***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study tested the hypothesis that the automated assessment of a stimulated ovary , using 3D ultrasound and sono-AVC ( automatic volume calculation ) , provides quicker analysis of follicular number and size than conventional 2D ultrasound , without any loss in measurement validity . Transvaginal ultrasound was performed on day 10 of stimulation in 89 prospect ively recruited subjects undergoing IVF treatment .  The number and mean diameter of follicles present in both ovaries was measured manually using 2D ultrasound . 3D data were then acquired and analysed using sono-AVC . Outcome measures included the number of follicles with a mean diameter > 9 mm , > 13 mm and > 17 mm . The time taken for measurements and data acquisition was recorded . The two methods were compared using a paired t-test or the Wilcoxon signed rank test . Complete data were available for 82 subjects . There was no significant difference in the number of follicles with mean diameters > 9 mm , > 13 mm and > 17 mm measured by either method . The total time taken for follicular measurements was significantly less ( P < 0.01 ) for the automated 3D method ( 180.5 + /- 63.6 versus 236.1 + /- 57.1 s ) which was associated with significantly less exposure to ultrasound ( 39.0 + /- 6.0 versus 236.10 + /- 57.1 s ; P < 0.001 ) . Automated 3D follicular measurements using sono-AVC provide a comparable but quicker assessment of follicle number and size In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old . Such investigations are often analysed inappropriately , notably by using correlation coefficients . The use of correlation is misleading . An alternative approach , based on graphical techniques and simple calculations , is described , together with the relation between this analysis and the assessment of repeatability BACKGROUND Sono-automatic volume calculation ( SonoAVC ) automatically identifies and measures the dimensions of hypoechogenic areas within data sets acquired using three-dimensional ultrasound . The objective of this study was to evaluate the predictive value of automated antral follicle counts according to their relative sizes in women undergoing assisted reproduction treatment ( ART ) . METHODS A total of 156 subjects aged < or = 40 years with a baseline FSH < or = 15 IU that undergo their first cycle of ART were prospect ively recruited .  SonoAVC was used to measure the data sets and record the number of antral follicles measuring < or = 9 mm in diameter . These follicles were then grouped into subsets according to their relative sizes : < or = 2.0 , 2.1 - 4.0 , 4.1 - 6.0 , 6.1 - 8.0 and 8.1 - 9.0 mm . The primary outcome was viable pregnancy confirmed on ultrasound 5 weeks following embryo transfer . RESULTS A total of 142 subjects were included for analysis of primary end-point . Those subjects who conceived had significantly more antral follicles measuring < or = 2 ( P = 0.041 ) and 2.1 - 4.0 mm ( P < 0.001 ) than those who had unsuccessful treatment . There were no significant differences between the groups in the number of antral follicles measuring 4.1 - 6.0 ( P = 0.191 ) , 6.1 - 8.0 ( P = 0.203 ) and 8.1 - 9.0 mm ( P = 0.601 ) . Multiple logistic regression showed that antral follicles measuring 2.1 - 4.0 mm were an independent predictor of pregnancy [ Exp(B ) = 1.234 , 95 % CI = 1.092 - 1.491 ; P = 0.004 ; AUC = 0.693 ] . CONCLUSION SonoAVC provides automated measures of antral follicle number and size . Using this technique , the number of antral follicles measuring 2.1 - 4.0 mm in diameter is an independent , significant predictor of pregnancy following in vitro fertilization treatment Aims : We define criteria to predict the number of mature oocytes using automated three-dimensional ( 3D ) ultrasound follicle measurements . Methods : Fifty in vitro fertilization/intracytoplasmic sperm injection patients underwent automated 3D echographic monitoring by a single research er following the stimulation procedure . Classic criteria for triggering oocyte maturation as defined in the literature were utilized . 3D parameters , including the follicular volume and follicle diameter calculated from the volume measurement , were related to the oocyte count , mature oocyte count and the number of observed fertilized oocytes . Results : We found that when oocyte maturation was induced , 55 % of the total follicles with a diameter of at least 10 mm had a volume of at least 1.5 cm3 . The number of mature eggs that were retrieved was correlated with the number of follicles observed with a volume of at least 1 cm3 or a calculated follicle diameter of at least 12 mm . Conclusion : Sonography-based automated volume count measurements of follicle volume and reconstructed follicle diameter can be used to reliably predict the number of mature oocytes OBJECTIVE To compare three-dimensional ultrasound parameters , antral follicle count ( AFC ) , ovarian volume , and ovarian vascularity indices with anti-Müllerian hormone ( AMH ) and other conventional endocrine markers for the prediction of poor response to  controlled ovarian hyperstimulation ( COH ) during assisted reproduction treatment ( ART ) . DESIGN Prospect i ve study . SETTING University-based assisted conception unit . PATIENT(S ) One hundred thirty-five women undergoing the first cycle of ART . INTERVENTION(S ) Transvaginal three-dimensional ultrasound assessment and venipuncture in the early follicular phase of the menstrual cycle immediately before ART . MAIN OUTCOME MEASURE(S ) Poor ovarian response and nonconception . RESULT ( S ) Antral follicle count ( Exp(B ) : 0.65 ) and AMH ( Exp(B ) : 0.13 ) were the most significant predictors of poor ovarian response on multiple regression analysis and their predictive accuracy was similar , with an area under the curve ( AUC ) of 0.935 and 0.905 , respectively . The AFC and AMH , as a combined test , did not significantly improve the level of prediction ( AUC = 0.946 ) . The sensitivity and specificity for prediction of poor ovarian response were 93 % and 88 % for AFC and 100 % and 73 % for AMH at an optimum cutoff values of < or = 10 and < or = 0.99 ng/mL , respectively . Age ( Exp(B ) : 1.191 ) was the only significant predictor of nonconception , although its predictive accuracy was also low ( AUC = 0.674 ) . CONCLUSION ( S ) The AFC and AMH are the most significant predictors of poor response to ovarian stimulation during ART . The AMH and AFC , either alone or in combination , demonstrate a similar predictive power but are not predictive of nonconception , which is dependent on the woman 's age OBJECTIVE To evaluate the reliability of a computer-assisted approach for automatically measuring ovarian follicles during  controlled ovarian hyperstimulation ( COH ) . DESIGN Prospect i ve , comparative study . SETTING Hospital Béclère , Clamart , France . PATIENT(S ) Twenty-seven infertile IVF-ET c and i date s undergoing COH . INTERVENTION(S ) Just before the oocyte retrieval , growing follicles ( n=72 ) had their mean diameters measured and their volumes determined semimanually by virtual organ computer-aided analysis ( VOCAL ) and automatically by SonoAVC .  Follicles were sorted in small ( 12 - 16 mm ; n=35 ) and large ( > 16 mm ; n=37 ) growing follicles . Measures were compared with the follicular fluid volume . MAIN OUTCOME MEASURE(S ) Concordance of results using intraclass correlation coefficient and limits of agreement methods , respectively . RESULT ( S ) Overall , VOCAL ( median : 3.42 mL ; range : 0.98 - 9.68 mL ) and SonoAVC ( 3.25 mL ; 0.98 - 8.63 mL ) measurements were equivalent to the corresponding actual follicle volume ( 3.20 mL ; 0.80 - 10.20 mL ) . The intraclass correlation coefficient values between follicular fluid volume and mean diameter , VOCAL , and SonoAVC were 0.51 , 0.95 , and 0.98 , respectively , for small follicles , and 0.80 , 0.93 , and 0.92 , respectively , for large follicles . 95 % limits of agreement between actual volume and VOCAL ( -1.09 to + 1.07 mL ) and SonoAVC ( -1.08 to + 0.84 mL ) measurements were comparable in both groups . CONCLUSION ( S ) Automated measurement of multiple follicular volumes using SonoAVC is a simple technique , which reliability is superior to usual diameter measurements and comparable to VOCAL . This technologic refinement invites us to switch toward volumetric monitoring of follicle growth during COH OBJECTIVE The purpose of this study was to compare 3-dimensional ( 3D ) and 2-dimensional ( 2D )  ovarian follicle counts and 3D counts using stored volumes between experienced and inexperienced operators . METHODS Follicles larger than 5 mm were counted on 1 r and omly selected ovary . Two-dimensional follicle counts were compared with stored 3D volumes by the same experienced operator ( registered diagnostic medical sonographer [ RDMS ] ) . Counts using 3D stored data were compared between the experienced operator and inexperienced operator ( principal investigator [ PI ] ) . The mean difference in follicle counts was computed , and a 1- sample Student t test was performed to test the hypothesis that the mean of the differences was 0 . Comparison of the 2 methods and observers by Bl and -Altman plots was used to determine any systematic differences based on the total number of follicles per selected ovary . RESULTS Mean differences differed from 0 ( P < .005 ) for all 3 comparisons : 2D RDMS versus 3D RDMS , 2D RDMS versus 3D PI , and 3D RDMS versus 3D PI . For the comparison of 2D versus 3D counts done by the RDMS , 5 ovaries ( 10 % ) had a difference of more than 5 follicles counted ; for the 2D RDMS versus 3D PI , 11 ovaries ( 22 % ) had a difference of more than 5 follicles ; for the 3D RDMS versus 3D PI , 8 ovaries ( 16 % ) had a difference of more than 5 follicles . Mean differences in counts ranged 0.29 to 1.04 for ovaries with 10 or fewer follicles compared with 3.94 to 9.00 for ovaries with more than 10 follicles . CONCLUSIONS Follicle counts using 3D volumes were similar to 2D counts , and 3D follicle counts done by an inexperienced operator were similar to counts done by an experienced sonographer BACKGROUND Ovarian response to gonadotrophin stimulation is monitored with serial ultrasound ( US ) examinations . Sonography-based Automated Volume Count ( SonoAVC ) is a relatively new three-dimensional ( 3D ) US technology , which automatically generates a set of measurements including the mean follicular diameter ( MFD ) and a volume-based diameter ( d(V ) ) for each follicle in the ovaries . The present study aim ed to assess the applicability and reproducibility of this automated follicle measurement method in an IVF programme . METHODS For this prospect i ve method comparison study , 100 women undergoing US monitoring of a controlled ovarian stimulation cycle were recruited . Each follicle was manually measured by taking the mean of maximal diameters on three orthogonal planes with two-dimensional ( 2D ) US . A 3D volume of each ovary was then captured . The ovarian volumes were later analysed using SonoAVC . The agreement between the two methods for the numbers of follicles and the size of the leading follicle was assessed with the Bl and -Altman method . The reproducibility of SonoAVC measurements was assessed with the intraclass correlation coefficient ( ICC ) . RESULTS Both SonoAVC-generated MFD and d(V)-based follicle counts , as well as the leading follicle diameter , had good agreement with conventional 2D US measurements . SonoAVC measurements had very good reproducibility , with ICC ≥0.8 for most evaluations . CONCLUSIONS Automated follicle monitoring with SonoAVC can replace or be used interchangeably with conventional 2D measurements . Automated follicle monitoring can save time , provide a method of quality control and create opportunities for developing HCG criteria based on follicular volume or for monitoring patients from a distance OBJECTIVE To evaluate the effect of a new automated technique of follicle measurement ( Sono automated volume calculation [ SonoAVC ] ) on the timing of oocyte maturation and subsequent oocyte retrieval . DESIGN Prospect i ve r and omized controlled trial . SETTING University-based Assisted Conception Unit . PATIENT(S ) Seventy-two women undergoing their first cycle of assisted reproduction treatment . INTERVENTION(S ) The timing of final follicle maturation and oocyte retrieval based on follicle tracking with use of either conventional two-dimensional ( 2D ) ultrasound or SonoAVC . 
    Output:
    
RESULTS The SonoAVC software shows excellent accuracy .
Comparing the technology with the " golden st and ard " two-dimensional ( 2D ) manual follicle measurements , SonoAVC leads to a significantly lower intra- and inter-observer variability .
However , there is no significant difference in clinical outcome ( pregnancy rate ) .
We noted a significant advantage in the time gained , both for doctor and patient .
By storing the images , the technology offers the possibility of including a quality control and continuous training and further st and ardization of follicular monitoring can be expected .
Ovarian reserve testing by measuring the antral follicle count with SonoAVC is highly reliable .
This overview of previously published literature shows how SonoAVC offers advantages for clinical practice , without losing any accuracy or reliability .