Wertheimer Avital, Nagar Ran, Oron Galia, Meizner Israel, Fisch Benjamin, Ben-Haroush Avi
Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital Petach Tikva, Israel; and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.
J Ultrasound Med. 2018 Apr;37(4):859-866. doi: 10.1002/jum.14421. Epub 2017 Sep 29.
The use of sonography-based Automated Volume Count (SonoAVC; GE Healthcare, Kretz, Zipf, Austria) leads to substantially lower intraobserver and interobserver variability with a considerable advantage in time gain for both the physician and patient. It offers the possibility of continuous training and standardization of follicular monitoring. Manual and automated follicular measurements during in vitro fertilization (IVF) are reported to be comparable during gonadotropin-releasing hormone (GnRH) agonist treatment. The aim of our study was to evaluate the effect of follicle tracking with 3-dimensional (3D) SonoAVC on treatment outcomes in GnRH antagonist IVF cycles.
A prospective trial included 54 women undergoing their first to fourth GnRH antagonist IVF cycles. Follicle tracking from the initiation of ovarian stimulation until the day of oocyte retrieval and timing of oocyte retrieval was done either by conventional 2-dimensional (2D) sonography or 3D SonoAVC (open-labeled parallel assignment). In both groups, recombinant human chorionic gonadotropin was injected when there were at least 3 leading follicles measuring 17 mm. The primary outcome was the oocyte maturation rate, and secondary outcomes were the fertilization rate and clinical pregnancy rate.
The number of retrieved oocytes, number and rate of mature oocytes, fertilization rate, and clinical pregnancy rate were similar for 2D sonography and 3D SonoAVC. On a multivariate regression analysis, the use of 3D sonography was not a significant independent predictor of mature oocytes or clinical pregnancy rates.
Follicle tracking with 3D sonographic follicular volume measurements does not achieve better fertility outcomes than standard 2D sonography.
使用基于超声的自动容积计数法(SonoAVC;通用电气医疗集团,奥地利齐普夫克雷茨公司)可显著降低观察者内和观察者间的变异性,在时间上为医生和患者带来相当大的优势。它为卵泡监测提供了持续培训和标准化的可能性。据报道,在促性腺激素释放激素(GnRH)激动剂治疗期间,体外受精(IVF)过程中手动和自动卵泡测量结果具有可比性。我们研究的目的是评估三维(3D)SonoAVC卵泡追踪对GnRH拮抗剂IVF周期治疗结局的影响。
一项前瞻性试验纳入了54名接受首次至第四次GnRH拮抗剂IVF周期治疗的女性。从卵巢刺激开始直至取卵日的卵泡追踪以及取卵时间,通过传统二维(2D)超声或3D SonoAVC(开放标签平行分配)进行。在两组中,当至少有3个主导卵泡直径达到17毫米时,注射重组人绒毛膜促性腺激素。主要结局是卵母细胞成熟率,次要结局是受精率和临床妊娠率。
2D超声和3D SonoAVC在回收的卵母细胞数量、成熟卵母细胞数量和比率、受精率以及临床妊娠率方面相似。在多变量回归分析中,使用3D超声并非成熟卵母细胞或临床妊娠率的显著独立预测因素。
与标准2D超声相比,采用3D超声卵泡容积测量进行卵泡追踪并不能获得更好的生育结局。