Antral Follicle Count
The response to gonadotropins may be roughly approximated by antral follicle count (AFC), estimated by vaginal ultrasound, which in turn reflects how many primordial follicles there are in reserve in the ovary.
In regard to how many antral follicles are achieved in "response" to ovarian hyperstimulation, women may be designated as low (or poor) responders, normal or average responders or high responders.
| Antral follicle count | Classification | Approximate expected response | Risks | Pregnancy rates | Recommendation |
|---|---|---|---|---|---|
| Less than 4 | Extremely low | Very poor or none | Cancelled cycle expected | 0–7% with 1 oocyte | Not attempt IVF |
| 4-7 | Low | Possibly/probably poor response | Higher than average rate of IVF cycle cancellation | 15% | High doses of gonadotropin likely |
| 8-10 | Reduced | Lower than average | Higher than average rate of IVF cycle cancellation | Slightly reduced | |
| 11-14 | Normal (but intermediate) | Sometimes low, but usually adequate | Slight increased risk for IVF cycle cancellation | Slightly reduced compared to the "best" group | |
| 15-30 | Normal (good) | Excellent | Very low risk for IVF cycle cancellation. Some risk for ovarian overstimulation | Best overall as a group with approx. 35% |
Low doses of gonadotropins |
| More than 30 | High | Likely high | Overstimulation and ovarian hyperstimulation syndrome | Very good overall as a group, but potential egg quality issues |
Low doses of gonadotropins |
Older poor responders have a lower range of pregnancy rates compared with younger ones (1.5–12.7 versus 13.0–35%, respectively).
Read more about this topic: Ovarian Hyperstimulation, Response Predictors
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