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Hum. Reprod. Advance Access published online on April 28, 2005
Human Reproduction, doi:10.1093/humrep/dei048
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received February 14, 2005
Revised March 22, 2005
Accepted April 1, 2005

Article

Predictors of antral follicle count during the reproductive years

J. Kline 1*, A. Kinney 2, A. Kelly 3, M.L. Reuss 4, and B. Levin 5

1 Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, New York, NY 10032, USA, 2Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA and 3Mailman School of Public Health, Columbia University, New York, NY 10032, USA,
2 Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York, NY and Graduate School of Arts and Sciences, Columbia University, New York, NY 10032, USA,
3 Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA and
4 Southwest Women's Sonography, Albuquerque, NM 87109, USA
5 Mailman School of Public Health, Columbia University, New York, NY 10032, USA,

* To whom correspondence should be addressed.
J. Kline, E-mail: jkk3{at}columbia.edu


  Abstract

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.

Keywords: age; epidemiology; FSH; inhibin B; ovarian follicles.
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