Prospective evaluation of automated follicle monitoring in 58 in vitro fertilization cycles: follicular volume as a new indicator of oocyte maturity.

OBJECTIVES

To assess the practical use of SonoAVC in an IVF program, and to establish new criteria for hCG administration based on follicular volume.

DESIGN

Prospective clinical study.

SETTING

Private IVF Center.

PATIENT(S): Fifty-eight women with infertility undergoing IVF.

INTERVENTION(S): Two dimensional (2D) and three dimensional (3D) scanning on the day of hCG administration.

MAIN OUTCOME MEASURE(S): Image quality, mean follicular diameter obtained by 2D and 3D sonography, follicular volume, number of oocytes retrieved, number of mature oocytes, time needed for each examination.

RESULT(S): Approximately 60% of the patients included in this study had good image quality and could be monitored by 3D scans with subsequent application of the SonoAVC software. When image quality is good, measurements obtained by the automated mode are comparable to those obtained manually in 62% of cases. Automated monitoring is significantly quicker than conventional manual monitoring. Follicles with a measured volume >/=0.6 cc on the day of hCG administration are associated with the finding of mature oocytes at the time of egg retrieval.

CONCLUSION(S): SonoAVC allows reliable evaluation of stimulated ovaries, and may help us establish new criteria for timing hCG administration based on follicular volume estimation rather than follicular size. Software improvements are needed to improve universal patient use.