Original Article Gynecol Obstet Invest 2014;77:117–120 DOI: 10.1159/000358395
Received: October 22, 2013 Accepted after revision: January 3, 2014 Published online: February 8, 2014
Lateralization of Ovarian Follicles Abdulrahman AlSerri Anita Kuriya Hananel Holzer Togas Tulandi Department of Obstetrics and Gynecology, McGill University, Montreal, Que., Canada
Key Words Antral follicle · Antral follicle count · Ovarian reserve · Polycystic ovaries · Lateralization
Abstract Background/Aim: To evaluate a possible lateralization of antral follicle count (AFC) based on the finding that endometriosis, if present, is more commonly found in the left hemipelvis. Methods: We evaluated the records of 6,617 baseline ultrasounds conducted at our Reproductive Center between 2007 and 2011 in a university teaching hospital setting. We included all ultrasounds with an AFC of 1 or greater and excluded those with incomplete documentation or with ovarian cyst, including endometriotic cysts (n = 909). The main outcome measure was the comparison of the number of antral follicles between the right and left ovary. Results: The number of antral follicles in the right ovary (median 18, range 15–22) was significantly higher than in the left ovary (median 16, range 13–20) among women with polycystic ovaries (PCO, AFC ≥24). Similarly, the number of antral follicles in the right ovary (median 8, range 6–10) was significantly higher than in the left ovary (median 7, range 5–9) in women with no PCO but normal ovarian reserve (AFC 10–23). Conclu-
© 2014 S. Karger AG, Basel 0378–7346/14/0772–0117$39.50/0 E-Mail [email protected] www.karger.com/goi
sions: In women with PCO and non-PCO with normal ovarian reserve, the right ovary contains a higher number of antral follicles than the left ovary. © 2014 S. Karger AG, Basel
Introduction
Evaluation of ovarian function has become an integral part of fertility workup. This includes measurement of antral follicle count (AFC) in the ovaries as an indirect evaluation of ovarian reserve. AFC is defined as the number of antral follicles of 2–10 mm in diameter [1–3]. Histological studies have demonstrated that the number of antral follicles is proportional to the number of primordial follicles in the ovaries [4]. In our clinical practice, we have been aware that the number of antral follicles between the right and left ovary appears to be different. Lateralization of endometriosis has been reported in which endometriosis implants and endometrioma are often found in the left hemipelvis [5]. Whether there is lateralization of antral follicles remains unknown. The purpose of our study is to evaluate whether there is lateralization of ovarian antral follicles. Togas Tulandi, MD, MHCM Department of Obstetrics and Gynecology, McGill University 687 Pine Avenue West Montreal, QC H3A 1A1 (Canada) E-Mail togas.tulandi @ mcgill.ca
Table 1. Profiles of women with and without PCO
Age, years
BMI
Menstrual cycle, days
Non-PCO 38 (35 – 40) 23.8 (20.4 – 26.9) 28 (28 – 30) PCO 33 (31 – 36) 30.9 (24.1 – 42.4) 30 (28 – 34) p value
Received: October 22, 2013 Accepted after revision: January 3, 2014 Published online: February 8, 2014
Lateralization of Ovarian Follicles Abdulrahman AlSerri Anita Kuriya Hananel Holzer Togas Tulandi Department of Obstetrics and Gynecology, McGill University, Montreal, Que., Canada
Key Words Antral follicle · Antral follicle count · Ovarian reserve · Polycystic ovaries · Lateralization
Abstract Background/Aim: To evaluate a possible lateralization of antral follicle count (AFC) based on the finding that endometriosis, if present, is more commonly found in the left hemipelvis. Methods: We evaluated the records of 6,617 baseline ultrasounds conducted at our Reproductive Center between 2007 and 2011 in a university teaching hospital setting. We included all ultrasounds with an AFC of 1 or greater and excluded those with incomplete documentation or with ovarian cyst, including endometriotic cysts (n = 909). The main outcome measure was the comparison of the number of antral follicles between the right and left ovary. Results: The number of antral follicles in the right ovary (median 18, range 15–22) was significantly higher than in the left ovary (median 16, range 13–20) among women with polycystic ovaries (PCO, AFC ≥24). Similarly, the number of antral follicles in the right ovary (median 8, range 6–10) was significantly higher than in the left ovary (median 7, range 5–9) in women with no PCO but normal ovarian reserve (AFC 10–23). Conclu-
© 2014 S. Karger AG, Basel 0378–7346/14/0772–0117$39.50/0 E-Mail [email protected] www.karger.com/goi
sions: In women with PCO and non-PCO with normal ovarian reserve, the right ovary contains a higher number of antral follicles than the left ovary. © 2014 S. Karger AG, Basel
Introduction
Evaluation of ovarian function has become an integral part of fertility workup. This includes measurement of antral follicle count (AFC) in the ovaries as an indirect evaluation of ovarian reserve. AFC is defined as the number of antral follicles of 2–10 mm in diameter [1–3]. Histological studies have demonstrated that the number of antral follicles is proportional to the number of primordial follicles in the ovaries [4]. In our clinical practice, we have been aware that the number of antral follicles between the right and left ovary appears to be different. Lateralization of endometriosis has been reported in which endometriosis implants and endometrioma are often found in the left hemipelvis [5]. Whether there is lateralization of antral follicles remains unknown. The purpose of our study is to evaluate whether there is lateralization of ovarian antral follicles. Togas Tulandi, MD, MHCM Department of Obstetrics and Gynecology, McGill University 687 Pine Avenue West Montreal, QC H3A 1A1 (Canada) E-Mail togas.tulandi @ mcgill.ca
Table 1. Profiles of women with and without PCO
Age, years
BMI
Menstrual cycle, days
Non-PCO 38 (35 – 40) 23.8 (20.4 – 26.9) 28 (28 – 30) PCO 33 (31 – 36) 30.9 (24.1 – 42.4) 30 (28 – 34) p value
