Comparison of the size of the leading follicle as assessed by conventional and automated follicle measurement methods in women undergoing controlled ovarian stimulation for IVF

Abstract

OBJECTIVE: To assess agreement in the size of the leading follicle between manual and automated follicle measurements. DESIGN: Method comparison study. MATERIALS AND METHODS: 100 women undergoing controlled ovarian stimulation (COH) for IVF were prospectively recruited. Each follicle was manually measured by taking the mean of maximal diameters on three orthogonal planes. A three dimensional volume of each ovary was captured and saved for later analysis with SonoAVC. All scans were done by a single observer. The leading follicle was identified and measured with the Sonography based Automated Volume Count (SonoAVC) software. SonoAVC automatically identifies follicles and generates the mean follicular diameter (MFD), and a volume based follicular diameter d(V). The agreement in the size of the leading follicle between two methods was assessed with Bland Altman Method. RESULTS: The mean differences in the size of the leading follicle between manual and SonoAVC d(V) measurements and between manual and sSonoAVC MFD measurements were less than 1mm. Full results are presented in table.Tabled 1Agreement between Manual and SonoAVC MeasurementsVolume based diameter vs Manual measurementBias (2D – dV)0.9 ± 1.4 mmUpper limit of agreement+3.8Lower limit of agreement-1.9MFD vs manual measurementBias (2D – MFD)- 0.7 ± 1.4 mmUpper limit of agreement+2.1Lower limit of agreement-3.5 Open table in a new tab CONCLUSION: The accuracy and reproducibility of manual follicular measurements decrease as the number and size of the follicles increase during a COH cycle. We seek to determine the number of follicles within certain categories based on size during follicular tracking. The absolute size of the leading follicle is another important piece of information used in decision making. However, this parameter has not been evaluated in previous comparative studies of SonoAVC. Our results demonstrate good agreement between manual and either SonoAVC measurements with regard to the leading follicle.