Changes in antral follicle count and ovarian volume with age

Yıl 2018, Cilt: 35 Sayı: 3, 57 - 61, 31.10.2019

Aysegul Kaya Arif Kokcu Emel Kurtoglu Tayfun Alper Mehmet Bilge Çetinkaya

Öz

We aimed to ascertain the chronologic
age at which these sonographic measurements begin to show a significant
difference. The study included 100 women (78, aged 19-44 and 22, aged 45-50)
menstruated spontaneously and without thyroid disease, diabetes mellitus,
hyperprolactinaemia, hypogonadotropic hypogonadism or polycystic ovary syndrome
and any gynaecologic surgery. They all underwent sonographic measurement of
total antral follicle (TAF) count and mean ovarian volume (MOV) on the second
or third days of menstrual cycle. Then, the women were assigned to 5 groups: group
1, 19–24 years; group 2, 25–29 years; group 3, 30–37 years; group 4, 38-44
years; and group 5, 45-50 years. There
was a significant association between chronological age and TAF number (r² =
0.328, p < 0.001). No significant difference was noted in TAF number among
the first three groups (² = 0.58, p > 0.05). TAF number was significantly different between groups 3 and 4
(Z: -3.463, p < 0.001), but not between groups 4 and 5 (Z: -1.698, p >
0.05). There was a significant
relationship between chronological age and MOV (r² = 0.149, p < 0.001). MOV
values did not show a significant difference among the first 4 groups
(² = 0.58, p> 0.05; ² = 7.87, p > 0.05 respectively). The MOV of group 5 was significantly different from those of
groups 1, 2, 3, and 4 (Z: -2.75, p < 0.01; Z: -4.351, p < 0.01; Z:
-2.722, p < 0.01; and Z: -2.829, p < 0.01 respectively). In conclusion, the
TAF count decreases significantly beginning at 38 years of age, while MOV
decreases significantly beginning at 45 years of age. Thus, there is no
significant decrease in the ovarian follicular reserve until the age of 38
years, or in the ovarian volume until the age of 45 years. 

Anahtar Kelimeler

Age, Ovarian reserve, Ovarian volume, Total antral follicle

Kaynakça

• Andolf, E., Jorgensen, C., Svalenius, E., Sunden, B. 1987. Ultrasound measurements of the ovarian volume. Acta Obstet. Gynecol. Scand. 66, 387-389.
• Brett, S., Bee, N., Wallace, W.H., Rajkhowa, M., Kelsey, T.W., 2009. Individual ovarian volumes obtained from 2-dimensional and 3-dimensional ultrasound lack precision. Reprod. Biomed. Online. 18, 348-351. DOI:10.1016/s1472-6483(10)60092-2
• Cedars, M.I., Evans, M., 2008. Menopause. In: Gibbs, R.S., Karlan, B.Y., Haney, A.F., Nygaard, I.E., editors, Danforth's Obstetrics and Gynecology. Philadelphia: Lippincott Williams & Wilkins; pp. 725-742.
• Christensen, J.T., Boldsen, J., Westergaard, J.G., 1997. Ovarian volume in gynecologically healthy women using no contraception, or using IUD or oral contraception. Acta Obstet, Gynecol. Scand. 76, 784-789. DOI:10.3109/00016349709024348
• Coccia, M.E., Rizzello, F., 2008. Ovarian reserve. Ann. N. Y. Acad. Sci. 127, 27-30. DOI:10.1196/annals.1434.011
• Domingues, T.S., Rocha, A.M., Serafini, P.C., 2010. Tests for ovarian reserve: Reliability and utility. Curr. Opin. Obstet. Gynecol. 22, 271-276. DOI:10.1097/GCO.0b013e32833b4f5c
• Faddy, M.J., Gosden, R.G., Gougeon, A., Richardson, S.J., Nelson, J.F., 1992. Accelerated disappearance of ovarian follicles in midlife — implications for forecasting menopause. Hum. Reprod. 7, 1342-1346. DOI:10.1093/oxfordjournals.humrep.a137570
• Haadsma, M.L., Bukman, A., Groen, H., Roeloffzen, E.M., Groenewoud, E.R., Heineman, M.J., Hoek, A., 2007. The number of small antral follicles (2-6 mm) determines the outcome of endocrine ovarian reserve tests in a subfertile population. Hum. Reprod. 22, 1925-1931. DOI:10.1093/humrep/dem081
• Hansen, K.R., Hodnett, G.M., Knowlton, N., Craig, L.B., 2011. Correlation of ovarian reserve tests with histologically determined primordial follicle number. Fertil. Steril. 95, 170-175. DOI:10.1016/j.fertnstert.2010.04.006
• Hsu, A., Arny, M., Knee, A.B., Bell, C., Cook, E., Novak, A.L., Grow, D.R. 2011. Antral follicle count in clinical practice: Analyzing clinical relevance. Fertil. Steril. 95, 474-479. DOI:10.1016/j.fertnstert.2010.03.023
• Jayaprakasan, K., Hilwah, N., Kendall, N.R., Hopkisson, J.F., Campbell, B.K., Johnson, I.R., Raine Fenning, N.J., 2007. Does 3D ultrasound offer any advantage in the pretreatment assessment of ovarian reserve and prediction of outcome after assisted reproduction treatment? Hum. Reprod. 22:1932-41. DOI:10.1093/humrep/dem104
• Johnson, N.P., Bagrie, E.M., Coomarasamy, A., Bhattacharya, S., Shelling, A.N., Jessop, S., Farquhar, C.,
• Khan, K.S., 2006. Ovarian reserve tests for predicting fertility outcomes for assisted reproductive technology: the International Systematic Collaboration of Ovarian Reserve Evaluation protocol for a systematic review of ovarian reserve test accuracy. BJOG. 113, 1472-14780. DOI:10.1111/j.1471-0528.2006.01068.x
• Kline, J., Kinney, A., Kelly, A., Reuss, M.L., Levin, B., 2005. Predictors of antral follicle count during the reproductive years. Hum. Reprod. 20:2179-89. DOI:10.1093/humrep/dei048
• Kwee, J., Elting, M.E., Schats, R., McDonnell, J., Lambalk, C.B., 2007. Ovarian volume and antral follicle count for the prediction of low and hyper responders with in vitro fertilization. Reprod. Biol. Endocrinol. 5,9. DOI:10.1186/1477-7827-5-9
• Lass, A., Silye, R., Abrams, D.C., Krausz, T., Hovatta, O., Margara, R., Winston, R. M., 1997. Follicular density in ovarian biopsy of infertile women: A novel method to assess ovarian reserve. Hum. Reprod. 12,1028-1031. DOI:10.1093/humrep/12.5.1028
• Lutchman Singh, K., Muttukrishna, S., Stein, R.C., McGarrigle, H.H., Patel, A., Parikh, B., Groome, N.P., Davies, M.C., Chatterjee, R., 2007. Predictors of ovarian reserve in young women with breast cancer. Br. J. Cancer. 96, 1808-1816. DOI:10.1038/sj.bjc.6603814
• Merz, E., Miri-Tesanic, D., Bahlmann, F., Weber, G., Wellek, S., 1996. Sonographic size of uterus and ovaries in pre- and postmenopausal women. Ultrasound. Obstet. Gynecol. 7, 38-42. DOI:10.1046/j.1469-0705.1996.07010038.x
• Oppermann, K., Fuchs, S.C., Spritzer, P.M., 2003. Ovarian volume in pre- and perimenopausal women: A population-based study. Menopause. 10, 209-213. PMID:12792291
• Pavlik, E.J., DePriest, P.D., Gallion, H.H., Ueland, F.R., Reedy, M.B., Kryscio, R.J., Van Nagell, J.R. 2000. Ovarian volume related to age. Gynecol Oncol 77, 410-412. DOI:10.1006/gyno.2000.5783
• Scheffer GJ, Broekmans FJ, Looman CW, Blankenstein M, Fauser BC, teJong FH, teVelde, E.R., 2003. The number of antral follicles in normal women with proven fertility is the best reflection of reproductive age. Hum. Reprod. 18, 700–706. DOI:10.1093/humrep/deg135
• Sharara, F.I., McClamrock, H.D., 2001. Use of microdose GnRH agonist protocol in women with low ovarian volumes undergoing IVF. Hum. Reprod. 16, 500-503. DOI:10.1093/humrep/16.3.500
• Sills, E.S., Alper, M.M., Walsh, A.P., 2009. Ovarian reserve screening in infertility: practical applications and theoretical directions for research. Eur. J. Obstet. Gynecol. Reprod. Biol. 146, 30-36. DOI:10.1016/j.ejogrb.2009.05.008
• Younis, J.S., Jadaon, J., Izhai, I., Haddad, S., Radin, O., Bar-Ami, S., Ben-Ami, M., 2010. A simple multivariate score could predict ovarian reserve, as well as pregnancy rate, in infertile women. Fertil. Steril. 94, 655-661. DOI: 10.1016/j.fertnstert.2009.03.036