Noob question - Antral Follicle Count Day 3

PrettyPalomino · May 2019

Sorry for this potentially stupid question but I've scoured Dr. Google to no avail.

I had my baseline ultrasound today and the tech counted 42 follicles (cycle day 3 - 21 on each side - I'm 31 yrs old). I cannot for the life of me find what a normal amount is. I'm seeing that 10 or less is considered abnormal and 10-20 is normal, so what the heck is 42?? I saw that an abnormally high amount could indicate PCOS but as far as I can tell, I'm regular and I get + OPKs.

Sorry, I know we aren't doctors but my follow-up to discuss results isn't until end of July, so I thought I'd check here to ease my conscience.

inthewoods23 · May 2019

@PrettyPalomino same! I think my count was 33+ or so. I've read that as well that it can indicate PCOS but all my numbers are within normal ranges (although my AMH is slightly high at 4.5) and my tracking indicates I ovulate regularly.

When they did my count the RN said they like to see 10 follicles on each ovary so the 10-20 follicles is probably a good norm.

Also, with a high AFC like you have you'll probably be more at risk for OHSS if you're using injections, but your doctor is probably a good resource about that. Did you doctor have any comments to the 42 number?

PrettyPalomino · May 2019

@inthewoods23 I am still going through a battery of tests. I went for CD2 blood work, that AFC ultrasound, next up is some sort of saline-through-the-tubes ultrasound in a week, and then CD 23 blood work. And then DH does a SA and blood work. Once the doc has all the results, we meet her again and she diagnoses/suggests treatment.

The tech was tight-lipped, as they're supposed to be I guess! It's so frustrating when you know they know what they're seeing, but they're not allowed to speak to it.

ACAC25 · May 2019

I agree with @inthewoods23! I was also told with patients with PCOS a high follicle and retrieval count. I would also be aware of hyper stimulation. It can make before and after the retrieval quite uncomfortable so definitely take it easy if you have a lot of follicles.
In terms of the saline through the tubes (I was told it's a hystosonogram or something). It is quite uncomfortable, definitely take painkillers before you go in.
Hopefully you get lots of answers soon!

cashewchicken · May 2019

I had about that many (40+) AFC when I first visited an RE at age 36. Like you, I’ve always tested + on OPK and fairly regular periods. I was told I had polycystic ovaries but not PCOS, as I had no other characteristics (such as excessive hair growth, no- or irregular periods, etc). I remember I was told the average number of eggs at my age was 5-10 total. Many patients with PCOS have high testosterone and high lutenizing hormone (LH) to follicle-stimulating hormone (FSH) ratio. Mine were normal for both, another reason why they didn’t think I had PCOS. My AMH level, an indicator for ovarian reserve, was really high at 11, which makes sense since my AFC was high.

Since my husband and I had normal results based on initial tests (unexplained infertility), we started with IUI. I responded really well to both clomid and letrozole, almost too well. For both meds, I had to start with the lowest dose. Even that resulted in 2-3 mature follicles. Unfortunately IUI wasn’t successful for us so we moved on to IVF. Like what others said, when you have high AFC, you have a high risk of hyper stimulation of ovaries (OHSS). So you’ll likely do a stimulation protocol that minimizes the chance of OHSS. The one upside to having a high AFC is that you are more likely to have a success with IVF. The quality of egg is important, but in IVF, the number of eggs you retrieve is important too.

PrettyPalomino · May 2019

@cashewchicken thanks so much for sharing, it does sound like the same situation. We're still far from diagnosis but I like to collect as much info as I can along the way. I also don't have any major PCOS symptoms apart from minor ones like oily skin, hair loss, etc. so it'll be interesting to see how the blood work comes out.

lucyb1954 · May 2019

Lurking but want to echo the vote for painkillers before the saline ultrasound. It is mighty uncomfortable!!! I also have a tipped uterus so that makes it worse but still. Not fun.

[Deleted User] · June 2019

Full disclosure, my first saline sono was sorta traumatic. I also went into it terrified and, "trying to relax." But the second my new doctor was mindful to be very gentle, and I literally barely felt anything at all. It wont necessarily be bad at all. I think if you go into it nervous it makes it harder. I mean seriously, it was almost pleasant the second time, I'm not even kidding. Im sure you'll be fine. ;)

<div class=" Spoiler">ETA Realistically, if they find a blockage that might make it more uncomfortable, but that's more the exception they find anything than the rule.</div><p>
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Noob question - Antral Follicle Count Day 3

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