A prospective assessment of the predictive value of basal antral follicles in in vitro fertilization cycles

Abstract Objective To determine the predictive value and define threshold values for basal antral follicle count in patients undergoing IVF. Design Prospective cohort analysis. Setting Tertiary care center. Patient(s) Two hundred eighty-nine patients. Intervention(s) Transvaginal ultrasonography before starting gonadotropin administration. Main outcome measure(s) Number of oocytes retrieved, basal hormone levels, and cycle outcomes. Result(s) Pregnant patients had significantly more antral follicles (13.8 ± 7.5 vs. 12.4 ± 10.0). Patients in whom cycles were canceled had significantly fewer antral follicles (7.6 ± 4.8 vs. 13.7 ± 8.8). Antral follicle count significantly correlated with most prestimulation and poststimulation IVF variables. Threshold analysis demonstrated a lower pregnancy rate (23.5% vs. 57.6%) and a higher cancellation rate (41% vs. 6.4%) associated with having four or fewer antral follicles. Conclusion(s) The basal antral follicle count identified patients who responded poorly to IVF stimulation. Having four or fewer antral follicles was associated with a high cancellation rate (41%) and, in patients without a cancelled cycle, a low pregnancy rate (23%). However, no antral follicle count absolutely predicted pregnancy or cycle cancellation.