Hansen Karl R, Morris Jamie L, Thyer Angela C, Soules Michael R
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington Medical Center, Seattle, Washington 98105, USA.
Fertil Steril. 2003 Sep;80(3):577-83. doi: 10.1016/s0015-0282(03)00741-6.
To determine the extent of intercycle and interobserver variability in antral follicle (AF) count and their impact on stimulation quality in IVF.
Prospective evaluation of the impact on AF count of GnRH agonist down-regulation and interobserver variability. Retrospective evaluation of intercycle variability in AF count.
University ART clinic.
PATIENT(S): Twenty subjects were used to evaluate the effect of GnRH agonist down-regulation upon AF count; six of whom were used to evaluate interobserver variability. Fifty patients experiencing two or three cycles of IVF within a 1-year interval.
INTERVENTION(S): Transvaginal ultrasound exams before and after down-regulation with a GnRH agonist. Videotaped day-3 transvaginal ultrasound exams.
MAIN OUTCOME MEASURE(S): [1] Intercycle and interobserver variability in antral follicle count. [2] Oocytes retrieved, peak estradiol, gonadotropin dose, duration of stimulation and cancellation rates.
RESULT(S): There is moderate intercycle and interobserver variability in AF counts. GnRH agonist down-regulation does not significantly change AF count. In infertility patients undergoing IVF, paired analysis between the low- and high-AF count cycles did not show a difference in quality of stimulation or cycle cancellation rates.
Within an individual patient, higher AF count in a given cycle was not predictive of better stimulation compared with the case of a lower count cycle.
确定窦卵泡（AF）计数的周期间和观察者间变异性程度及其对体外受精（IVF）刺激质量的影响。
对促性腺激素释放激素（GnRH）激动剂降调节对AF计数的影响及观察者间变异性进行前瞻性评估。对AF计数的周期间变异性进行回顾性评估。
大学辅助生殖诊所。
20名受试者用于评估GnRH激动剂降调节对AF计数的影响；其中6名用于评估观察者间变异性。50名患者在1年间隔内经历了两到三个IVF周期。
使用GnRH激动剂降调节前后进行经阴道超声检查。对第3天经阴道超声检查进行录像。
[1]窦卵泡计数的周期间和观察者间变异性。[2]获卵数、雌二醇峰值、促性腺激素剂量、刺激持续时间和取消率。
AF计数存在中度的周期间和观察者间变异性。GnRH激动剂降调节不会显著改变AF计数。在接受IVF的不孕症患者中，低AF计数周期和高AF计数周期之间的配对分析未显示刺激质量或周期取消率存在差异。
在个体患者中，与低计数周期相比，给定周期中较高的AF计数并不能预测更好的刺激效果。
