VP64.11: Automated 3D (SonoAVC) versus 2D ovarian follicles count in IVF cycles in patients with large ovarian endometrioma

This study compared the performance of bidimensional ultrasonography (2D-TVS) and three-dimensional automated volume calculation (SonoAVC) in calculating ovarian follicle count in patients with large endometriomas undergoing in vitro fertilisation (IVF) cycles. This prospective study included patients with ovarian endometrioma with largest diameter ≥ 5cm undergoing IVF. Exclusion criteria for the study were: previous unilateral ovariectomy, premature ovarian failure and non-endometriotic ovarian cysts. The exams were performed by using a Voluson E10 machine. The number and mean diameter of follicles were measured manually using 2D ultrasound. 3D data was then acquired and analysed using Sono-AVC. Only ovaries with endometriomas with largest diameter ≥ 5cm were considered in the analysis. 103 patients were included in the study, and 105 ovaries were included in the analysis. The mean diameter of the largest endometrioma was 7.2 ( ± 1.3) cm; 23 (22.3%) patients had other endometriomas with a smaller diameter in the same ovary (n = 8), in the contralateral ovary (n = 13) or both the ovaries (n = 2). The mean follicular count per ovary was significantly lower when measured manually than with SonoAVC (p < 0.001). There was no significant difference in the number of follicles with mean diameters ≥ 17 mm measured by 2D-TVS and SonoAVC. SonoAVC identified significant more follicles with mean diameters ≥ 9 mm (p = 0.006) and ≥ 13 mm (p = 0.041) than 2D-TVS. The was no significant difference in the diameter of the leading follicle measured manually or by SonoAVC (p = 0.893). There was a good correlation between the number of oocytes retrieved and the number of follicles detected by 2D-TVS (Pearson correlation coefficient, 0.807) or by SonoAVC (0.893). When large ovarian endometriomas are present, SonoAVC may improve the detection of follicles with diameter <17mm.