AFC and # of Eggs

[Anonymous]

It is my understanding that the IVF process encourages more follicles to grow into eggs but it cannot increase the number of available follicles. I am 41 yo; my AFC was 6 on day 2 of my cycle. My Dr called it "respectable" (How depressing). Yesterday was day 5 of stim meds and today they counted 10 follicles at my first ultrasound appt since they did AFC. I dont understand how that squares with my understanding that the IVF meds cannot create new follicles. Is it that follicles are so small when they do AFC that they miss some? Can anyone explain? This is not my first IVF but my first with this clinic -- i am encouraged bc this is a higher number of follicles than at the same point in previous cycles.

[Anonymous]

It's been a while since I read up on this, and my understanding is far from perfect, so take this with a grain of salt. Women typically lose 1000 eggs per month, which works out to about 30 follicles a day (though much less as you get older), so follicles "come up to bat" everyday. So when you start stimming you are growing not just the follicles from that specific day but also the days after, but given that the mature follicles they retrieve will need to be in a fairly tight size range - say 15mm-22mm or whatever it is - they can't be many days apart, so maybe 2-3 days worth of follicles (that just graduated from preantral to antral)? This why as you stim you'll continue to see new follicles under 10mm pop up, but unless it's very early in the stims they won't be viable as they don't have time catch up to their older follicle siblings. The way you put it - were some too small to be seen for the AFC? - might be accurate in that some of the "too small" ones were only a day or so away from being big enough, so you're seeing them now.

As I said, my understanding could be completely wrong, but the important thing is that yes, you can certainly end up with more follicles and mature eggs than your AFC. My eggs retrieved has always been more than double my AFC, and nearly all eggs were mature. I hope this helps. That's great that your follicle count went up; I hope it keeps going! Good luck!

[Anonymous]

Thanks this make a lot of sense and actually explains a few things for me. I didnt realize follicles appeared everyday; i thought it happened once a month. During my last cycle (at another clinic) I had about 6 follicles at the first mid-stim appt however the follicle count increased as the cycle went along with a max of about 11/12. However on egg retrieval day they only collected 5 mature eggs. My dr explained what happened but through the fog of anesthesia and my disappointment at the low number it didnt sink in. I just remember him saying the lead follicles were ready to go so they couldnt wait any longer. I am please they saw 10 at this point in the stim process.

[Anonymous]

I am 38 w DOR and usually start with 4-6. I've retrieved 9-13 in each of my three cycles.