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Human Reproduction, Vol. 16, No. 9, 2030-2031, September 2001
© 2001 European Society of Human Reproduction and Embryology

Letters to the editor

Women with small ovarian volume and microdose GnRH agonist protocol

Fady I. Sharara

Virginia Center for Reproductive Medicine, 8233 Old Courthouse Road, Suite 150, Vienna, VA 22182, USA, E-mail: fsharara{at}aol.com

Dear Sir.

I would like to thank Dr Hammadieh and colleagues for their correspondence regarding our recent manuscript (Sharara and McClamrock, 2001Go). I totally agree that the best study would be to perform a prospective, randomized, controlled trial using a standard stimulation protocol in women with small ovarian volume. Only then can we put this issue to rest. That said, I still firmly believe that these women will show a sub-optimal response to standardized protocols employing a long luteal gonadotrophin-releasing hormone (GnRH) agonist protocol. Whether these women do better using GnRH antagonist based protocols remains to be seen.

The issue of inter- and intra-observer variation in ovarian volume measurements has been previously addressed (Higgins et al.1990Go; Syrop et al.1995Go; Sharara and McClamrock, 1999Go), and is around 4–7%. Again, it would be ideal if the same sonographer performed all the ovarian volume measurements, however this may prove logistically difficult in busy IVF centres.

References

Higgins, R.V., Van Nagell, J.R., Woods, C.H. et al. (1990) Interobserver variation in ovarian measurements using transvaginal sonography. Gynecol. Oncol., 39, 69–71.[ISI][Medline]

Sharara, F.I. and McClamrock, H.D. (1999) The effect of ageing on ovarian volume measurements in infertile women. Obstet. Gynecol., 94, 57–60.[Abstract/Free Full Text]

Sharara, F.I. and McClamrock, H.D. (2001) Use of microdose GnRH agonist protocol in women with low ovarian volumes undergoing IVF. Hum. Reprod., 16, 500–503.[Abstract/Free Full Text]

Syrop, C.H., Willhoite, A. and Van Voorhis, B.J. (1995) Ovarian volume: a novel predictor for assisted reproduction. Fertil. Steril., 64, 1167–1171.[ISI][Medline]


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This Article
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