Research On Follicular Output Rate And Ovarian Response In Vitro Fertilization And Embryo Transfer

Objective To evaluate if the follicular output rate (FORT) is an effective parameter forpredicting the ovarian response in IVF-ET, and to define the more suitable FORT threshold.Methods We recruited920IVF-ET patients from Apr.,2008to Dec.,2012. Baseline antralfollicle count (bAFC) and preovulatory follicle count (PFC) were performed, respectively, forcalculating the FORT value. The initial and renewed groups were set according to differentFORT thresholds. The COH and IVF laboratory data between these three groups would beanalyzed.Results (1) The AFC (16.79±0.23vs13.38±3.90vs9.44±3.62, p＜0.001) and bAFC(13.53±0.88vs10.79±0.84vs9.59±0.06, p＜0.001) of the low FORT group weresignificantly higher than the other groups. However, the serum estradiol levels(2817.23±0.59vs2315.34±0.32vs2032.12±0.12, p＜0.001) and the PFC (9.3±0.6vs6.8±0.4vs4.7±0.2, p＜0.001) of the high FORT group on the day of hCG were remarkablyhigher than the other groups.(2) The priority for the high FORT group could also bewitnessed on the following parameters: the number of oocytes retrieved and metaphaseⅡoocytes、fertility rates、merogenesis rates、embryos obtained rates、top-morphology embryorates and pregnancy rates (all p＜0.01). However, the cancellation rates for embryo transfercycle of the high FORT group were dramatically higher than the other groups (p＜0.001).(3)The AFC、bAFC and PFC of the pregnancy group were notably higher (11.40±4.62vs9.75±4.22,7.01±3.06vs5.98±2.54,10.68±3.53vs9.43±3.24, all p=0.02) than thenonpregnancy group.(4) The priority for the pregnancy group could also be noticed on thenumber of oocytes retrieved and metaphaseⅡ oocytes、fertility rates、merogenesis rates、 embryos obtained rates and FORT values (all p＜0.05).(5) The degree of specificity andaccuracy for predicting poor ovarian reaction (POR) of the renewed grouping method weremuch higher than the initial one (24%vs10%,27%vs16%), while the degree of sensitivitywas lower (92%vs70%).Conclusions (1) It was indicated that women with high FORT values could perform moreactively to the exogenous gonadotrophin, according to their antral follicle count and oocyteretrived.(2) There could be better oocyte quality and endometrium receptivity for womenwith high FORT values, on the basis of IVF laboratory data.(3) FORT could be treated as aneffective index for predicting the IVF-ET outcome, since there were much higher FORTvalues for the pregnancy group.(4) The renewed FORT threshold could be taken as thesuitable parameter for POR prediction, according to the much higher degree of sensitivityand accuracy.