Antral Follicle Count

[wintersnowdropstoday]

Hi,

I have secondary infertility. On letrozole but no success as yet (6 months). I have been told I have PCOS and this is the cause of my anovulatory cycles. My initial prescription for letrozole was for 6 months and now that is over I am unsure of next steps. Would it be IVF? Could I ask to try letrozole for longer? I think this would be my preference but unsure if I am wasting time.

I have an AMH of 31 pmol at 36 yrs old, but I don't know my Antral follicle count - the scan report states “both ovaries appear polycystic and are accessible. Right ovary contains at least 30 follicles 2-9mm and Left ovary contains 11mm follicle and at least 15 2-9mm”.

Based on this info, does that mean my AFC is over 45? Am I therefore wasting time with the letrozole as there's too many eggs/cysts to allow for a good quality one to get through?

It sounds like you need to go back to your fertility team. Nobidy here will be able to tell you what your specialist will agree to.

A lot will depend on the things they specifically see in your scans abd how you responded to the letrozole. That sounds like a lot of follicles, but it doesn't say if you had any dominant ones or ones that looked close to releasing.

Most specialists won't recommend trying medicated cycles or IUI endlessly - many draw the line at 3 cycles of each before progressing, as if they aren't working then IVF may be more successful.

However ultimately you can agree a plan with then that may be a compromise.

Book an appointment with your fertility team.