Use of Follicular Output Rate to Predict Intracytoplasmic
Sperm Injection Outcome

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Abstract

Background

The measurement of follicular output rate (FORT) has been proposed as a good indicator for evaluating follicular response to the exogenous recombinant folliclestimulating hormone (rFSH). This places FORT as a promising qualitative marker for ovarian function. The objective of the study was to determine FORT as a predictor of oocyte competence, embryo quality and clinical pregnancy after intracytoplasmic sperm injection (ICSI).

Materials and Methods

This prospective study was carried out on a group of infer- tile females (n=282) at Islamabad Clinic Serving Infertile Couples, Islamabad, Pakistan, from June 2010 till August 2013. Downregulated females were stimulated in injection gonadotropins and on ovulation induction day, pre-ovulatory follicle count (PFC) was determined using transvaginal ultrasound scan (TVUS), and FORT was determined as a ratio of PFC to antral follicle count (AFC)×100. Group I consisted of females with a negative pregnancy test, while group II had a positive pregnancy test that was confirmed with the appearance of fetal cardiac activity. Linear regression analyses of categorical variables of clinical pregnancy along with other independent variables, including FORT, were performed using SPSS version 15.0.

Results

Pregnancy occurred in 101/282 women who were tested, recording a clinical pregnancy rate of about 35.8%. FORT values were higher in group II as compared to group I females (P=0.0001). In multiple regression analysis, 97.7, 87.1, 78.2, and 83.4% variations were explained based on the number of retrieved oocytes per patients, number of metaphase II oocytes retrieved, number of fertilized oocytes, and number of cleaved embryos, respectively, indicating FORT as an independent predictor.

Conclusion

FORT is a predictor of oocyte competence in terms of a number of retrieved, mature and fertilized oocytes. It also gives information about the number of cleaved embryos and clinical pregnancy rate.

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Most cited references 19

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The role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count.

S L Broer, F Broekmans, Ben Mol … (2009)

To assess the value of antimullerian hormone (AMH) as a test to predict poor ovarian response and pregnancy occurrence after IVF and to compare it with the performance of the antral follicle count (AFC). A systematic review of existing literature and a meta-analysis were carried out. After a comprehensive search, studies were included if 2 x 2 tables for outcomes poor response and pregnancy in IVF patients in relation to AMH or AFC could be constructed. Academic referral center for tertiary care. Cases indicated for IVF. None. Poor response and nonpregnancy after IVF. A total of 13 studies were found reporting on AMH and 17 on AFC. Because of heterogeneity among studies, calculation of a summary point estimate for sensitivity and specificity was not possible. However, for both tests summary receiver operating characteristic curves for the outcome measures poor response and nonpregnancy could be estimated and compared. The curves for the prediction of poor response indicated no significant difference between the performances of AMH and AFC. For the prediction of nonpregnancy, poor performance for both AMH and AFC was found. In this meta-analysis it was shown that AMH has at least the same level of accuracy and clinical value for the prediction of poor response and nonpregnancy as AFC.

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Antral follicle responsiveness to follicle-stimulating hormone administration assessed by the Follicular Output RaTe (FORT) may predict in vitro fertilization-embryo transfer outcome.

V Gallot, Kathryn da Silva, R Fanchin … (2012)

Looking for a qualitative marker of ovarian function, we aimed to verify whether responsiveness of antral follicles to FSH administration, as reflected by the Follicular Output RaTe (FORT), is related to their reproductive competence. We studied 322 IVF-ET candidates aged 25-43 years who underwent controlled ovarian hyperstimulation with similar initial FSH doses. Antral follicle (3-8 mm) count (AFC) and pre-ovulatory follicle (16-22 mm) count (PFC) were performed, respectively, at the achievement of pituitary suppression (before FSH treatment) and on the day of hCG administration. The FORT was calculated by PFC × 100/AFC. FORT groups were set according to tercile values: low ( 58%; n= 97). The average FORT was 50.6% (range, 16.7-100.0%). Clinical pregnancy rates per oocyte retrieval increased progressively from the low to the high FORT groups (33.3, 51.2 and 55.7%, respectively, P< 0.003) and such a relationship assessed by logistic regression was independent of the confounding covariates, women's ages, AFC and PFC. The observed relationship between IVF-ET outcome and the percentage of antral follicles that effectively respond to FSH administration reaching pre-ovulatory maturation suggests that FORT may be a qualitative reflector of ovarian follicular competence. Further studies with broader inclusion criteria and more personalized protocols are needed to validate these results.

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Serum anti-Müllerian hormone levels are negatively related to Follicular Output RaTe (FORT) in normo-cycling women undergoing controlled ovarian hyperstimulation.

V Genro, M Grynberg, J B Scheffer … (2011)

Since in rodents anti-Müllerian hormone (AMH) has been shown to inhibit antral follicle responsiveness to FSH, we aimed at verifying whether a relationship exists between serum AMH levels and antral follicle responsiveness to exogenous FSH in normo-cycling women.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Fertil Steril

Journal ID (iso-abbrev): Int J Fertil Steril

Journal ID (publisher-id): Royan Institute

Title: International Journal of Fertility & Sterility

Publisher: Royan Institute

ISSN (Print): 2008-076X

ISSN (Electronic): 2008-0778

Publication date (Print): Jul-Sep 2016

Publication date (Electronic): 1 June 2016

Volume: 10

Issue: 2

Pages: 169-174

Affiliations

[1 ]Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan

[2 ]Department of Obstetrics and Gynecology, United Medical and Dental College, Karachi, Pakistan

[3 ]Department of Biochemistry, Faculty of Medicine, Rabigh, King Abdul Aziz University, Jeddah, Saudi Arabia

[4 ]House Officer Civil Hospital, Karachi, Pakistan

[5 ]House Officer, Services Hospital, Lahore, Pakistan

Author notes

[*Corresponding Address: ]P.O. Box3500Department of Biological and Biomedical SciencesThe Aga Khan University Stadium RoadKarachi -74800Pakistan Email: drrehana7@ 123456gmail.com

Article

Other ID: Int-J-Fertil-Steril-10-169

DOI: 10.22074/ijfs.2016.4906

PMC ID: 4948068

PubMed ID: 27441049

SO-VID: c51cba67-1b0d-4913-804a-1f90206e4d14

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 12 July 2015

Date accepted : 2 November 2015

Custom metadata

Citation Rehman R, Mustafa R, Baig M, Arif S, Hashmi MF. Use of follicular output rate to predict intracytoplasmic sperm injection outcome. Int J Fertil Steril. 2016; 10(2): 169-174.

Keywords: intracytoplasmic sperm injection,assisted reproductive techniques,infer- tility,ovarian follicles,follicular output rate

Data availability:

Keywords: intracytoplasmic sperm injection, assisted reproductive techniques, infer- tility, ovarian follicles, follicular output rate

Use of Follicular Output Rate to Predict Intracytoplasmic Sperm Injection Outcome

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Abstract

Background

Materials and Methods

Results

Conclusion

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Most cited references 19

The role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count.

Antral follicle responsiveness to follicle-stimulating hormone administration assessed by the Follicular Output RaTe (FORT) may predict in vitro fertilization-embryo transfer outcome.

Serum anti-Müllerian hormone levels are negatively related to Follicular Output RaTe (FORT) in normo-cycling women undergoing controlled ovarian hyperstimulation.

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