The Oocyte/Antral Follicle Count Index: Does Maximizing Oocyte Yield Translate Into Better Assisted Reproductive...

Area of Science:

• Reproductive Endocrinology
• Infertility Treatment
• Ovarian Stimulation

Background:

• Antral follicle count (AFC) is a key indicator of ovarian reserve.
• The optimal number of oocytes to aspirate relative to AFC in assisted reproductive technologies (ART) is debated.
• Understanding this relationship is crucial for maximizing ART cycle efficacy.

Purpose of the Study:

• To investigate whether aspirating more oocytes than the AFC benefits current and future ART cycle outcomes.
• To compare outcomes between groups with an oocyte/AFC index (OAFCI) <1 and ≥1.

Main Methods:

• Retrospective analysis of 399 intracytoplasmic sperm injection (ICSI) and 283 fertility preservation (FP) cycles (2018-2022).
• Patients were categorized by OAFCI (<1 or ≥1).
• Primary outcomes included clinical pregnancy rates (CPR) and live birth rates (LBR); secondary outcomes included oocyte maturity, fertilization, and cryopreservation rates.

Main Results:

• Oocyte maturity was unaffected in ICSI but slightly lower in FP with OAFCI ≥1.
• OAFCI ≥1 was linked to significantly more cryopreserved embryos (ICSI) and vitrified oocytes (FP).
• No significant difference in CPR or LBR was observed between OAFCI groups in fresh cycles.

Conclusions:

• Aspiration of more oocytes than AFC does not negatively affect fresh cycle success rates.
• Higher oocyte yield, particularly when cryopreserved, may contribute to improved cumulative pregnancy rates in subsequent cycles.
• This suggests a potential benefit for future reproductive potential through enhanced cryopreservation.