Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: Results of a worldwide web-based survey

Purpose: The purpose of the present study was to identify trends in the therapeutic approaches used to measure antral follicle count (AFC) in patients undergoing in vitro fertilization (IVF) treatment worldwide. Methods: A retrospective evaluation utilizing the results of a web-based survey, IVF-Worldwide (www.IVF-Worldwide. com), was performed. Results: Responses from796 centers representing 593,200 cycles were evaluated. The majority of respondents (71.2%) considered antral follicle count as amandatory part of their practicewithmost (69.0 %) measuring AFC in the follicular phase. Most respondents (89.7 %) reported that they would modify the IVF stimulation protocol based on the AFC. There was considerable variation regarding a limit for the number of antral follicles required to initiate an IVF cycle with 46.1%designating three antral follicles as their limit, 39.9 % selecting either four or five follicles as their limit, and 14.0%reporting a higher cutoff criteria.With respect to antral follicle size, 61.5 % included follicles ranging between 2 and 10mm in the AFC. When asked to identify the best predictor of ovarian hyper-response during IVF cycles, AFC was selected most frequently (49.4 %), followed by anti-Mullerian hormone level (42.7 %). Age was selected as the best predictor of ongoing pregnancy rate in 81.7 % of respondents. Conclusions: While a large proportion of respondents utilized AFC as part of their daily practice and modified IVF protocol based on the measurement, the majority did not consider AFC as the best predictor of ongoing pregnancy rate.