A prospective analysis of the changes in ovarian morphology during hormonal pituitary suppression before in vitro fertilization.

OBJECTIVE

To assess the change in ovarian morphology at three specific times integral to an IVF cycle, and to evaluate the factors associated with a change in ovarian morphology after pituitary desensitization.

DESIGN

Prospective cohort analysis.

SETTING

Academic IVF center.

PATIENT(S): Infertile patients undergoing 85 IVF cycles.

INTERVENTION(S): Eighty-five patients had a transvaginal ultrasound to assess ovarian morphology on unstimulated menstrual day 3, 21 days after starting oral contraceptives (OCs), and 14 days after starting GnRH agonist (GnRH-a).

MAIN OUTCOME MEASURE(S): Ovarian morphology.

RESULT(S): Compared with the basal total ovarian volume, ovarian volume was significantly decreased after 21 days of OCs and after 14 days of GnRH-a. A significant decrease was noted in the total number of antral follicles from the basal state to after 21 days of OCs and after 14 days of GnRH-a treatment. There was no significant effect on pregnancy outcome rates. Univariate analysis showed a significant correlation between ovarian morphology and IVF stimulation parameters.

CONCLUSION(S): Hormonal suppression significantly alters ovarian morphology. If the use of ovarian morphology is to be used to counsel patients and predict IVF success as suggested by some studies, it should be standardized for the day the ovarian morphology is evaluated.