Antral follicles


#1

Hi,I am 40 years old and have no children yet. I was just at the specialists doing a vaginal ultrasound to check if everything was ok. I wasnt there to get to know about fertility problems, only to check nothing was damaged. She said everything was ok. I had my first day of menstruation, not bleeding very much though. She and I saw some black dots when looking at the ovary. I think she looked at only one ovary at the time, as she switched to look at the other one, I think, but I am not sure. When I came home I started reading about antral follicles and now I wonder and are scared I dont have enough antral follicles to be able to have children. I didnt know what those black dots were but I could count 3-5 at least, I think. I dont remember quite. So I have some questions I hope someone can help me with.

On a ultrasound, can both ovaries show at the same time?
I am asking this because I hope that the 3-5 black dots I did see was only in one ovary, so that would mean I have maybe 3-5 dots in the other ovary as well.

And how do one count antral follicles? how does one see them in the ovary? In my ultrasound exam I did not see any red marks, only black dots. I thought the black dots were the antral follicles, but I see on ovary ultrasound pictures online that the antral follicles are marked with red ( when they have been counted ) and that these red marks are tiny spots inside these black dots. So how can the specialist know how many antral follicles I have when it didnt show anything in these black dots. Unless she saw something I didnt see. I just saw black.

I am sorry all my questions, but I dont understand this, have tried reading online how do they see these antral follicles but I cant find any answer anywhere. Only that they count them somehow. Does my ultrasound exam mean that she is not counting them? I guess so as they dont have any picture of the ultrasound. I guess it doesnt help me go back there and ask how many antral follicles I have. I guess I probably need a new ultrasound exam to find this out?

I would be thankful if someone know.


#2

The follicles show up just as black dots on the ultrasound. Most likely, the dots you saw were antral follicles, but I wouldn’t go by the number you possibly saw. They’re very very small at the beginning of your cycle, so they’re difficult to count when you’re actually trying to do so. Also, ovaries are round with follicles all over, so they have to scan to different depths to see all there is to see. If your tech wasn’t looking for them, then you certainly don’t have any way to know how many there are.

Chin up! Generally antral follicle counts are done on day 3 of your cycle. If you’re really anxious about this, perhaps you can call and go back in and get it done. Although they may be able to tell you from the scan they did today - or at least give you a general idea. Either way, it’s worth a call.


#3

Thank you so much for this information! it helped much :slight_smile: I didnt know they were so difficult to see and that they need to look at them in depth. I am also glad to hear that they are very small at the beginning at the menstruation cycle, maybe that means there are more antral follicles than I think or hope. I will definitely get a new appointment as I am worried is it too late soon for me to have children and to know how many years left I have. It definitely worth a call yes :slight_smile:


#4

You can also have widely different number of follicles in your two ovaries - which do not show up in one scan together, they both have to be scanned separately. So it is possible to have 2 in one and 10 in the other (as was the case for me on one of my scans).


#5

Ovaries

[quote=Sunshina]Hi,I am 40 years old and have no children yet. I was just at the specialists doing a vaginal ultrasound to check if everything was ok. I wasnt there to get to know about fertility problems, only to check nothing was damaged. She said everything was ok. I had my first day of menstruation, not bleeding very much though. She and I saw some black dots when looking at the ovary. I think she looked at only one ovary at the time, as she switched to look at the other one, I think, but I am not sure. When I came home I started reading about antral follicles and now I wonder and are scared I dont have enough antral follicles to be able to have children. I didnt know what those black dots were but I could count 3-5 at least, I think. I dont remember quite. So I have some questions I hope someone can help me with.

On a ultrasound, can both ovaries show at the same time?
I am asking this because I hope that the 3-5 black dots I did see was only in one ovary, so that would mean I have maybe 3-5 dots in the other ovary as well.

And how do one count antral follicles? how does one see them in the ovary? In my ultrasound exam I did not see any red marks, only black dots. I thought the black dots were the antral follicles, but I see on ovary ultrasound pictures online that the antral follicles are marked with red ( when they have been counted ) and that these red marks are tiny spots inside these black dots. So how can the specialist know how many antral follicles I have when it didnt show anything in these black dots. Unless she saw something I didnt see. I just saw black.

I am sorry all my questions, but I dont understand this, have tried reading online how do they see these antral follicles but I cant find any answer anywhere. Only that they count them somehow. Does my ultrasound exam mean that she is not counting them? I guess so as they dont have any picture of the ultrasound. I guess it doesnt help me go back there and ask how many antral follicles I have. I guess I probably need a new ultrasound exam to find this out?

I would be thankful if someone know.[/quote]

I am sorry to ask this, but when you say this is they wanted to see if everything is ok, what did they explain was what they are looking for? I have had three different Dr. who had different protocals. I ask the question because I think it is important for you to be able to articulate and understand what is being checked and why.


#6

These are questions you really should be asking your doctor. If they were just “checking to see everything was ok” then it is unlikely they were doing an antral follicle count. The red dots you mention are marks that a doctor puts on there to identify where they see them (like using a hilighter to circle around text in a book so you don’t forget where it is) and is not anything the ultrasound is picking up as those are only black/grey/white. An ultrasound can zoom in and out to get close up pictures or far away and can also look at different layers within your tissue. If they were looking at your ovaries specifically then they’d be zoomed in and only see one. Like i said, you really should talk to your doctor. Your questions to me indicate that you do not have a lot of knowledge about your fertility or infertility procedures and that is ok, but there are lots of books out there that can help you better understand your fertility and what all the tests are. Not sure how old you are but when you hit 40, every day is precious so get informed and don’t be afraid to ask your doctor questions.

Lastly, it is important to note that antral follicle counts are highly inaccurate measure of fertility. If you have an RE then they should be ordering many more tests such as baseline hormone levels, FSH, estrogen, progesteron, prolactin, etc and also AMH. Combined with knowing your age, your hormone results, results from anatomy checks on your uterus and tubes using other tests, and other factors like your reproductive health, weight, eating and other habits, and past medical history will all combine to give you a picture of your fertility health. GOOD LUCK!