{"id":105991,"date":"2020-09-22T11:47:10","date_gmt":"2020-09-22T09:47:10","guid":{"rendered":"https:\/\/ivi-fertility.com\/?p=105991"},"modified":"2022-04-12T17:35:21","modified_gmt":"2022-04-12T15:35:21","slug":"primordial-follicle-fertility","status":"publish","type":"post","link":"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/","title":{"rendered":"How do ovarian and antral follicles relate to fertility?"},"content":{"rendered":"<p>The beautiful complexity and delicate balance of the reproductive system are among the wonders of human biology. It would be impossible to claim that any one element was more important than the others because they all play an essential part, but it is true to say that without <strong>ovarian follicles<\/strong> there could be no egg to be fertilised; without a fertilised egg there could be no embryo, no pregnancy and no little bundle of joy to culminate the process.<\/p>\n<p>Here we\u2019re going to take a closer look at the role that ovarian and <strong>antral follicles<\/strong> play in <strong>fertility<\/strong> and how a reduction in their number can lead to <strong>infertility<\/strong>. We will also explain why the <strong>antral follicle count<\/strong> is so crucial in the success of various <strong>infertility<\/strong> treatments like IUI and IVF. To start at the beginning: what is an <strong>ovarian follicle<\/strong> and what are <strong>antral follicles<\/strong>?\u00a0<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_68_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#Ovarian_follicles_%E2%80%93_what_are_they\" title=\"Ovarian follicles \u2013 what are they?\">Ovarian follicles \u2013 what are they?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#i\" title=\"\u00a0\">\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#Why_are_antral_follicles_important_for_fertility\" title=\"Why are antral follicles important for fertility?\">Why are antral follicles important for fertility?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#What_is_a_normal_antral_follicle_count\" title=\"What is a normal antral follicle count?\">What is a normal antral follicle count?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#Why_is_the_antral_follicle_count_important_for_fertility_treatment\" title=\"Why is the antral follicle count important for fertility treatment?\">Why is the antral follicle count important for fertility treatment?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#i-2\" title=\"\u00a0\">\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/#Finding_out_more_about_fertility_treatment\" title=\"Finding out more about fertility treatment\">Finding out more about fertility treatment<\/a><\/li><\/ul><\/nav><\/div>\n<h3><span class=\"ez-toc-section\" id=\"Ovarian_follicles_%E2%80%93_what_are_they\"><\/span><strong>Ovarian follicles \u2013 what are they?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Every woman on the planet was born with all the follicles she will ever have. These formed in the ovaries during the foetal development stage and at birth there could be anything between 600,000 and 1,000,000 <strong>ovarian follicles<\/strong>. At this stage they are not eggs but <strong>primordial follicles<\/strong> and there is a long process to go through before they mature.<\/p>\n<ul>\n<li><strong>Primordial follicles<\/strong> measure only 25 micrometres and are impossible to see with the naked eye. This is the stage of all follicles inside the ovaries at birth.\n<\/li>\n<li><strong>Primary follicles<\/strong> follow with the onset of puberty, with a few primordial follicles developing to the primary stage each and every day from puberty to menopause.\n<\/li>\n<li><strong>Secondary follicles<\/strong> develop as part of each monthly cycle, and start to grow in size with additional cells which secrete hormones.\n<\/li>\n<li><strong>Tertiary follicles<\/strong>, also known as <strong>antral follicles<\/strong>, are the all-important stage where they have developed far enough to be surrounded by a fluid-filled sac called the antrum. They are now large enough to be observed via an ultrasound scan and measure between 2 and 10 mm. An antral follicle of 5 mm is 200 times larger than a primordial follicle. At this point they also start to secrete anti-Mullerian hormone (AMH). Measuring the level of this hormone in the blood is an alternative to an ultrasound scan to estimate your ovarian reserve.\n<\/li>\n<li><strong>Graafian follicle<\/strong> is the final stage where the follicle has developed to the point where it can release a mature egg. Only one or occasionally two follicles reach this stage each month, the rest fade and are reabsorbed in a process known as atresia.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"i\"><\/span>\u00a0<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Why_are_antral_follicles_important_for_fertility\"><\/span><strong>Why are antral follicles important for fertility? <\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>It is natural and inevitable that the number of eggs remaining, which is the ovarian reserve, decreases with age. But there is no exact correlation between the two. Some women may have a low ovarian reserve, meaning they would have difficulty getting pregnant naturally, at an earlier age than the norm. For example, a woman with a very low ovarian reserve before the age of 40 may be diagnosed with premature ovarian failure. Even though counting the exact number of eggs left is impossible, an <strong>antral follicle count <\/strong>has been shown to be a good indicator of ovarian reserve.<\/p>\n<p>This is important for two reasons. A woman who is unsure whether or not to wait a couple of years before trying for pregnancy may need the reassurance of knowing she has a good ovarian reserve, and conversely a low <strong>antral follicle count<\/strong>, showing a low reserve, may indicate that she should try sooner rather than later, or go ahead with freezing her eggs at an earlier age. Secondly, an estimate of ovarian reserve is important in predicting how well a woman will respond to ovarian stimulation used as part of a treatment for <strong>infertility<\/strong>.<\/p>\n<p>&nbsp;<\/p>\n<h3><span class=\"ez-toc-section\" id=\"What_is_a_normal_antral_follicle_count\"><\/span><strong>What is a normal antral follicle count?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>An <strong>antral follicle count<\/strong> of 15 is the average for a woman aged between 25 and 34. For a 35 to 40-year-old, you could expect an average of 9, falling to an average of 4 between 41 and 46 years. For any age, a count of 3 to 6 is generally considered low.<\/p>\n<p>&nbsp;<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Why_is_the_antral_follicle_count_important_for_fertility_treatment\"><\/span><strong>Why is the antral follicle count important for fertility treatment?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>As an indicator of likely response to hormonal drugs to stimulate the ovaries, an estimate of ovarian reserve is very important. The test is carried out by transvaginal ultrasound and the technician physically counts the number of follicles they can see which have reached the antral stage. This is essential information for the <strong>fertility<\/strong> specialist to prescribe the level of stimulation appropriate for a particular patient. However, the number of eggs required is very different according to the <strong>fertility<\/strong> treatment in question.<\/p>\n<p><a href=\"https:\/\/ivi-fertility.com\/assisted-reproduction-treatments\/artificial-insemination\/\"><strong>Intrauterine Insemination (IUI)<\/strong><\/a><\/p>\n<p>This treatment involves injecting an optimised sperm sample directly into the woman\u2019s uterus at the time of ovulation. Therefore a good number of eggs stimulated for IUI would be one or two, to avoid the risk of multiple births. If too many eggs are produced, your <strong>fertility<\/strong> specialist may need to cancel the cycle, ask you to refrain from sex and try again in another menstrual cycle.<\/p>\n<p><a href=\"https:\/\/ivi-fertility.com\/assisted-reproduction-treatments\/in-vitro-fertilisation\/\"><strong>In vitro fertilisation (IVF)<\/strong><\/a><\/p>\n<p>For IVF treatment, however, generally the more mature eggs that can be retrieved, the better the chances of success. Anything between 8 and 15 <strong>antral follicles<\/strong> would be an acceptable number. You shouldn\u2019t be disappointed if the number of eggs which are eventually retrieved after ovarian stimulation does not quite correspond with the number of follicles you\u2019ve been told you have. This is because every follicle will not necessarily contain a good quality egg.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"i-2\"><\/span>\u00a0<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<h3><span class=\"ez-toc-section\" id=\"Finding_out_more_about_fertility_treatment\"><\/span><strong>Finding out more about fertility treatment <\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Do remember that if you have been diagnosed with a low ovarian reserve, it does not necessarily mean that you can\u2019t become pregnant naturally, or that <strong>fertility<\/strong> treatment won\u2019t work. In fact, although there are no guarantees, in the vast majority of cases, we can help. You can <a href=\"https:\/\/ivi-fertility.com\/ask-for-an-appointment\/\">contact us at IVI<\/a> to find out more about tests, diagnosis, and which treatments may be appropriate for you.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"The beautiful complexity and delicate balance of the reproductive system are among the wonders of human biology. It would be impossible to claim that any one element was more important than the others because they all play an essential part, but it is true to say that without ovarian follicles there could be no egg&#8230; <a class=\"view-article\" href=\"https:\/\/ivi-fertility.com\/blog\/primordial-follicle-fertility\/\">View Article<\/a>","protected":false},"author":1,"featured_media":105992,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[256,257,170,251,258],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How do ovarian and antral follicles relate to fertility? - IVI Fertility<\/title>\n<meta name=\"description\" content=\"Do you know what ovarian follicles or fertilised egg mean for fertility? 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