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.