Hum. Reprod. Advance Access originally published online on April 28, 2005
Human Reproduction 2005 20(8):2179-2189; doi:10.1093/humrep/dei048
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Predictors of antral follicle count during the reproductive years
1 Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, New York, NY 10032, 2 Gertrude H. Sergievsky Center and 3 Mailman School of Public Health, Columbia University, 4 Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York, NY and Graduate School of Arts and Sciences, Columbia University, 5 Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032 and 6 Southwest Women's Sonography, Albuquerque, NM 87109, USA
7 To whom correspondence should be addressed at: Psychiatric Institute, Epidemiology, 722 West 168th Street, Room 1607, New York, NY 10032. Email: jkk3{at}columbia.edu
BACKGROUND: We sought to identify indicators of antral follicle count which would be serviceable to clinicians seeking to estimate the number of ovarian follicles without relying on sonographic counts. METHODS: We examined the relations of chronological age and four potential indicators of ovarian age—ovarian volume, FSH, dimeric inhibin B and estradiol—to antral follicle count in 176 recently pregnant women. We identified the regression models which best predict low antral follicle count (
10 follicles). RESULTS: Chronological age, ovarian volume, FSH and inhibin B were each significantly associated with antral follicle count. Fifty-three (30.1%) women had 10 antral follicles. In the total sample, at the cutpoint corresponding to 80% sensitivity, the positive predictive value for a regression model with all four variables was 60%. All regression models performed less well in women <35 years (13.9% with low count) than in women 
35 years (52.0% with low count). In older women, the positive predictive value for the model with all four variables was 79%, compared with 60% for a model with chronological age alone. CONCLUSIONS: Our models provide a basis for advising women aged 35 years who are either trying to conceive or wish to learn whether they may postpone childbearing.
Key words: age/epidemiology/FSH/inhibin B/ovarian follicles
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