Understanding ovarian health is crucial for assessing fertility potential in women. Basal ultrasound scans and antral follicle counts are important tools used to evaluate ovarian reserve, and that’s what we are discussing here.
Antral Follicles
Antral follicles are small fluid-filled structures within the ovaries where eggs mature. During early menstrual cycles, multiple antral follicles start developing, ranging in size from 2 to 10 millimeters. Later, one dominant follicle grows larger (18-27 millimeters) and releases estrogen, preparing the uterus for potential pregnancy. Ovulation occurs when this follicle ruptures and releases an egg.
Basal Ultrasound Scan
A basal ultrasound scan assesses the uterus and ovaries at the beginning of the menstrual cycle, typically within the first 5 days. It involves a transvaginal ultrasound to visualize structures and follicle development.
Timing of Basal Ultrasound for Antral Follicles
The optimal time to evaluate antral follicles through basal ultrasound is typically between the 2nd and 4th day of menstrual bleeding. This timing provides insights into ovarian reserve and potential fertility.
Normal Number of Antral Follicles
The number of antral follicles varies with age, reflecting ovarian reserve. In women under 35, having at least 10 antral follicles between both ovaries is considered normal. Below 5-7 follicles suggests lower ovarian reserve, which can impact fertility.
Variability of Antral Follicle Count
Antral follicle counts can vary slightly from month to month due to hormonal fluctuations and other factors. This variability underscores the importance of combining ultrasound findings with other tests, like anti-Mullerian hormone (AMH) levels, for a comprehensive assessment of ovarian reserve.
Purpose of Basal Ultrasound and Indications
A basal ultrasound at the start of the menstrual cycle helps predict ovarian response in fertility treatments such as ovarian stimulation for in vitro fertilization (IVF). It guides treatment planning based on ovarian reserve and other patient factors like age and previous cycle responses. Additionally, it ensures no ovarian cysts interfere with medication during stimulation.
Other Diagnostic Tests for Assessing Ovarian Reserve
In addition to basal ultrasound and antral follicle count, AMH blood tests are widely used to assess ovarian reserve. These quantitative tests complement each other in providing a comprehensive view of fertility potential. Basal FSH levels and other indicators like ovarian blood flow patterns on ultrasound can also contribute to assessing ovarian health.
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