Reproducibility and reliability of automated volumetric measurement of single preovulatory follicles using SonoAVC

Objective: To evaluate the reproducibility and the reliability of an innovative, computer-assisted approach for automatically measuring ovarian follicles. Design: Prospective, comparative study. Setting: Hospital Beclere, Clamart, France. Patient(s): Fifteen infertile women undergoing IVF-ET in monodominant follicle cycles. Intervention(s): Just before oocyte retrieval, follicles were three-dimensionally reconstructed from transvaginal ultrasonographic images. Volumes were determined both manually by visual outlining of inner follicle borders (VOCAL) and automatically using SonoAVC. Each procedure was repeated three times. Follicular fluid volume indicated the actual follicle volume. Main Outcome Measure(s): Reproducibility and concordance of results were assessed by the intraclass correlation coefficient (ICC) and the limits of agreement method, respectively. Result(s): At any time, VOCAL (3.68, 2.41-8.29 mL; 3.73, 2.70-7.16 mL; 3.89, 2.96-7.83 mL; median, ranges, respectively) and SonoAVC (3.57, 2.41-8.19 mL; 3.71, 2.49-8.90 mL; 4.07, 3.12-8.16 mL, respectively) volume measurements failed to be statistically different from the corresponding actual follicle volume (3.60, 2.90-8.00 mL). Reproducibility (ICC, 95% confidence intervals) of repeated VOCAL (0.95, 0.87-0.98) and SonoAVC (0.97, 0.94-0.99) measurements as well as 95% limits of agreement between actual volumes and VOCAL (-0.48 to +0.80 mL) and SonoAVC (-0.61 to +0.99 mL) measurements were comparable. Conclusion(s): Automatic measurement of ovarian follicle volumes from three-dimensionally reconstructed ultrasound images (SonoAVC) is a rapid and simple technique, which reproducibility and reliability are comparable to the semimanual technique (VOCAL). It opens new perspectives for the accurate and objective assessment of ovarian function by ultrasound. (Fertil Steril (R) 2010;93:2069-73. (C) 2010 by American Society for Reproductive Medicine.)