Age-related normogram for antral follicle count: McGill reference guide

Fertil Steril. 2011 Feb;95(2):663-6. doi: 10.1016/j.fertnstert.2010.08.047. Epub 2010 Sep 25.


Objective: To produce age-related normograms for antral follicle count in an infertile population without polycystic ovaries.

Design: Retrospective cohort analysis.

Setting: University teaching center.

Patient(s): Eighteen hundred sixty-six infertile patients.

Intervention(s): Baseline transvaginal ultrasound examination between days 2 and 4 of the menstrual cycle.

Main outcome measure(s): Correlation between age and different percentiles of antral follicle count.

Result(s): The age-related normogram for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile of antral follicle count showed a biphasic mode of antral follicle count decline with two different rates of antral follicle count loss: a steep-slope phase (high rate of antral follicle count loss) and a moderate-slope phase (restrained rate of antral follicle count losses). In the low antral follicle count percentiles (3rd, 10th, 25th), the phase of high loss rate of follicles preceded the phase of slow loss rate, whereas in the high antral follicle count percentiles (75th, 90th, 97th) the opposite was found.

Conclusion(s): Age-related normograms in infertile women without polycystic ovaries demonstrate a biphasic pattern of decreased antral follicles. These normograms could provide a reference guide for the clinician in consulting with women with infertility. However, future validation with longitudinal data is still needed.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aging / physiology*
  • Cell Count / methods
  • Cell Count / standards
  • Cohort Studies
  • Female
  • Humans
  • Infertility, Female / diagnosis
  • Infertility, Female / etiology
  • Infertility, Female / pathology
  • Middle Aged
  • Nomograms*
  • Ovarian Follicle / cytology*
  • Ovarian Follicle / diagnostic imaging
  • Ovarian Follicle / pathology
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / pathology
  • Practice Guidelines as Topic*
  • Reference Values
  • Retrospective Studies
  • Ultrasonography
  • Young Adult