What is the typical antral follicle count (AFC) per ovary in reproductive-age women, and what is its clinical use?

• A. About 10 to 40 per ovary; used to estimate ovarian reserve.
• B. Approximately 5 to 20 antral follicles per ovary; used to assess ovarian reserve and predict response to stimulation.
• C. Fewer than 5 per ovary indicates a very high response.
• D. More than 20 per ovary indicates poor response.

Answer: (B)

Antral follicle count is a ultrasound-based measure of the pool of recruitable follicles in the ovaries, giving a practical read on ovarian reserve and how the ovaries might respond to stimulation. In reproductive-age women, the typical count per ovary is about 5 to 20. This range helps clinicians estimate remaining reproductive potential and plan treatment, especially for IVF, by guiding the choice of stimulation doses and counseling about likely outcomes.

A lower count suggests diminished ovarian reserve and a potentially poorer response to gonadotropin stimulation. Conversely, a higher count indicates a larger recruitable pool and a greater chance of a strong or even excessive response, which can influence dosing to reduce the risk of ovarian hyperstimulation. Note that AFC can be influenced by technique and cycle timing, so it’s interpreted as part of a broader assessment of ovarian function.