What Are Follicles and What Do They Mean for My IVF Treatment?

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Considering, or going through, IVF treatment can be an emotional, confusing and stressful time. IVF treatment is full of terminology and a plethora of features, factors, considerations and concerns. That’s why we’ve taken one element of IVF at a time, to give you a good grasp of all the elements involved in IVF treatment. In this article we’ll be looking at antral follicles; what they are and what they mean in terms of your fertility and chances of IVF success.

What are Antral Follicles?
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Your ‘ovarian reserve’ is the number of eggs that you currently have. All women are born with every single one of the eggs they will have in their lifetime and an egg is lost at every menstrual cycle. There is no way of directly counting the eggs in your ovarian reserve but counting your antral follicles is a good way to gauge the number.

Antral follicles are small 2mm-8mm fluid-filled cavities next each of your oocytes (undeveloped, immature eggs). These little cavities can be seen and counted using a vaginal ultrasound and an accurate antral follicle count can give you a good idea of the number of eggs you have left in your ovaries. Furthermore, the size and shape of your antral follicles, as seen on your vaginal ultrasound, could indicate the health and quality of your remaining eggs. This information makes an antral follicle count a very useful tool for gauging your fertility and your suitability for IVF treatment.

What do My Antral Follicle Levels Mean for My IVF Treatment?
If you’ve already had an antral follicle count to judge your suitability for IVF treatment you might be wondering what the results of your ultrasound mean. Of course there are always exceptions and surprises but, in general the results pan out like this:

Less than 4 antral follicles: This is a very low count. This suggests that your ovaries will have an extremely poor response to ovarian stimulation. If your antral follicle count is this low you should consider giving up on IVF and cancelling your treatment as it unfortunately has a very low chance of success.

4-6 antral follicles: This is a fairly low count. Ovarian stimulation is not likely to have a good response and to counter this you will probably need to be given high doses of FSH to give your ovaries a better chance. It is possible that with a low count like this your IVF treatment may be cancelled. Sadly, when egg retrieval is successful, there is a lower chance of pregnancy with antral follicle counts at this low level.

7-10 antral follicles: This is still a fairly low count with the possibility of IVF cycle cancellation and a slightly lower chance of ultimate pregnancy success.

11-15 antral follicles: This is the lower end of ‘average’. Usually ovarian stimulation has reasonable results but can be on the low side. Pregnancy success rates are fair but not excellent.

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