Establishing a Minimum Predictive Threshold Follicular Size and Oocyte Retrieval in ICSI Cycle

Follicular Size and Oocyte Retrieval in ICSI Cycle : Establishing a Minimum Predictive Threshold. A Prospective Cohort Study

This study uses number and size of ovarian follicles on the day of ovulation trigger as key determinants for oocytes yield to optimize outcomes in IVF and ICSI Protocols

Accurate prediction of oocyte yield is a key factor in optimizing outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles. Follicle number and follicle diameter measured on the day of ovulation trigger are known to be strongly associated with oocyte retrieval and oocyte maturity. Larger follicles are more likely to yield mature (metaphase-II) oocytes, while smaller follicles contribute less consistently to oocyte yield.

Despite the established association between follicular size and oocyte maturity, there is currently no standardized clinical model that estimates the minimum expected number of retrieved oocytes based on the distribution of follicle diameters on the trigger day. Most existing studies focus on average outcomes rather than providing a practical tool to estimate the lowest anticipated oocyte yield for individual patients.

This study aims to estimate the minimum number of oocytes retrieved based on the number and diameter of ovarian follicles measured on the day of ovulation trigger. By developing a predictive approach based on follicular size distribution, this study seeks to support clinical decision-making, optimize trigger timing, and improve patient counseling regarding realistic expectations of oocyte yield.

Inclusion Criteria:

• women aged 18 to 35 years undergoing ICSI.
• at least four follicles above 15 mm in diameter on the day of trigger
• Downregulation using either GNRH antagonist or agonist protocol
• Provision of written ,informed consent
• BMI 18 to 35 kg per meter square

Exclusion Criteria:

• anticipated poor responder, according to Bologna criteria
• cycle canceled prior to retrieval or without trigger administration
• Oocyte cryoperservation cycles or natural IVF cycles
• presence of ovarian pathology affecting the follicular assessment (endometriosis,cysts )