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Fertility preservation in women with malignancies: the accuracy of antral follicle count collected randomly during the menstrual cycle in predicting the number of oocytes retrieved

  • Fertility Preservation
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Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the capacity of random antral follicle count (AFC), i.e., AFC recorded at any time during the menstrual cycle, to predict the number of retrieved mature oocytes in women with malignancies undergoing random start ovarian hyperstimulation

Methods

A consecutive series of 72 women with malignancies who underwent ovarian hyperstimulation aimed at egg freezing between July 2014 and December 2016 was retrospectively reviewed. A standardized random start protocol was used for all women. AFC and serum AMH were systematically assessed prior to initiating ovarian hyperstimulation. The main outcome was the retrieval of ≥ 10 mature oocytes. The accuracy of random AFC was tested with the c-statistics (area under the ROC curve).

Results

For the whole cohort, the c-statistics for the prediction of ≥ 10 mature oocytes using AFC and serum AMH were similar. Specifically, the areas under the curve were 0.76 (95%CI 0.66–0.87) and 0.82 (95%CI 0.72–0.92), respectively (p = ns). Moreover, when considering the subgroup of women recruited after day 5 of the cycle (proper random start, n = 52), the areas under the curve did not also differ. Specifically, they resulted in 0.77 (95%CI 0.64–0.89) and 0.83 (95%CI 0.72–0.95), respectively (p = ns).

Conclusions

AFC collected at any time during the menstrual cycle can provide valuable information for the counseling of women with malignancies scheduled for oocyte cryopreservation. Its reliability appears to be non-inferior to that of serum AMH.

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Authors and Affiliations

  1. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Francesca Filippi, Alessio Paffoni, Marco Reschini & Edgardo Somigliana

  2. Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Fabio Martinelli & Francesco Raspagliesi

  3. Università degli Studi di Milano, Milan, Italy

    Edgardo Somigliana

  4. Fondazione Ca’ Granda, Ospedale Maggiore Policlinico - Infertility Unit, Via Fanti 6, 20122, Milan, Italy

    Edgardo Somigliana

Authors
  1. Francesca Filippi
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  2. Fabio Martinelli
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  3. Alessio Paffoni
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  4. Marco Reschini
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  5. Francesco Raspagliesi
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  6. Edgardo Somigliana
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Correspondence to Edgardo Somigliana.

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Conflict of interest

Edgardo Somigliana received during the last 3 years grants of research from Ferring and Merck-Serono. All the other authors do not have any financial disclosure to declare.

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Filippi, F., Martinelli, F., Paffoni, A. et al. Fertility preservation in women with malignancies: the accuracy of antral follicle count collected randomly during the menstrual cycle in predicting the number of oocytes retrieved. J Assist Reprod Genet 36, 569–578 (2019). https://doi.org/10.1007/s10815-018-1377-0

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  • DOI: https://doi.org/10.1007/s10815-018-1377-0

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