what does an AFC of 23 mean

Based on the evidence retrieved, an AFC of 23 is a strong result. The retrieved studies show that antral follicle count is a direct marker of ovarian reserve, and the numbers they report for women in their 30s are far lower than 23. One study of subfertile women found a mean AFC of 4.6 at age 30, dropping to 3.7 by age 35 and 2.9 by age 40 [2]. Another study of infertile Nigerian women found a mean AMH of 1.22 ng/mL in the 30-39 age group [1]. An AFC of 23 sits well above every mean reported in these records, which means it indicates a high number of resting follicles for a woman in her 30s.

The evidence does not give a single probability of "viable eggs" from an AFC of 23, because viability depends on more than count. Egg quality, meaning the chance a given egg is chromosomally normal, also falls with age. One large study found that only 44% of the best-looking embryos from women under 35 were chromosomally normal, dropping to 21% in women 41 and older [3]. So an AFC of 23 tells you the quantity is there, but it does not tell you the quality of each egg. The two markers move together in the sense that both decline with age, but a high count does not override the age-related rise in aneuploidy.

My call: an AFC of 23 is a high count, roughly five times the average for a 30-year-old in the retrieved subfertile population [2]. It suggests a good supply of eggs for IVF. But it is not a guarantee of live birth, because the chance that any single egg is normal still depends on age. Confidence is high that 23 is a favorable count, and moderate on what it means for live birth, since the records do not link AFC 23 directly to pregnancy outcomes.