Abstract
To produce age-related nomograms for ovarian antral follicle count (AFC) in infertile women. It was done a cross-sectional study of patients attended in the center of assisted reproduction Fêmina, from March 2010 to October 2011. The patients were submitted to transvaginal ultrasonography from day 2 to day 4 of their menstrual period. Patients included were between 21 to 45 years old, with regular menses, two healthy ovaries, without any evidence of endocrinopathies and who gave written informed consent. Patients excluded were smokers, with galactosemia or ovarian cysts, with antecedents of liver disease, ovarian surgeries or who were treated with chemotherapy or radiotherapy. In order to check the evolution of the AFC in relation to patient age, we used the 5th, 25th, 50th, 75th and 95th percentiles. Linear regression was carried out using these percentiles, permitting us to determine the effect of age on the CFA. A total of 172 patients with a mean age of 32.7 years were included in the trial. The male and tubal factors were the main causes of infertility, accounting for 65% of cases. The age-related nomogram for the 5th, 25th, 50th, 75th and 95th percentiles of AFC revealed that changes were best fitted by a linear function. The percentiles that showed the highest correlations were 25 (r=-0.9; p<0.001), 50 (r=-0.9; p<0.001) and 75 (r=-0.9; p<0.001). A nomogram was constructed correlating age with the different AFC percentiles in infertile women without endocrinopathies. This showed a linear pattern of decline in AFC with age in all percentiles. These nomograms could provide a reference guide for the clinician. However, future validation, with longitudinal data, still is needed.
Highlights
To produce age-related nomograms for ovarian antral follicle count (AFC) in infertile women
O melhor modelo matemático encontrado para expressar o comportamento da contagem de folículos antrais (CFA), em relação à idade, em todos os percentis, foi a regressão linear
A análise de regressão mostrou que, em todos os percentis, houve correlação linear, negativa e forte entre a CFA e a idade das pacientes
Summary
To produce age-related nomograms for ovarian antral follicle count (AFC) in infertile women. A correlação entre a CFA histológica e o número de folículos primordiais remanescentes, nos ovários das pacientes, tem sido constatada há vários anos[7,12,13]. Vários estudos verificaram, também, uma diminuição no número de folículos primordiais e antrais com o aumento da idade[14]; mas, somente com o aperfeiçoamento dos aparelhos de ultrassonografia, foi possível mostrar a correlação entre a CFA pela ultrassonografia e a idade[15,16].
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