What is the significance of antral follicle count in ovarian reserve assessment?

• A. AFC predicts time to pregnancy
• B. AFC correlates with remaining follicular pool and helps predict ovarian response
• C. AFC directly measures fertility
• D. AFC is only used to diagnose menopause

Answer: (B)

Antral follicle count reflects how many recruitable follicles remain in the ovaries, giving a real-time snapshot of ovarian reserve. This matters because the number of small follicles visible on ultrasound is tied to the size of the remaining primordial follicle pool, so a higher count generally indicates a larger reserve.

That’s why this measure is most useful for predicting how the ovaries will respond to stimulation in assisted reproduction. A higher AFC suggests a stronger ovarian response and more eggs retrieved with stimulation, while a low AFC points to a higher risk of a poor or suboptimal response. It helps clinicians tailor stimulation protocols and set realistic expectations about egg yield and prognosis.

AFC does not directly measure fertility or predict time to pregnancy, nor is it used solely to diagnose menopause. It’s one piece of the overall assessment of ovarian function, best interpreted alongside age, AMH, FSH, and clinical context.