Saturday, June 15, 2013

Your antral follicle count could vary depending on....

I'm now five days in to my IVF cycle. On CD1, I went to my RE's for the baseline scan. I was expected an antral follicle count of around 25, because that is what two scans in the past few months have shown.

To my dismay, this scan showed an count of around 16. I was depressed and did not know what the heck was happening. I had a scan at another place that had a prehistoric looking setup, and the count (after 1 minute of examination) was 15. This prompted a major crying jag and wondering if I should halt the IVF because there was something funky at work...again.

But then, a confirmation could only come from the place where I had  done the last scans, which  had  a much fancier 4D machine. So, I took myself back to the other place, and there the scan (done by another operator, as the ) revealed a count of 24. 

In other words, in the same cycle, 2 days apart, my counts were 16 or 24, depending on the machine used (!!!)

I just also realized...my big "drop" in follicle counts from 30 to 16, which I had thought was so momentous, and what I though represented a big shift in my physiology, may just be attributable to the machines used. A face palm moment, to be sure.

Here is a sum up of the scans I've done:

August 2010: San Diego RE, Dr G: 33
December 2010: India, 4D machine: 30
Mid 2011: New York, 2D machine Dr. L: 16
Late 2012: India, 2D machine, Dr. M:13
Jan 2013: India, 4D machine: 25
Feb 2013: India, 4D machine: 16 (big drop in the AFC in my left ovary)
March 2013: India, 4D machine: 25 (phew!)
June 2013: India, 2D machine, Dr. M: 16
June 2013: India, another 2D machine: 15
June 2013:  India, 4D machine: 24.

Note: what is really unknown here is what kind of machine my San Diego RE used. But, I have to give credit where it is due, I LOVED this guy's setup. Having gone to multiple different clinics around the world, I have to say that they had the most organized, systematic way of doing things. Every ultrasound scan was monitored by a nurse (standard practice) and the details were recorded in a form created for this purpose (only they did this). When I got my medical records from him, the minute details of each ultrasound I had ever done was printed out, without me having to memorize it.  Everybody does more or less the same thing, but what I am coming to value more than anything is the attention paid to the little details.

But I digress: here is the sum up: my ovaries have never stopped looking polycystic, or rather multi-cystic. I think that there could be a mild inverse correlation between my vitamin D level and my antral follicle count (in other words, the higher the blood Vit. D  level, the lower the number of AFC recruited), and there was a theory for that, but the drop may never been as dramatic as I thought it was.

I asked the doctor at the place with the fancy machine why there was a difference between 4D and 2D scanning, and she said well, the ovary is a 3D round structure, so  its possible that a 2D scan may miss some.I looked up papers on this subject which said that the fancier machines may be better at getting an accurate count in somebody with a higher AFC.

 The more you learn, you realize how little you knew. But anyway, this cycle is underway; wish me luck!

5 comments:

  1. Wishing you buckets of luck!!! Keeping toes & fingers crossed for you

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  2. Wishing you lots and lots of luck.

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  3. Interesting about the different AFC counts! Wishing you lots and lots of luck!!!

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