Bozdag Gurkan, Calis Pinar, Zengin Dila, Tanacan Atakan, Karahan Sevilay
Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2016 Nov;206:120-124. doi: 10.1016/j.ejogrb.2016.09.013. Epub 2016 Sep 20.
To construct antral follicle count (AFC) nomogram of general population for every age and to compare our data with previous studies to assess whether available AFC nomograms present any geographical inconsistency.
A prospective cross-sectional study was conducted to document AFC nomogram among women in 20-50 years with regular menstrual bleeding. Patients admitted with hirsutism, menstrual irregularity, diagnosis of current/history of endometrioma and hormonal drug use within the last 6 months were excluded. For the final analysis, a total of 381 eligible women were recruited in which all scanning was performed in the early follicular phase. The 25th, 50th and 75th percentiles were compared with previous nomogram.
The mean decrease of AFC in each year was 0.41. Among the age groups, there were no statistical significance between 20-24, 25-29 and 30-34, whereas decline in AFC was obvious after 35 years and beyond. The figures comparing our data and previous studies depicted similar steady decline at 25th, 50th and 75th percentiles.
The current age related nomogram presented a steady decline in AFC that became significant after 35 years in otherwise healthy women with regular menstrual bleeding. Those percentiles might be used as a reference guide to point out the current status of ovarian reserve for a given woman. Additionally, producing nomogram might enforce using percentiles instead of constant thresholds to define various medical conditions such as polycystic ovarian morphology or diminished ovarian reserve. However, longitudinal data with larger sample size are still needed for the validation of those percentiles.
构建各年龄段普通人群的窦卵泡计数（AFC）列线图，并将我们的数据与以往研究进行比较，以评估现有的AFC列线图是否存在地域差异。
对20至50岁月经出血规律的女性进行前瞻性横断面研究，以记录AFC列线图。排除患有多毛症、月经不规律、目前诊断为子宫内膜瘤或有子宫内膜瘤病史以及在过去6个月内使用激素药物的患者。最终分析共纳入381名符合条件的女性，所有扫描均在卵泡早期进行。将第25、50和75百分位数与以往的列线图进行比较。
AFC每年平均下降0.41。在各年龄组中，20至24岁、25至29岁和30至34岁之间无统计学差异，而35岁及以后AFC的下降明显。比较我们的数据与以往研究的数据发现，在第25、50和75百分位数处呈现出相似的稳定下降趋势。
当前的年龄相关列线图显示，在月经出血规律的健康女性中，AFC呈稳定下降趋势，35岁后变得显著。这些百分位数可作为参考指南，指出特定女性的卵巢储备现状。此外，制作列线图可能会促使使用百分位数而非固定阈值来定义各种医学状况，如多囊卵巢形态或卵巢储备功能减退。然而，仍需要更大样本量的纵向数据来验证这些百分位数。
