Ultrasound-based tests allowing women undergoing in-vitro fertilization (IVF) to count their chickens before they've hatched may provide alternatives to the hormone-based tests used today. Less costly and invasive than the current ovarian reserve tests, clinicians may in future consider using ultrasound scans of a woman's ovaries to predict her ovaries' response to IVF.
Research published today in Reproductive Biology and Endocrinology details how Janet Kwee et. al. from Vrije Universiteit Medical Centre in Amsterdam, The Netherlands studied 110 women aged 18-39 who had difficulty conceiving. She counted the number of antral follicles, small egg-bearing ovarian follicles about 2-10 mm in diameter, with transvaginal sonography (ultrasound).
Kwee compared the follicle count with ovarian volume with the results from ovarian reserve endocrine tests. The antral follicle count was an effective predictor of the number of eggs the patient would ultimately produce when her ovaries had been stimulated during IVF treatment.
A test that can be administered before IVF that indicates ovarian response might be used to counsel patients as to their chances of success, and help clinicians decide the starting dose of hormones used to stimulate the patient's ovaries for the best results. After around age 40, the ovaries' size decreases - an early sign that the number of follicles, and potential eggs, is depleted. Women with few eggs in their ovarian reserve are less likely to have an adequate ovarian response for successful IVF.
"The follicle count is just as good a test for ovarian response as expensive and time consuming endocrine tests," says Kwee, who adds that the count appears to be "the only test able to reliably predict low and high responders."
Ovarian volume and antral follicle count form the prediction of low and hyper responders with in vitro fertilization
Janet J Kwee, Mariet ME Elting, Roel R Schats, Joseph J McDonnell, Nils CB Lambalk
Reproductive Biology and Endocrinology (In press)
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