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[Basic ovarian status and follicular response to superovulation stimulation in an in vitro fertilization and embryo
Objective:
To study the relationship between patient age, cycle day 3 basal ovarian status, serum estradiol (E2) level and the ovarian response in an in vitro fertilization and embryo transfer (IVF-ET) program.
Method:
102 cases and 102 cycles of IVF-ET patients with regular menstrual period and normal cycle day 3 basal follicular-stimulating hormone (FSH < 20 IU/L) level were studied. The same superovulation regimen was employed. The ovarian response was classified as low when follicle number (diameter > 10 mm) was fewer than 3 on the day of hCG injection, moderate when the number was 3-14, and high when follicle number exceeded 14.
Results:
(1) Patients older than 35 years tended to be low responders; women younger than 30 years usually responded well with production of more than 15 follicles. (2) The number of cycle day 3 follicles was positively correlated with the number after stimulation with gonadotropin. When total basal follicle number in both ovary exceeded 20, ovarian an hyperstimulation syndrome should be watched out. (3) On cycle day 3 the diameter of the largest follicle was negatively correlated with the ovarian response. In low responders the diameter of the largest follicle was usually larger than 4 mm. (4) Despite of the different size and number of the cycle day 3 follicles the serum E2 level was quite similar.
Conclusion:
Age and basal ovarian status including the number and size of the antral follicles are valuable factors to be considered in the prediction of ovarian response to the same gonadotrophic stimulation protocol.