Why antral follicle count is a number you need to know
Antral follicle count is a reliable readout of how active your ovaries are.
Together with AMH and FSH, antral follicle counts adds a precious information to what exactly the time is on your personal biological clock and how many eggs you have left.
You can then build on this information yourself and adjust your life habits so as to give to those eggs all they need to make the best babies possible. The nice thing is, there are plenty of things that you can do to naturally increase your fertility to a lesser or greater degree (depending on the genetic factors but also on how hard you try).
What is antral follicle count?
In any healthy young women, about 30-50 new antral follicles appear on the surface of the ovaries every single day. The majority of them will die before ever going beyond the stage of being a tiny bubble, because the timing is wrong for the most part of the month for them to develop any further.
Only on one single day (at the beginning of each menstrual cycle) will the timing be right (meaning the FSH signal strong enough) in order for one group of follicles to continue growing and competing further until one finally becomes an ovulatory egg. So, only once a month, about 30-50 antral follicles enter this internal beauty contest (10-15 days of maturation followed by ovulation) and the queen gets the prize of possibly becoming your daughter or son.
30-50 antral follicles or more are typical for ovaries of a young and highly fertile woman.
However, as a woman ages, the follicles become fewer (if you are 40 or above and trying to get pregnant please read this post). Most women who are undergoing fertility treatment will hardly see more than 5-10 antral follicles as they start injecting stimulation drugs (highly concentrated FSH which triggers the maturation proces).
Therefore, it is essential for any young woman who cares about someday becoming a mother to know how many antral follicles she currently has.
This number (called “antral follicle count”), combined with the FSH and AMH values, gives the best possible estimate of what the time is on her biological clock.
As long as the numbers confirm that your ovaries have this dynamic, bubbling surface, you are fine. You can wait, have relationships or not, and work on your career (if you work for Facebook, they may even pay to you to freeze your eggs).
Want to know my advice on your fertility journey? Please send me an e-mail as described here and we’ll set up a Skype-consultation at a time that suits you !
How to determine antral follicle count?
It’s very easy. To determine this number, your gynecologist should, during a regular check-up, simply turn the ultrasound to a higher magnification and inspect both your ovaries for little bubbles and count them.
You will also be able to see these little spots on the screen (here is a video of antral follicle counting being done).
With thirty or more follicles altogether, the ovarian reserve is still strong.
With twenty or more, the woman should start thinking about having babies.
With about ten antral follicles, women are entering the stage where natural fertility is declining and they need to take action. For those who are in a relationship, it is time to address the question of becoming parents soon. For those who are not, it is time to focus on finding one. Whatever the situation, there is still time to adapt to the circumstances or change them.
At about five antral follicles or less at any given time in the month (the numbers are quite stable from one day to another), you might be in trouble. The chances for a natural conception are not bright anymore and it may not be easy to convert the remaining eggs to babies (but I did this, and with a bit of luck, you can do it, too).
My message is: Ladies, find out what time it is on your personal biological clock! Have your ovarian reserve markers checked (FSH, AMH, antral follicle count) and find out how many eggs you have left! With this information, you can better plan and enjoy your life. While you still have a high ovarian reserve, there is more time to change jobs, careers, and partners.
As a young woman, you will only be taught how NOT to get pregnant, but the realities of fertility will rarely be discussed. That part you have to learn yourself. So, check on your fertility about every two years and once your reserve starts declining, know it is time to settle with the one you want to have children with. At all times, you should adapt your nutrition and lifestyle as to support the quality of your eggs and slow the clock down as much as possible.