Female reproductive organ comprises of around one to two millions of immature follicles. Upto the onset of puberty(13-14yrs), this numbar declines to around 300,000 or 400,000. At around 35-37 years of age, a female is left with 25,000 follicles only. Follicles are the fluid filled sacs in both ovaries and each follicle comprising of an immature oocyte. After the onset of menstruation, one oocyte undergoes ovulation period, attains maturity and converts into egg that ultimately gets released in every menstrual cycle. Around 1000 immature follicles are lost every month from puberty to 35 years of age. After 35 years, this number gets multiplied and very few follicles remain to undergo maturity. These lost follicles undergo disintegration back into the ovaries in a process called atresia.
Some other external factors like smoking, stress or drinking alcohol can badly affect the number of follicles in ovaries.
The reproductive ability or the fertility of a woman is measured by antral follicle count in both the ovaries.
Antral Follicle Count by Age: Antral follicle count(AFC) is the total number of eggs or mature follicles in both the ovaries. As the normal follicles are very small and only antral follicles reach a size of 0.8 – 1.1cm in diameter and can be seen in Ultrasound scan. The doctor applies ultrasound technique via vaginal route to count the total number of mature follicles. The antral follicle count is also known as ovarian reserve of a woman. It determines the possibilities of a woman to get pregnant. It is generally recommended to the women who undergo IVF( In vitro fertilization) or women of higher age.
The AFC test is done on third day of menstrual cycle. The doctor or technician inserts a transducer into the vagina that emits ultrasound waves to get images of follicles on the ultrasound display screen. The transducer is moved left or right to get an idea about mature follicles in both the ovaries.
An ovary with less than 4-5 follicles is considered less fertile. However it doesn’t exactly diminish the chances of getting fertile but the success rate of fertilization in IVF pregnancies get low.
The average antral follicle counts with different age variables is:
-25yrs to 34 yrs : 15( Average Follicle Count), 3(Low follicle count) and 30(high follicle count).
-35yrs to 40yrs: 9(Average Follicle Count),1(Low Follicle Count) and 25(High Follicle Count)
-41yrs to 46 yrs: 4(Average Follicle Count), 1 (Low Follicle Count) and 17(High Follicle Count)
An Antral Follicle Count by Age determines good ovarian reserve and high chances of IVF success and pregnancy. A low AFC indicates less chances of fertility. A high AFC indicates presence of PCOD(Polycystic Ovarian Disease). The doctor can further recommend medicines to improve AFC and cure any cysts if present in ovaries.
