Antral Follicle Count

My husband and I are in the midst of fertility testing.  I am 32 and he is 35.  My day 3 FSH is normal - 7.6 and all results of my cycle monitoring were normal (good size follicle, good estrogen/progesterone).  My day 3 ultrasound, however, showed only 7 antral follicles - 4 on my left, 3 on my right.  Also on my left was a 1.6 corpus luteum cyst left over from my last cycle.  I was extremely concerned about the fact that there were only 7 follicles as everything I have read suggests less than 10 is a concern.  My RE suggested I should not worry as my FSH was good and AFC can vary month to month.  As well, she said the presence of a hemoragic cyst disrupts the image and there may well have been more follicles they couldn't see.  Nonetheless, I am still concerned.  Can a single AFC be a marker for diminished ovarian reserve?  Could this be the cause of our infertility?  I am wondering if my RE is simply being too optimistic because of my age.  Any thoughts you might have would be welcome.

[Elaine Brown, MD]

Hi!
If you were my patient, I would say exactly what your RE is saying--wait for another cycle and see what the antral follicle count looks like.  Because everyone is different, it is theoretically possible that you could have a somewhat diminished reserve, although your FSH certainly doesn't suggest that is true.  Even if so, it is only one predictor of what your response will be to ovarian stimulation.  If your RE isn't concerned, I'm sure that she will at least let you attempt a cycle to see how your ovaries really do respond.
Remember too, that you only really want one or two embryos for transfer, so you don't really need 15 or 20 ( although that would be nice too!).
Two things:  Stressing over your results is NOT going to help, and accupuncture might.
So, if you were my patient, I would recommend the latter and not the former!


Good luck!

Dr B