<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>
<bold>Aim:</bold> To compare the rate of ovarian hyperstimulation syndrome in women with and without polycystic ovarian syndrome, and to determine the cut-off for the antral follicle count and the anti-Müllerian hormone level predictive of ovarian hyperstimulation syndrome in both groups. <bold>Methods:</bold> This was a prospective cohort study conducted in women aged 20–35 years who were undergoing controlled ovarian stimulation. The women were divided into those with polycystic ovarian syndrome and the controls on the basis of the Rotterdam criteria. The outcome of stimulation was recorded, and the ovarian response markers were compared in both groups. <bold>Results:</bold> Among 689 women included in the study, 276 (40.1%) had polycystic ovarian syndrome, and 476 (59.9%) were used as the controls. Ovarian hyperstimulation syndrome occurred in 19.6% of the cases, and in 7.7% of the controls (<italic>p</italic> &lt;0.001). The conception rate was greater in the group of cases (52.5% vs. 16.5%, <italic>p</italic> = 0.001). Among the cases, the sensitivity and specificity for the prediction of hyper-response were 94.4% and 97.3% for AFC, and 92.6% and 93.7% for the anti-Müllerian hormone, at the cut-off values of ≥18 and ≥6.425 ng/ml, respectively. Among the controls, the sensitivity and specificity for the prediction of hyper-response were 93.8% and 97.1% for the antral follicle count, and 93.6% and 94.5% for the anti-Müllerian hormone, at the cut-off values of ≥10 and ≥3.95 ng/ml, respectively. <bold>Conclusion:</bold> Group-specific values should be used to identify and counsel women undergoing controlled ovarian stimulation. In light of available evidence, gynaecologists should be trained to perform ultrasound evaluation, determine the antral follicle count of their patients, and offer them appropriate counselling.</p>
</abstract>

Aim: To compare the rate of ovarian hyperstimulation syndrome in women with and without polycystic ovarian syndrome, and to determine the cut-off for the antral follicle count and the anti-Müllerian hormone level predictive of ovarian hyperstimulation syndrome in both groups. Methods: This was a prospective cohort study conducted in women aged 20–35 years who were undergoing controlled ovarian stimulation. The women were divided into those with polycystic ovarian syndrome and the controls on the basis of the Rotterdam criteria. The outcome of stimulation was recorded, and the ovarian response markers were compared in both groups. Results: Among 689 women included in the study, 276 (40.1%) had polycystic ovarian syndrome, and 476 (59.9%) were used as the controls. Ovarian hyperstimulation syndrome occurred in 19.6% of the cases, and in 7.7% of the controls (p <0.001). The conception rate was greater in the group of cases (52.5% vs. 16.5%, p = 0.001). Among the cases, the sensitivity and specificity for the prediction of hyper-response were 94.4% and 97.3% for AFC, and 92.6% and 93.7% for the anti-Müllerian hormone, at the cut-off values of ≥18 and ≥6.425 ng/ml, respectively. Among the controls, the sensitivity and specificity for the prediction of hyper-response were 93.8% and 97.1% for the antral follicle count, and 93.6% and 94.5% for the anti-Müllerian hormone, at the cut-off values of ≥10 and ≥3.95 ng/ml, respectively. Conclusion: Group-specific values should be used to identify and counsel women undergoing controlled ovarian stimulation. In light of available evidence, gynaecologists should be trained to perform ultrasound evaluation, determine the antral follicle count of their patients, and offer them appropriate counselling.

Antral follicle count and anti-Müllerian hormone level as predictors of ovarian hyperstimulation syndrome in women with polycystic ovarian syndrome undergoing controlled ovarian stimulation

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Aim: To compare the rate of ovarian hyperstimulation syndrome in women with and without polycystic ovarian syndrome, and to determine the cut-off for the...

Characteristics	Mean ± SD or count (%)
Age (years)	31.32 ± 3.82
Height (m)	1.57 ± 0.04
Weight (kg)	55.66 ± 3.45
BMI (kg/m²)	22.64 ± 1.71
Duration of fertility (years)	3.19 ± 0.93
Type of infertility
Primary	591 (85.8%)
Secondary	98 (14.2%)
Group
PCO	276 (40.1%)
Control	413 (59.9%)
Pregnancy
Yes	213 (30.1%)
No	476 (69.1%)
OHSS
Yes	86 (12.5%)
No	603 (87.5%)

AFC	CUT-OFF	AUC	95 (CI)	Sensitivity	Specificity
PCO	18	0.969	(0.939-0.992)	94.4%	97.3%
Control	10	0.972	(0.975-0.997)	93.8%	97.1%
AMH
PCO	6.425 ng/ml	0.972	(0.946-0.990)	92.6%	93.7%
Control	3.95 ng/ml	0.974	(0.956-0.993)	93.6%	94.5%

Characteristics	Group		P value
	PCO	Control
	Mean ± SD	Mean ± SD
	Count N %	Count N (%)
Age	31.09 ±3.81	31.53 ± 3.82	0.175
BMI	23.27 ± 1.94	22.21 ± 1.41	0.001
Duration infertility	3.29 ± 0.91	3.13 ± 0.94	0.245
Type of infertility			0.001
Primary	214 (77.5%)	377 (91.3%)
Secondary	62 (22.5%)	36 (8.7%)
AFC	14.32 ± 3.69	6.4 ± 2.47	0.001
AMH	6.36±1.10	3.71 ± 0.45	0.001
OHSS			0.006
Yes	54 (19.6%)	32 (7.7%)
No	222 (80.4%)	381 (92.3%)
Pregnancy			0.001
Yes	145 (52.5%)	68 (16.5%)
No	131 (47.5%)	345 (83.5%)

Antral follicle count and anti-Müllerian hormone level as predictors of ovarian hyperstimulation syndrome in women with polycystic ovarian syndrome undergoing controlled ovarian stimulation

Article Category: research-article

Published Online: Sep 09, 2021

Page range: 200 - 205

Received: Nov 13, 2020

Accepted: Feb 11, 2021

DOI: https://doi.org/10.15557/jou.2021.0032

Keywords
antral follicle count (AFC), polycystic ovarian syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS)

© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

Fig. 5.

Basic characteristics of the study population

AUC for AFC and AMH to predict hyper-response

Comparison of cases and controls

Antral follicle count and anti-Müllerian hormone level as predictors of ovarian hyperstimulation syndrome in women with polycystic ovarian syndrome undergoing controlled ovarian stimulation

Article Category: research-article

Published Online: Sep 09, 2021

Page range: 200 - 205

Received: Nov 13, 2020

Accepted: Feb 11, 2021

DOI: https://doi.org/10.15557/jou.2021.0032

Keywordsantral follicle count (AFC), polycystic ovarian syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS)

© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

Fig. 5.

Basic characteristics of the study population

AUC for AFC and AMH to predict hyper-response

Comparison of cases and controls

Keywords
antral follicle count (AFC), polycystic ovarian syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS)