Impact of antral follicular count on ovulation and pregnancy rate in sub infertile women with polycystic ovarian syndrome undergoing ovulation induction by clomiphene citrate and gonadotropins.

OBJECTIVES

To show the relationship between antral follicular count (AFC) levels and ovulation and pregnancy rates in sub-fertile women with polycystic ovarian syndrome who received clomiphene citrate and gonadotropin-based ovulation induction therapy.

MATERIAL AND

METHODS

A cohort study conducted from 1st February 2023 to 1st April 2025. A hundred sub-infertile women with polycystic ovarian syndrome were included. During days 3-5 of the menstrual cycle, a blood sample to measure basal anti-mullerian hormone (AMH), estradiol E (2), luteinizing hormone (LH) and follicular stimulating hormone (FSH).Antral follicular count (AFC) was measured for both ovaries through transvaginal ultrasound. All patients received Clomiphene citrate tablets and gonadotropins during a single cycle. Patients with at least 18 mm follicle received 5000 IU of human chorionic gonadotropin. Anovulation diagnosed when mid-luteal serum progesterone is below 10 pmol/L. Two weeks later, B-hCG levels were measured.

RESULTS

The average number of antral follicles was 26.90 ± SD 9.73. The length of infertility was closely related to the groups of antral follicle count (p ≤ 0.001). Antral follicular count is a statistically significant predictor of ovulation (p =≤ 0.001). A strong association was found between antral follicular count and pregnancy, which was statistically significant (p ≤ 0.001).

CONCLUSIONS

Antral follicular count can be used to assess response to treatment of subfertile polycystic ovarian syndrome women to ovulation induction by drugs, the rate of ovulation and pregnancy.