Predictive Accuracy of Antral Follicle Count (AFC) in the Assessment of Ovarian Reserve by Comparing it with Serum Basal FSH level in Women with Subfertility

Abstract

Objective: This study aimed to assess the predictive accuracy of Antral Follicle Count (AFC) in evaluating ovarian reserve compared to serum basal FSH levels in women with subfertility.

Methodology: A cross-sectional study conducted at the Benazir Bhutto Hospital's Out-patient department of Obstetrics and Gynaecology from October 1, 2019, to March 30, 2020, included 93 women aged 18-48 with subfertility. Exclusions were made for those with a history of ovarian surgery, chemo or radiotherapy, and unwillingness to provide consent. Patient evaluation considered age, subfertility duration, menstrual cycle length, and BMI. Basal serum FSH levels were measured on day 3 of the menstrual cycle, and transvaginal ultrasound was used to determine antral follicle counts.

Results: Among participants, 42.1% were ≤ 30 years old, and 57.9% were > 30 years old. 71% had a BMI ≤ 27, and 29% had a BMI > 27. Cycle lengths of >21 days were observed in 9.7% of patients, while 49.7% had cycle lengths of 21-38 days, and 40% had > 38 days. High FSH levels were found in 64.8% of patients, and 35.2% had low FSH levels. In terms of AFC, 81.4% had low counts, while 18.6% had high counts.

Conclusion: Diminished ovarian reserve (DOR) prediction should consider multiple factors, including age, BMI, menstrual cycle length, and biomarkers such as AFC and basal FSH levels. A comprehensive assessment of these factors is essential for accurate ovarian reserve prediction in subfertile women.