{"id":57029,"date":"2020-12-17T19:38:10","date_gmt":"2020-12-17T17:38:10","guid":{"rendered":"https:\/\/www.juanacrespo.es\/?p=57029"},"modified":"2023-06-05T10:07:12","modified_gmt":"2023-06-05T08:07:12","slug":"antral-follicle-count","status":"publish","type":"post","link":"https:\/\/www.old.juanacrespo.es\/en\/antral-follicle-count\/","title":{"rendered":"WHAT IS ANTRAL FOLLICLE COUNTING AND HOW DO WE PERFORM IT IN JUANA CRESPO"},"content":{"rendered":"<p>Unlike men, who can produce sperm throughout their lives, women are<strong> born with a certain number of eggs<\/strong>. This number cannot increase despite medical advances and will therefore <strong>gradually decrease over the years<\/strong>.<\/p>\n<p>Ovarian reserve is the number of eggs a woman has at a specific time. Although it is not the only relevant factor in determining the chances of becoming pregnant, it is directly related to it.<\/p>\n<h2>What are antral follicles?<\/h2>\n<p><strong>Antral follicles<\/strong> are<strong> small structures contained in the ovaries<\/strong>. They are shaped like sacs of fluid and contain, in turn, the <strong>immature ova or oocytes<\/strong>.<\/p>\n<p>At the beginning of each menstrual cycle, the ovaries recruit several antral follicles. <strong>One of them will develop into a mature egg<\/strong> which, when the time comes, will be released at ovulation and wait in the fallopian tube to be fertilised by a sperm. At this point, <strong>the remaining antral follicles receive a hormonal message to disappea<\/strong>r.<\/p>\n<p>If there is no pregnancy, shortly before menstruation, another cohort of antral follicles will appear to restart the cycle.<\/p>\n<h2>How do we count antral follicles?<\/h2>\n<p>Antral (resting) follicles are shaped like a small sphere filled with fluid. Although small in size, they are<strong> visible at the beginning of the menstrual cycle<\/strong>, especially on days 3-5.<\/p>\n<p>To find out how many antral follicles a woman has (and therefore how many oocytes she may have for ovarian puncture during IVF treatment), we will <strong>perform a vaginal ultrasound<\/strong>. This test, along with others explained in this article, allows our gynaecologists to check the quantity and <a href=\"https:\/\/www.juanacrespo.es\/en\/specialty\/poor-quality-eggs\/\" target=\"_blank\" rel=\"noopener\">quality of the ovarian reserve<\/a>.<\/p>\n<p>The test is very simple (similar to a routine gynaecological check-up), completely painless, and does not require any type of anaesthesia. It is carried out in an examination room at the clinic and takes only a few minutes.<\/p>\n<p>During this time, our doctors will <strong>observe the antral follicles recruited by the ovary and count<\/strong> the ones measuring between 2 and 10 mm, which are the ones which are likely to <strong>mature and be fertilised<\/strong>.<\/p>\n<h2>What is the usual number of follicles?<\/h2>\n<p>A woman with a normal ovarian reserve has <strong>between 10 and 20 antral follicles in each menstrual cycle<\/strong>, although this number can vary each month.<\/p>\n<p>If the number is less than 10, our medical team will consider the woman&#8217;s ovarian reserve to be low. In these cases, it is usual to recommend that the patient undergo <a href=\"https:\/\/www.juanacrespo.es\/en\/treatment\/in-vitro-fertilization\/\" target=\"_blank\" rel=\"noopener\"><strong>IVF treatment<\/strong><\/a> to achieve pregnancy, although it will always depend on each case and particular circumstances.<\/p>\n<p>It is possible, for example, that the mother-to-be not only has a low ovarian reserve, but that <strong>the oocyte response to hormone treatment is also low<\/strong> (what we call &#8220;low responders&#8221;). In these cases we will carry out a strategy based on:<\/p>\n<ol>\n<li style=\"list-style-type: none;\">\n<ol>\n<li>On the one hand, <strong>applying a stimulation protocol<\/strong> that not only adapts to the patient&#8217;s circumstances, but also trying to select the optimal cycle to obtain the best oocyte. This involves a medium-term strategy, but we will ensure that the gamete has the best quality for fertilisation and future embryo implantation.<\/li>\n<li>Together with<strong> the application of a personalised stimulation<\/strong>, we will establish recommendations based on an adequate diet and healthy exercise that we can complement with: vitamins, antioxidants or the intake, for example, of coenzyme Q10. These recommendations, together with an appropriate stimulation protocol, can significantly improve the results of the treatment.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/www.juanacrespo.es\/wp-content\/uploads\/2020\/12\/cita-medica.jpg\" alt=\"doctors appointment \" width=\"605\" height=\"429\" \/><\/p>\n<h2>What other cases are there?<\/h2>\n<p>If the number of antral follicles is very low and the woman is over 40 years of age (considered late motherhood), it may be necessary to<strong> resort to <\/strong><a href=\"https:\/\/www.juanacrespo.es\/en\/treatment\/egg-donation\/\" target=\"_blank\" rel=\"noopener\"><strong>egg donation treatment<\/strong><\/a>.<\/p>\n<p>However, before recommending egg donation treatment or <a href=\"https:\/\/www.juanacrespo.es\/en\/embrio-implantation-process\/\" target=\"_blank\" rel=\"noopener\">embryo implantation<\/a>, the doctor will<strong> carry out a preliminary study of the medical and reproductive history of the patient<\/strong> or couple. She will also request any complementary tests that she considers appropriate. And, finally, with all the information, she will decide, together with the patient, the best treatment option for gestation.<\/p>\n<p>If, on the other hand, the opposite is the case and a woman&#8217;s antral follicle count is higher than 20, it is possible that there are ovulation problems related to <strong>polycystic ovary syndrome <\/strong>or excess prolactin in the blood (hyperprolactinaemia) that can have a negative effect on fertility.<\/p>\n<p>In any case, having a <a href=\"https:\/\/www.juanacrespo.es\/en\/low-ovarian-reserve-treatments\/\" target=\"_blank\" rel=\"noopener\"><strong>low ovarian reserve<\/strong><\/a> does not mean that you cannot get pregnant. However, your ovaries may not respond optimally to <a href=\"https:\/\/www.juanacrespo.es\/en\/ovarian-stimulation-phases\/\" target=\"_blank\" rel=\"noopener\">ovarian stimulation<\/a> medication. This is why we carry out a preliminary diagnosis to help us establish the most appropriate treatment strategy for you.<\/p>\n<h2>What is the purpose of the antral follicle count and in which cases is this test recommended?<\/h2>\n<p>The number or count of antral follicles is related to the <strong>oocyte reserve<\/strong> and <strong>ovarian function<\/strong>.<\/p>\n<p>It is a very common <strong>fertility test <\/strong>in reproductive medicine that will help us to assess your health and chances of pregnancy.<\/p>\n<p>In general terms, the antral follicle count serves to:<\/p>\n<ul>\n<li>Evaluate a woman&#8217;s ovarian reserve.<\/li>\n<li>Diagnose primary ovarian insufficiency.<\/li>\n<li>Help diagnose PCOS (polycystic ovary syndrome).<\/li>\n<li>Inform the mother-to-be about her fertility status in relation to her age (i.e. whether she has more or less than an average number of follicles compared to other women her age).<\/li>\n<\/ul>\n<p>On the other hand, in assisted reproduction treatments, the antral follicle count will help us to <strong>predict the number of mature (dominant) follicles<\/strong> that can be stimulated and retrieved by follicular puncture. This information has a direct bearing on hormone treatment and IVF success rates.<\/p>\n<h2>Are there other tests to determine a woman&#8217;s ovarian reserve?<\/h2>\n<p>As mentioned above, the <strong>antral follicle count <\/strong>is not the only test to assess a woman&#8217;s ovarian reserve. There are other methods:<\/p>\n<ul>\n<li>One of them is to <strong>perform a blood test<\/strong>, between days 2 and 4 of the menstrual cycle, to check the presence of FSH (Follicle Stimulating Hormone) Hormone and the levels of oestradiol and LH hormone.<\/li>\n<\/ul>\n<p>The former is responsible for <strong>stimulating oocyte maturation<\/strong>, while the latter is the oestrogen that activates the hormone LH (ludotropin), which triggers ovulation.<\/p>\n<ul>\n<li>Another method of measuring ovarian reserve is to <strong>determine the levels of anti-M\u00fcllerian hormone in the blood<\/strong>. This hormone is directly proportional to ovarian production: the higher the amount of hormone, the greater the ovarian reserve available.<\/li>\n<\/ul>\n<p>It is important to emphasise that the anti-M\u00fcllerian hormone only provides<strong> information about the quantity of oocytes, but not about their quality<\/strong>.<\/p>\n<p>When assessing a woman&#8217;s fertility and ovarian reserve, all these tests should be considered together. The first two (blood tests and vaginal ultrasound for antral follicle count) should be carried out at a specific time in the menstrual cycle, while the third (anti-M\u00fcllerian hormone levels) can be carried out at any time.<\/p>\n<p>At <a href=\"http:\/\/juanacrespo.es\/en\" target=\"_blank\" rel=\"noopener\">Juana Crespo<\/a> we are experts in the <strong>diagnosis and treatment of patients with low ovarian reserve<\/strong>. Do you have any questions about this treatment? Contact us and tell us about your case.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Unlike men, who can produce sperm throughout their lives, women are born with a certain number of eggs.  [&#8230;]<\/p>\n","protected":false},"author":20,"featured_media":30693,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","footnotes":""},"categories":[66],"tags":[],"class_list":["post-57029","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/posts\/57029","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/comments?post=57029"}],"version-history":[{"count":1,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/posts\/57029\/revisions"}],"predecessor-version":[{"id":57075,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/posts\/57029\/revisions\/57075"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/media\/30693"}],"wp:attachment":[{"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/media?parent=57029"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/categories?post=57029"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.old.juanacrespo.es\/en\/wp-json\/wp\/v2\/tags?post=57029"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}