What is an Ideal Number of Follicles for IVF?

By Fertility Advocate Jennifer “Jay” Palumbo

When I was undergoing fertility treatment, a friend of mine was going through IVF literally the same time as me AND at the same clinic. So after every monitoring appointment, we’d compare data.

“How many follicles did you have?”

“What’s your estrogen level?”

“Does the vaginal wand remind you of your ex-boyfriend, or is it just me?”

Of course, you can’t control any of these things, but when you’re trying to conceive, and it’s not happening, you start looking at other areas to see what you CAN control.

I share this because while knowing how many follicles you should ideally have can be helpful, I do want to urge you not to obsess about it. Why? Because it’s not like you can go home and create more follicles in your spare time. It’s a piece of a puzzle (your reproductive organs being the puzzle in this case), but it’s not the entire picture.

What is a Follicle?

If you’re undergoing fertility treatment, you may encounter lots of medical terminologies you’ve never heard before. For instance, you might not know that your ovarian follicles are an essential part of your fertility, and how many you have will help determine how likely you are to conceive. But what are follicles? When I first the word “follicle” concerning my fertility, I thought, “Why is hair growing on my ovaries????”

It turns out that follicles are found on the outside layer of the ovaries. They are tiny sacs of fluid that contain immature eggs or oocytes. When the follicles have grown to the appropriate size and the eggs are mature, it ruptures and releases it. This process is ovulation, which usually occurs monthly for a woman between puberty and menopause.

How Many Follicles Should I Have?

While your doctor can give you an estimation of how many follicles you have, it’s not possible to provide you with an exact number. This is because until a follicle develops, they are too small to see or detect with an ultrasound. However, once hormones trigger follicle development, they grow in size, making their presence more known. Follicles typically around 10mm are referred to as antral follicles and are visible to ultrasound. At this point, Reproductive Endocrinologistscan count the follicles and estimate a woman’s ovarian reserves. Usually, an antral follicle count (AFC) will occur when a doctor assesses whether or not assisted fertility treatment is right for you.

What is an Ideal Amount of Follicles for IVF?

Ah, the magic question! Although there is no precise guideline for a good number of follicles for IVF, the overall goal is to produce more than you would naturally (meaning without hormone injections.) Why? Because you want to create as many embryos as you can. The more eggs available, the higher the chance of the treatment being successful. Make sense?

However, it’s worth noting that the most important thing is the egg quality within those follicles. This is why your fertility specialist will monitor the follicle sizes and health. Once they have reached an appropriate size, you will undergo the egg retrieval procedure, where your doctor will retrieve your eggs for in vitro fertilization.

The bottom line is that it’s not so much how many follicles you have or what they look like, as much as it matters the quality inside (much like people). All you can do is follow your doctor’s instructions, keep your sense of humor and do your best.

And if any of you agree with me on the vaginal wand/ex-boyfriend thing, please contact me as there is much to discuss!

To read more from Jennifer, click here