THE ANTRAL FOLLICLE COUNT PREDICTS THE OUTCOME OF PREGNANCY IN A CONTROLLED OVARIAN HYPERSTIMULATION INTRAUTERINE INSEMINATION PROGRAM

Purpose: Our purpose was to test whether age-related changes in antral follicle counts call predict the pregnancy outcome in the early folli cular phase of a controlled ovarian hyperstimulation/intrauterine inse mination (COH/IUI) program. Methods: A selected group of 107 women (36 healthy women requesting child ses preselection, 52 women with unexpl ained infertility, and 19 with minimal endometriosis) who underwent co ntrolled ovarian hyperstimulation with clomiphene citrate (CC) plus hu man menopausal gonadotrophin (hMG) and subsequent intrauterine insemin ation Mere enrolled in the study. Transvaginal ultrasonography (7.0 MH z) was used to determine the total number of antral follicles (2-8 mm) in the right and left ovaries. The association among the antral folli cle count, age, dominant follicle, and estradiol (E-2) level on the da y of human chorionic gonadotropin (hCG) was analyzed. Tile association of the pregnancy rate and OHSS with the antral follicle count, domina nt follicle count, and age was also examined. Results: The total antra l follicle number decreased with age (P < 0.0001). Dominant follicle n umber increased with total antral follicle number women who received C C plus hMG/IUI (P < 0.0001). Tile pregnant group had a higher number o f antral follicle and dominant follicles in comparison with the nonpre gnant group (P < 0.01 and P < 0.02, respectively), The E-2 level on th e day of hCG injection increased positively with the total number of a ntral follicles (P < 0.0001) and the total number of dominant follicle s (P < 0.0001). In women aged younger than 35 years, the pregnancy rat e and dominant follicle number rose as the number of antral follicles increased (P < 0.03 and P < 0.0001, respectively). The pregnancy rare was low (2/39) in women aged older than 35 years regardless of the num ber of antral follicles (P < 0.05) and the extent of hMG administratio n (P < 0.02). Women aged older than 35 also produced fewer dominant fo llicles (P < 0.001). No pregnancy was achieved in a patient,vith an an tral follicle number of less than five (17 cases), Conclusions: Age-re lated changes in antral follicle count significantly predicted the dom inant follicle count and the pregnancy outcome. In women with antral f ollicle counts of less than five or who are older than 35 years, the a pplication of COH/IUI may not be indicated.