Can Antral Follicle Count (AFC) Change?

As you embark on your egg freezing journey, you're likely to encounter a whirlwind of medical terms, tests, and metrics that can feel overwhelming at first. Among these is an especially important one: the Antral Follicle Count (AFC). This key indicator plays a significant role in understanding your chances of success with egg freezing by measuring the number of follicles in your ovaries.

But what exactly is AFC, and why does it matter so much? More importantly, is it a fixed number, or can it change over time? These are questions that many folks grapple with as they navigate egg freezing.

In this article, we'll dive into the world of AFC, demystifying this important metric and exploring its variability. We'll break down the science in a way that's accessible and relevant to your egg freezing journey, helping you understand what your AFC means for your fertility and how it might influence your treatment plan.

Whether you're just starting to consider egg freezing or you're already in the midst of the process, understanding AFC can empower you to make informed decisions about your reproductive future. It's not just about numbers on a chart; it's about gaining insight into your body's unique fertility landscape and working with your healthcare team to optimize your chances of success.

By the end of this article, you'll have a clearer understanding of what AFC is, how it's measured, why it matters, and yes - whether it can change. Armed with this knowledge, you'll be better equipped to navigate your egg freezing journey with confidence and clarity.

What is AFC and how is it measured?

Antral Follicle Count is a key indicator of your ovarian reserve - essentially, it's a snapshot of your egg supply. Whereas AMH measures your ovarian reserve through a hormone blood test, AFC is an actual look at your antral follicles, which are small fluid-filled sacs containing immature eggs. But what is an ovary follicle exactly? An ovary follicle is a structure within the ovary that contains a developing egg. To assess AFC, a fertility doctor performs a transvaginal ultrasound, typically early in your menstrual cycle, to count these follicles in your ovaries.

The number of visible follicles, your AFC, is a helpful predictor of how your ovaries might respond to fertility medications during the egg freezing process. A higher count generally suggests a better ovarian reserve and potentially more eggs that can be retrieved.

Fertility doctors use this information to tailor your treatment plan, determining which medications to use and in what doses. It's like creating a personalized roadmap for your egg freezing journey.

Does AFC change within a cycle?

While it's often recommended to perform the AFC early in your menstrual cycle, experts suggest that it can be assessed at various points. However, it's important to remember that there can be some fluctuation depending on when the ultrasound is done. In fact, studies have shown that AFC can vary by as much as 30-34% within a single cycle. This variability is worth keeping in mind as you interpret your results.

Can AFC change month to month?

Does antral follicle count change? Yes, your AFC isn't set in stone. Indeed, it can vary from one menstrual cycle to the next. This variability is one reason why fertility specialists often consider AFC alongside other markers, like Anti-Müllerian Hormone (AMH) levels, to get a more comprehensive picture of your ovarian reserve.

Remember, AFC correlates with the number of eggs retrieved during an IVF cycle, which is why it's such a valuable predictor for egg freezing outcomes.

A very low AFC (typically less than 5-7) is associated with a smaller number of eggs retrieved and potentially reduced pregnancy rates down the line. On the flip side, a high AFC (20 or more) could indicate a risk of ovarian hyperstimulation syndrome (OHSS) during fertility treatments.

Can I increase my AFC?

While AFC generally declines with age, there are factors that can influence it. For instance, if you're using hormonal contraceptives or certain other medications, your AFC might appear lower than it actually is. Once you stop these medications, you might see an increase in your AFC.

To increase your chances of a successful egg freezing cycle, optimize your fertility health as soon as possible. This step will look a little different from person to person since everyone has their own unique medical history and concerns. Generally speaking though, optimizing your health will include following a balanced diet and making other healthy lifestyle choices. In some cases, you may want to consider adding certain vitamins and supplements to your regimen too. Make sure to talk to your fertility specialist if you’re not sure!

You may also want to consider doing multiple egg retrieval cycles. If you have the resources and time to do multiple cycles, this can vastly improve the pool of eggs to choose from in the future. This is an especially helpful option for people who are older or have a low AFC. If your fertility provider thinks more cycles will improve your chances, they’ll discuss those recommendations with you.

What is a normal AFC by age?

The normal range of antral follicle count can vary depending on your age. In general, those who are younger tend to have a higher number of antral follicles, indicating a larger ovarian reserve. As a person ages, the number of antral follicles naturally declines, reflecting the diminishing ovarian reserve.

While the specific numbers can vary, a typical AFC for someone in their 20s and early 30s may range between 10-20 follicles, in their late 30s around 8-15 follicles, and by their 40s, it could further decline to under 10 follicles. It's important to remember that these numbers are approximate and can vary based on individual factors such as genetics and overall reproductive health.

One study of infertile women looked at exactly how antral follicle count declines with age, finding the median AFC to be:

• 14 at age 25
• 12 at age 30
• 10 at age 35
• 8 at age 40
• 6 at age 45

What does this mean for you?

Understanding the variability of AFC can help you approach your egg freezing journey with realistic expectations. If your first AFC measurement isn't what you hoped for, remember that it can change. Your fertility doctor might recommend retesting in a subsequent cycle or adjusting your treatment plan based on your individual AFC trends.

Remember, AFC is just one piece of the puzzle. Your age, overall health, and other fertility markers all play crucial roles in determining your egg freezing outcomes. The goal is to create a personalized plan that gives you the best chance of success.

As you navigate this process, don't hesitate to ask your fertility doctor questions. Understanding your body and your options is empowering, and it can help you make informed decisions about your fertility preservation journey.