The Fertility Center of Las Vegas

Antral follicle count measures ovarian reserve

Women are born with their lifetime supply of eggs already inside their ovaries. Starting with your first menstrual cycle, eggs are released by your ovaries each month, causing egg supply to decline over the years. Your remaining supply of eggs is called your ovarian reserve, an indicator of your fertility potential. The antral follicle count is a test that measures your ovarian reserve.

Antral follicle count is a transvaginal ultrasound study, performed in the early phase of your menstrual cycle, in which your physician visually counts the number of egg-containing follicles that are developing on both of your ovaries. You will have a clear view of your follicles in images projected onto a screen in the exam room.

This simple procedure is just one of several fertility tests that our Las Vegas fertility doctors will order to measure your ovarian reserve. Combined with other test results, your antral follicle count helps your physician better understand whether assisted reproductive technology (ART) is needed, and if so, which fertility treatment is the best choice for you.

What your antral follicle count means

Antral follicles are tiny structures – just 2 mm to 10 mm wide – that can be viewed by ultrasound very early in your menstrual cycle. While multiple follicles may develop, typically only one egg-containing follicle reaches maturity and is released by your ovaries each month.

Our Las Vegas fertility doctors will help you schedule your test for a specific day of your cycle, typically day three. At the imaging center, an ultrasound technician or your physician will insert a probe into your vagina, then will direct the probe as needed to examine and count the follicles on each of your ovaries. The test takes only a few minutes and is similar to a pelvic exam.

The higher the number of follicles that are visible on ultrasound, the greater the number of follicles that can’t be seen. In other words, a higher number means a greater ovarian reserve. A higher number also indicates that you would likely respond well to ovarian stimulating drugs that would be used in basic fertility procedures, such as intrauterine insemination (IUI) and more advanced options like in vitro fertilization (IVF), in which the goal is to produce multiple eggs for a better chance of pregnancy.

  • A high or very high number of antral follicles indicates that the ovaries will likely respond well to ovarian stimulation, increasing your chances of pregnancy.
  • An antral follicle count in the low-to-median range may indicate declining ovarian reserve. While response to ovarian stimulation medications is less predictable, a good response is possible or even likely.
  • A low antral follicle count (three to six follicles) indicates low ovarian reserve, but does not reliably predict failure to conceive. If IVF is attempted, higher doses of ovarian stimulation medication may be needed.
  • Women with an extremely low count may not be good candidates for IVF using their own eggs, as their ovaries are unlikely to produce enough eggs for retrieval.

Plan your fertility workup

Although antral follicle count is a valuable indicator of fertility, a low number does not necessarily mean you will be unable to have a baby. To establish the best treatment plan for you, our Las Vegas fertility doctors will examine many factors as part of your complete fertility workup.

To start your comprehensive fertility evaluation, contact us to schedule a consultation.