve, fit as one extreme in the spectrum of AFC; a low count constitutes the other extreme, with the lowest ovarian reserve and poor treatment outcome. The findings remained statistically significant also after adjustment for the number of oocytes retrieved, suggesting this measure of ovarian reserve comprises information on oocyte quality and not only quantity (Fig 1).
Figure 1 Figure 1: Pregnancy rate (%) per started stimulation (solid line) relative to log transformed antral follicle count (AFC), with confidence interval (dotted lines). Pregnancy rates increased (log−) linearly and leveled out above the AFC ∼30. The corresponding graph for the live-birth rate described the same pattern. AF=antral follicles. Density (red) denotes the distribution after log transformation. The AFC numbers given along the x-axis are back-transformed for ease of interpretation. N=4,308 IVF-ICSI treatment cycles. (Reprinted from Holte J, Brodin T, Berglund L, et al. Antral follicle counts are strongly associated with live-birth rates after assisted reproduction, with superior treatment outcome in women with polycystic ovaries. Fertil Steril. 2011;96:594-599, Copyright 2011, with permission from American Society for Reproductive Medicine.)