Automated measurement of follicle volume for the determination of trigger day in poor responder IVF patients

Abstract

Objective: To identify a cutoff value for volume using Sono-automatic volume calculation (Sono-AVC) that could be used to determine the appropriate time of human chorionic gonadotropin (hCG) during COH in antagonist cycles of low ovarian response in vitro fertilization (IVF) patients. Material and Methods: Sixty-four IVF cases first underwent two-dimensional ultrasound. Subsequently, the follicles were analyzed via Sono-AVC. Using receiver operating characteristic (ROC) analysis, a cutoff value was identified for volume, to be used as the hCG criterion on the day of hCG measurement. A total of 544 follicles from 64 patients were screened by Sono-AVC and sorted descendingly. In all of the patients, the follicles in both ovaries had been visualized; only follicles identified manually as being larger than 10 mm and those measured by Sono-AVC to be over 0.4 cc in volume were screened and sorted. Results: ROC analysis was done using the number of mature oocytes, and an hCG volume of 1.06 cc or greater on the day of measurement was identified as a cutoff value with a sensitivity of 91% for estimating maturation. Conclusion: Using the Sono-AVC method to determine hCG timing in cases with a low ovarian reserve and/or those who are poor responders might enhance the efficacy and reliability of treatment.