Antral Follicle Count (AFC) is a key fertility test that estimates a woman’s ovarian reserve by counting the number of small follicles present in the ovaries at the beginning of the menstrual cycle, typically on day 2 or 3. These follicles are called antral follicles, which are fluid-filled sacs containing immature eggs.
How is AFC Done?
- AFC is assessed using a transvaginal ultrasound (TVS), which provides a clear view of the ovaries.
- The number of small antral follicles, typically measuring 2 to 10 mm in diameter, are counted in each ovary.
- The follicle count varies naturally, but it is a direct indicator of how many eggs are potentially available for ovulation in that cycle and overall ovarian reserve.
What is a Normal AFC?
- A normal AFC ranges from about 10 to 15 follicles in each ovary on day 2 or 3 of the menstrual cycle.
- The range can vary slightly based on age, genetics, and health status. Generally:
- Younger women tend to have higher AFCs (15-30 total follicles).
- AFC decreases gradually with age, especially after age 35.
- An AFC below 5-7 may suggest diminished ovarian reserve.
Why is AFC Important?
- AFC is one of the best predictors of ovarian reserve—the quantity and quality of a woman’s remaining eggs.
- It helps fertility specialists assess a woman’s fertility potential and design personalized treatment plans, especially for assisted reproductive technologies like IVF.
- The AFC gives an indication of the expected response to ovulation induction medications and the potential number of eggs that can be retrieved.
Conclusion
Antral follicle count is a simple yet powerful ultrasound test done early in the menstrual cycle to evaluate a woman’s ovarian reserve. A normal AFC of 10-15 antral follicles per ovary indicates good fertility potential and responsiveness to fertility treatments. Regular assessment of AFC helps guide clinical decisions in infertility management and improve chances of successful conception.