How Many Follicles Are Normal in Each Ovary?
To assess a woman’s ovarian reserve, various tests can be performed, but the most predictive ones are the antral follicle count and hormonal profile analysis.
Antral follicles are structures that contain immature eggs surrounded by follicular fluid. These immature eggs can continue their development until they become mature eggs ready to be released. Additionally, antral follicles produce estrogens and the anti-Müllerian hormone (AMH), which actively participate in regulating the menstrual cycle and preparing the endometrium for potential implantation.
Antral follicles are visible on ultrasound when they reach 2 to 9 mm in size. Due to their easy diagnosis, the antral follicle count at the beginning of the cycle is one of the most used methods for calculating a woman's ovarian reserve.
The more antral follicles, the better the expected ovarian reserve. A count of 8 or more antral follicles indicates a good ovarian reserve, while a lower count may suggest a diminished ovarian reserve.
The main factors affecting ovarian reserve include:
- Age: Ovarian reserve naturally declines with age. From age 35 to 40, this decline accelerates significantly.
- Genetic factors: Certain genetic factors may influence the rate of egg depletion.
- Lifestyle factors: Smoking, alcohol consumption, a poor diet, and chronic stress can accelerate ovarian reserve deterioration.
- Medical conditions: Polycystic ovary syndrome (PCOS), or endometriosis can affect ovarian reserve. Additionally, certain autoimmune diseases, pelvic infections, and conditions that disrupt hormonal balance can impact ovarian function.
- Medical treatments: Chemotherapy and radiotherapy, particularly when directed at the pelvic region, can significantly reduce ovarian reserve. Likewise, ovarian surgeries may decrease the number of available follicles.
What Can I Do If I Have a Low Ovarian Reserve?
- Adopt healthy habits such as a balanced diet and regular exercise, and, to improve the quality of available eggs, avoid harmful habits such as smoking and alcohol.
- Ovarian stimulation techniques help maximize the number of eggs available per cycle.
- In cases of a very low ovarian reserve or advanced maternal age, egg donation is one of the most successful alternatives.
We recommend consulting a fertility specialist to design a personalized plan based on your age and specific situation.