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• W4313856825 abstract "We thank Drs. Albayrak, Aydin, and Koroglu for their insights and interest in our research (1Albayrak N. Aydin T. Koroglu N. Correlation of ovarian follicle size with IVF outcomes.Fertil Steril. 2023; 119: 705Abstract Full Text Full Text PDF Scopus (1) Google Scholar, 2Shapiro B.S. Rasouli M.A. Verma K. Raman A. Garner F.C. Aguirre M. et al.The effect of ovarian follicle size on oocyte and embryology outcomes.Fertil Steril. 2022; 117: 1170-1176Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar). We agree that there are advantages to limiting a study to specific infertility diagnoses. However, in our study, this would have adversely affected the number of data and generalizability. Alternatively, one could use additional patient factors, such as cohort size, patient diagnosis, age, and body mass index, in multivariate analysis. However, this approach would probably require a comparatively large study. Patient factors and follicle sizes could be used in automated algorithms for pretrigger prediction of embryology outcomes, although approximately 3 mm of growth should be added to compensate for the time between pretrigger ultrasound and retrieval (3Abbara A. Vuong L.N. Ho V.N.A. Clarke S.A. Jeffers L. Comninos A.N. et al.Follicle size on day of trigger most likely to yield a mature oocyte.Front Endocrinol (Lausanne). 2018; 9: 193Crossref PubMed Scopus (36) Google Scholar, 4Baerwald A.R. Walker R.A. Pierson R.A. Growth rates of ovarian follicles during natural menstrual cycles, oral contraception cycles, and ovarian stimulation cycles.Fertil Steril. 2009; 91: 440-449Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar). The concern that decreased ovarian reserve might alter the relationship between follicle size and embryology outcomes is largely mitigated by the finding that age did not have a strong effect on that relationship, except for the largest follicle group (≥28 mm) having inferior outcome in older patients (Supplemental Fig. 2, available online). Regarding the statistical test selection, our primary and secondary outcomes were analyzed as dichotomous (yes or no and regarding whether the follicle yielded an oocyte) rather than numerical data (e.g., percentage of a given patient’s follicles that yielded a blastocyst of a given grade). The latter approach requires the patient as the unit of analysis and therefore asks a different question than ours. However, we recognize that other models with the patient as the unit of analysis would have their own prognostic value. The respondents also mention the high number of punctured follicles in our study. This might be explained by 3 factors. First, the 75 subjects in our study included 20 oocyte donors, who typically had high ovarian response and often underwent repeated cycles. Second, we intentionally punctured all observed small follicles to obtain their associated embryology data. Third, we may have stimulated somewhat longer than some other centers (see our trigger criterion) to obtain more oocytes under our freeze-all strategy. The last of these partly motivated our research to evaluate whether prolonged stimulation results in very large “postmature” follicles that yield substantially fewer or inferior oocytes than small follicles. We saw no evidence to support this hypothesis in younger patients, and such an evidence in older patients was limited to follicles ≥28 mm in diameter. Future studies should consider the excellent points raised by Drs. Albayrak, Aydin, and Koroglu. Much work remains to optimize ovarian stimulation for the freeze-all strategy. Correlation of ovarian follicle size with IVF outcomesFertility and SterilityVol. 119Issue 4PreviewWe recently read with great interest the article, “The effect of ovarian follicle size on oocyte and embryology outcomes” published in a recent issue of Fertility and Sterility (1). Although we enjoyed perusing the article, we identified several point that may affect the findings. The issues we want to point out are related to the inclusion and exclusion criteria of the study, as well as the choice of test family for the statistical analyses of both the findings and sample size. Full-Text PDF" @default.
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• W4313856825 title "Reply of the Authors: Correlation of ovarian follicle size with in vitro fertilization outcomes" @default.
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