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448411 
Journal Article 
Abstract 
Effect of IVF lead follicle size on the trailing cohort 
Amols, M; Rollene, N; Hudson, S; Jensen, J; Coddington, C 
2009 
Yes 
Fertility and Sterility
ISSN: 0015-0282
EISSN: 1556-5653 
91 
3, Supplement 1 
S22-S22 
English 
WOS:000264143900048 
Background: Follicular size has been used to time hCG administration during In Vitro Fertilization (IVF) cycles. Standard practice in many IVF centers is to administer hCG when the lead follicle reaches an average diameter of 18 mm. A trailing cohort may contain immature oocytes also triggered resulting in retrieval of immature oocytes unable to be inseminated.

Objective: We sought to determine if IVF outcomes were affected when the lead follicle was permitted to grow beyond 18 mm, thus allowing smaller follicles (the “trailing cohort”) to reach further maturity.

Material and Methods: A retrospective chart analysis was performed. Data was extracted from medical records of patients seen in the IVF clinic between 1995–2003. Patients were included if lead follicle size was greater than 18 mm at time of hCG administration, and that the major cohort of follicles were trailing greater than 2 mm from the leading follicle. The size of the lead follicle and average size of the follicles of the major cohort was collated. The number of oocytes retrieved, number of mature oocytes available for insemination, fertilized, cryoperserved, transferred, and pregnancy rate was documented and analyzed.

Results: N = 21 cases. Mean lead follicle size at “hCG administration” was 21.17 mm (± 1.30) with the trailing mean follicle size of the major cohort at 16.55 mm (± 0.74), giving a mean distance between the lead follicle and the trailing cohort of 4.62 mm (± 1.23). Outcomes (Table I): Mean # of oocytes retrieved, # of oocytes inseminated, maturity rate, and fertilization rate were 11.76 (± 5.08), 9.43 (± 4.52), 80.32% (± 16.30), 67.10% (± 17.03) respectively. All 21 cases (100%) resulted in a fresh embryo transfer and 17 cases (81%) had embryos to freeze. The overall pregnancy rate was 71%.