Mean ovarian diameter (MOD) as a predictor of poor ovarian response

PURPOSE

To determine the predictive value of mean ovarian diameter of ovarian response in controlled ovarian hyperstimulation (COH), in outcome with normal FSH level in early follicular phase of menstrual cycle.

METHODS

A prospective study established the prognostic value of the mean ovarian diameter of total 57 cases, including 17 patients undergoing IVF treatment with poor ovarian response and 40 patients (control group) with adequate ovarian response.

RESULTS

The mean ovarian diameter (MOD) of patients in the cancelled group was significantly lower (19.23 +/- 2.78) than in a comparable control group (24.67 +/- 3.38) [p < 0.001]. The mean ovarian diameter was a good predictor of poor ovarian response-area under receiver operating characteristic curve-ROCAUC = 0.88. The best criterion value discriminating between cancelled cycle and punctured was < or = 20.6 mm.

CONCLUSIONS

Our data demonstrate that the mean ovarian diameter provides good prognostic information in outcomes with poor ovarian response during controlled ovarian hyperstimulation in IVF. The test is easy to perform and it is a good informative resource.

Prognostic value of some ovarian reserve tests in poor responders

BACKGROUND

The objective of this study was to determine the prognostic value of the basal estradiol (E2) and inhibin-B levels, the antral follicle count (AFC), and the clomiphene citrate challenge test (CCCT) of ovarian response in controlled ovarian hyperstimulation (COH), in an outcome with normal follicle-stimulating hormone (FSH) concentration in the early follicular phase of the menstrual cycle.

METHODS

Fifty-two patients undergoing IVF treatment were included in the study. Blood samples were collected for assessment of basal E2, FSH, and inhibin-B levels. Transvaginal ultrasound of an unstimulated cycle was performed to determine the mean antral follicle count (AFC). Serum FSH concentration was measured again on day 10 for CCCT performance.

RESULTS

The mean values of women's age, and basal and day 10 FSH levels were significantly higher in cancelled cycles than in the control group, whereas basal inhibin-B and AFC were significantly higher in the latter. The mean basal E2 concentration was similar in both groups. The results from the logistic regression analysis show that CCCT (cut-off point FSH > 12.5 mIU/ml; AUCROC = 0.90) was a better single predictor of poor ovarian response than AFC (AUCROC = 0.85) and inhibin-B (AUCROC = 0.79) with a correct prediction for CCCT (86.5%), antral follicle count (84.6%), and for inhibin-B (82.7%).

CONCLUSIONS

In women with normal basal FSH level, the determination of E2 has no prognostic value for the outcome of poor responders. However, CCCT, AFC, and inhibin-B tests, when applied separately, produce good prognostic values. CCCT is the best single predictor of poor ovarian response, followed by antral follicle count and basal inhibin-B values. In spite of that, CCCT does not add significantly to the simpler AFC ultrasound test in the prediction of poor ovarian response.

Bronchial dysplasia induced by radiation in miners exposed to 222Rn progeny

OBJECTIVES

To investigate whether sputum cytology can be used to monitor epithelial cell changes in groups at high risk of lung cancer from exposure to radiation.

METHODS

Dysplasia of bronchial cells was investigated by means of sputum cytology in a group of 434 underground miners. 100 of them were not exposed, and 334 were exposed to 222Rn progeny at cumulative exposures < 450 working level months.

RESULTS

The frequency of dysplasia in the exposed group was significantly higher than that in the not exposed group (P < 0.0001), and an exposure-response relation was found. This relation was different for smokers and non-smokers.

CONCLUSIONS

Possibly the frequencies of dysplasia could be used to assess past exposures of groups of miners. This approach could be applied to cases where data on radiation monitoring are not available or are very scarce.