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Birla Fertility & IVF

What is Antral Follicle Count (AFC)?

  • Published on September 06, 2022
What is Antral Follicle Count (AFC)?

Did you know? The pool of eggs in a woman decreases in size and number as she ages. Yes! That’s a fact, women are born with millions of follicles which are referred to as  “ovarian reserve– quality and quantity of eggs” and they keep on declining until they hit menopause.

Antral follicle count (AFC) provides an estimate of your ovarian reserve and plays an important role in predicting the chances of a successful pregnancy.

If you are in your 30s or approaching it and want to get pregnant, then you might want to know about your ovarian reserve in more detail. This information will help you make a more informed decision regarding your pregnancy timeline and also determine if you need any fertility treatment or not.

What are Antral Follicles? 

An antral follicle is a tiny fluid-filled sac inside the ovary. A single ovary contains multiple follicles through which eggs are released each month during menstruation.

During ovulation, antral follicles are instrumental in maturing and releasing eggs at the optimal time. Many antral follicles participate in this process each menstrual cycle, but typically only one follicle successfully ovulates an egg. Occasionally, multiple mature eggs are released, increasing the likelihood of conceiving twins.

After ovulation is successfully done, the antral follicle turns into a corpus luteum (temporary organ in the ovary). Each antral follicle has a cavity inside it, referred to as an antrum. The size of the antrum determines the overall size of the antral follicle. An antral follicle around 1-2 mm in diameter can be easily seen and counted during the ultrasound.

What is Antral Follicle count (AFC)? 

An antral follicle count measures the number of follicles in the ovary. The count can be detected through transvaginal ultrasound during an ongoing menstrual cycle, specifically between the 2nd and 4th day.

An antral follicle count not only determines the status of the ovarian reserve but also your likelihood of conceiving a child. It further provides information about your fertility health like whether you have primary ovarian insufficiency (premature ovarian failure) or any other conditions like polycystic ovarian syndrome (PCOS)

How much antral follicle count (AFC) is good for pregnancy? 

Unfortunately, there is no exact AFC for pregnancy. However, according to the experts and studies, the normal antral follicle count is considered when each of your ovaries has 5-10 antral follicles with approximately 2-10 mm in diameter.

You can also refer to the below table to understand different AFC reserve levels and what they indicate:

Antral Follicle Count (AFC) Result (Per Ovary)
Normal Reserve 5-10 antral follicles  per ovary
Low Reserve <5  antral follicles per ovary
High Reserve >10 antral follicles per ovary
Polycystic Ovaries >13 enlarged antral follicles per ovary

How is the antral follicle count test performed? 

With the help of a transvaginal ultrasound test, you can get an antral follicle count to measure your ovarian reserve. It is a simple 30-minute test where scanned images would be showcased simultaneously on the monitor.

How antral follicle count is related to age?

A woman’s fertility decreases as she ages, which also affects her follicle count. Refer to the table below to assess the antral follicle count range categorized by age, covering both ovaries:

Age AFC (For Both Ovaries)
20-24 Years 15 -30
25 – 34 Years >12-25
35 – 40 Years <8-15
41 – 46 Years Pre-menopausal stage 4-10

Does low AFC reserve mean infertility? 

A low reserve of antral follicle count does not automatically indicate infertility. An antral follicle count just predicts the likeliness of a woman getting pregnant. With an early diagnosis of a diminished ovarian reserve and the fertility expert guidance for correct treatments including lifestyle changes, you can improve your fertility and chances of successful conceiving.

How to improve antral follicle count?

In the initial stages, the doctor recommends lifestyle modification and may introduce supplements with mild androgen to increase antral follicle count and improve diminished ovarian reserve.

Correlation between IVF and antral follicle count?

The correlation between IVF (In Vitro Fertilization) and Antral Follicle Count (AFC) is crucial in assessing a woman’s ovarian reserve and predicting the success of IVF treatment.

A lower AFC generally indicates poor ovarian reserve, suggesting a lower chance of a successful pregnancy. During IVF, fertility drugs are given to boost ovarian stimulation as well as AFC.  As a result, there will be a greater probability of retrieving quality eggs, developing healthy embryos for implantation, and successful IVF outcomes.

Also, in some cases, if you are not able to conceive with low antral follicle count,  IVF with donor eggs/oocytes is an effective assisted reproduction technique to achieve conception.

Conclusion

An antral follicle count (AFC) test is important to be aware of your fertility health. It assesses and determines the ovarian reserve including quantity as well as quality of the eggs. Along with the status of your ovarian reserve, the AFC test will tell you about other conditions, like PCOD/PCOS, or if you require any treatment to avoid any complications related to conceptions. AFC test

If you are still confused about antral follicle count’s role in pregnancy and trying to conceive, consider speaking to a fertility specialist for more clarity. You can call us at the given number to speak to our fertility specialist or fill out an appointment form with the required details.

Written by:
Dr. Souren Bhattacharjee

Dr. Souren Bhattacharjee

Consultant
Dr. Souren Bhattacharjee is a distinguished IVF specialist with over 32 years of experience, spanning across India and prestigious institutions in the UK, Bahrain, and Bangladesh. His expertise covers the comprehensive management of male and female infertility. He has been trained in infertility management from various reputed institutes in India and UK including the esteemed John Radcliffe Hospital, Oxford, UK.
Over 32 Years of Experience
Kolkata, West Bengal

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