EVALUATION OF THE OVARIAN RESERVE IN YOUNG LOW RESPONDERS WITH NORMALBASAL LEVELS OF FOLLICLE-STIMULATING-HORMONE USING 3-DIMENSIONAL ULTRASONOGRAPHY

Objective: To assess the ovarian content of selectable (2-5 mm) follic les using three-dimensional ultrasonography in low responders to ovari an stimulation for IVF. Design: Prospective case-control study. Settin g: IVF program at the Institute Valenciano de Infertilidad. Patient(s) : Ten low responders less than or equal to 35 years of age with normal basal serum FSH and eight control patients with normal response in a previous cycle. Intervention(s): Blood was drawn under basal (day 3) c onditions. Three-dimensional ultrasound was performed in both ovaries using a vaginal probe. Main Outcome Measure(s): Basal serum E-2 and FS H measurements. The ovarian volume and the number of follicles greater than or equal to 2 mm in each ovary were recorded and compared betwee n the groups. Result(s): Low-responder women had significantly higher serum FSH levels than controls despite having FSH values within the no rmal range. The number of selectable follicles and the total number of follicles with an antrum were significantly decreased in low responde rs as compared with normal responders. Ovarian volume did not differ b etween the groups. Conclusion(s): This study introduces three-dimensio nal ultrasound as a novel method for the evaluation of low responders. The results show that the most plausible explanation for low response in young women with normal serum FSH is diminished ovarian reserve. ( Fertil Steril(R) 1998;70:671-1. (C) 1998 by American Society for Repro ductive Medicine.).