PRETREATMENT TRANSVAGINAL ULTRASOUND EXAMINATION PREDICTS OVARIAN RESPONSIVENESS TO GONADOTROPINS IN IN-VITRO FERTILIZATION

The objective of this study was to determine the predictive value of t he number of follicles seen by transvaginal ultrasound before gonadotr ophin stimulation on the ovarian responsiveness of 166 infertile women undergoing in-vitro fertilization (IVF) treatment. The main variables were patient age, ovarian volume and number of ovarian follicles meas uring 2-5 mm on transvaginal ultrasound before gonadotrophin stimulati on. Based on the sum of ovarian follicles in both ovaries the patients were divided into three groups of inactive (<5 follicles), normal (5- 15 follicles) or polycystic (PCO)-like ovaries (>15 follicles). The ma in outcome measure was the number of recovered oocytes. The number of follicles was correlated more strongly with the number of recovered oo cytes (r(2) = 0.131; P = 0.0001) than age alone (r(2) = -0.053; P = 0. 005). Fewer oocytes were recovered from patients with inactive ovaries (5.4 +/- 2.5; P = 0.006) than with normal (7.5 +/- 4.5) or PCO-like o varies (10.5 +/- 5.1). Ovarian volume was correlated with the number o f follicles before stimulation (P = 0.0001), but not with the number o f oocytes. The number of small follicles present before ovarian stimul ation was a better predictor of the outcome than ovarian volume or age alone. Patients can be identified with inactive ovaries which will ha ve a poor response to IVF treatment, a key factor for counselling coup les and optimizing resources.