What is Antral Follicle Count (AFC)?

Antral follicle count (AFC)

Before going through a fertility treatments, IVF specialist will ask some fertility tests to be performed. The “antral follicle count” (AFC) is one of those key fertility tests. The antral follicle count, together with some hormone blood tests, are considered as a must for fertility testing.


What is an Antral follicle?

Women are born with all the eggs they will ever have. The number of eggs decrease constantly until menopause. “Ovarian reserve” refers to the reserve of the ovaries in other words “remaining egg supply” to be able to have babies.

Antral follicle is a small follicle (fluid-filled sac) in the ovaries that contains a immature egg that can potentially develop and ovulate in the future. A mature follicle (about to ovulate) measures between 18 – 25 mm.


What does AFC stand for?

The “antral follicle count” (AFC) means the sum of those follicles on both ovaries that can be detected by transvaginal ultrasound. Together with AMH test results and the age of a woman, the number of antral follicles, stand for the most accurate indicators of ovarian reserve that links with reproductive potential of woman. In other words, AFC indicates, how many eggs are left in your ovaries and the total number of mature eggs you might retrieve from a stimulation cycle.

Antral follicule numbers also good indicators for;

Ovarian response to stimulating medications used in IVF (How many eggs might be retrieved from a stimulation cycle)

  • Chances for a succesful IVF
  • Risk for a cycle cancellation


How does AFC change according to the age?

As the age icreases, women have less eggs remaining and fewer antral follicles. The number of follicles declines at a faster rate after age 35. Although these figures vary from woman to woman there are general benchmarks based on the studies.*



Age                             Average AFC            Lowest AFC              Highest AFC

25 to 34                                 15                               3                                 30

35 to 40                                 9                                 1                                 25

41 to 46                                 4                                 1                                 17


*Source: https://academic.oup.com/humrep/article/18/4/700/596535


Does a low AFC mean that you are unable to have a baby?

Although antral follicle count is a valuable indicator of fertility, a low number does not necessarily mean you will be unable to have a baby since for getting pregnant one good quality egg to be ovulated might be sufficient.

Please feel free to consult us to find out the best fertility treatment option for you.

What is an anti-müllerian hormone (AMH)?

AMH, also known as anti-Müllerian hormone, is a protein hormone created by unique cells inside ovarian follicles. Both male and female reproductive tissues produce AMH. Your age and gender will determine how AMH functions and whether your levels are normal.

AMH influences an unborn child’s development of sex organs. A baby will begin growing reproductive organs in the first few weeks of pregnancy. The baby will already have the genes to become either a male (XY genes) or a female (XX genes).

What is the AMH test?
An AMH test is often used to check a woman’s ability to produce eggs that can be fertilized for pregnancy. The number of eggs that a woman’s ovaries can produce declines as the woman gets older. AMH levels help show how many potential egg cells a woman has left. This is known as the ovarian reserve. If a woman’s ovarian reserve is high, she may have a better chance of getting pregnant.

Doctors can estimate a woman’s egg count by looking at her blood levels of AMH, which can also help them determine how many follicles are present in her ovaries. AMH levels for a fertile woman are between 1.0 to 4.0 ng/ml; under 1.0 ng/ml is considered low and indicative of a diminished ovarian reserve.

AgeAMH Level (ng/ml)


https://pubmed.ncbi.nlm.nih.gov/20970126/ Fertil Steril, 2011. Age-related distribution of basal serum AMH level in women of reproductive age and a presumably healthy cohort.


Nutritional Recommendations For Polycystic Ovary Syndrome

Basic Nutritional Treatment Principles in Polycystic Ovary Syndrome:

• Daily energy needs are determined according to individual characteristics. While providing bodyweight loss, it is aimed to lose 5-10% of the current weight in the first 6 months.

• Foods with a low glycemic index, high fiber content, low fat, and high protein content are preferred.

• Adequate consumption of oily fish (fish of unknown origin should not be consumed as it may contain heavy metals) is beneficial in terms of intake of omega-3 fatty acids. Appropriate Omega-3 supplementation is important in nutritional therapy.

• Fresh vegetables and fruits, which fight against inflammation with the vitamins, minerals, and antioxidants they contain, should be consumed sufficiently in the diet. In addition, packaged foods and allergic foods should be restricted to reduce inflammation in the body.

• Saturated fat intake should be limited and healthy fats (such as olive oil, almond, avocado) should be preferred.

• Particular attention should be paid to adequate vitamin D and calcium consumption.

• The consumption of refined carbohydrates, processed foods, and alcohol should be avoided.

• Daily caffeine intake should be limited and a sufficient amount of water should be consumed.

Rabia Yalinca, Dietician

Does IVF treatment cause Ovarian Cancer?

Since the development of IVF, one of the most controversial topics highlighted by specialists has been the link between fertility treatment and a higher risk of ovarian cancer. New research from the Netherlands was published in the Journal of the National Cancer Institute on November 17, 2020. “It’s reassuring to know that women who had ovarian stimulation for assisted reproductive technology have no elevated risk of malignant ovarian cancer, even over time,” says leading author Flora E. van Leeuwen, Ph.D., of the Netherlands Cancer Institute.

The new study, done in the Netherlands, included 30,625 women who received ovarian stimulation as well as 9,988 those suffering from infertility who did not receive any such treatment. The study followed these participants for a median period of 24 years. In comparing the two groups, no increased risk was shown for those women who received ovarian stimulation, even after two decades. Another noteworthy discovery was that women with more successful IVF cycles had a lower risk.

Experts have evaluated these findings based on all available information. After a thorough examination, they concluded that the study’s findings contradict the premise that IVF procedures raise the risk of ovarian cancer. This new study is all the more critical when the number of infertile couples is at an all-time high.

As Cyprus IVF hospital, we understand how stressful and challenging fertility treatment can be. Reassuring our patients is a goal we work on daily. We’re more excited than ever to share the findings of this study with you.

We are now a member of Fertility Help Hub!

We are constantly expanding our partnerhips around the world aiming to make IVF journey as comfortable as possible for our patients.

In this respect, we are delighted to announce that we have launched a new partnership with Fertility Help Hub.

Fertility Help Hub (FHH) guides and connects a likeminded community, from the highs and lows of pre-conception, through pregnancy and parenthood. Everything FHH does, rooted in a place of experience: from shared stories, and offers to daily expert advice and events.

Eloise Edington, Founder & CEO of FHH, explained their mission as to create a community and to connect with others who actually understand what a fertility struggle feels like. It is an inclusive and free platform, offering everyone around the world all of the things they might need to have along the way: a supportive community, fertility specialist guidance, shared stories and offers, collected together in one beautiful, optimistic space.

Eloise expressed that “We are delighted to be partnering with Cyprus IVF Hospital, to offer our readers medical expertise and third-party reproductive choices at an affordable cost.”