Are you planning on starting a family? If yes, you may be asked to undergo a scan called the follicular study ultrasound as a tool to monitor your ovulation cycle. But what is it, why is it recommended, and how does it work? Continue reading to find answers to these questions. By the end of it, you will have a good understanding of the importance of a follicular scan, making it easy to decide the best approach to conception.
Ovarian Follicles and the Follicular Phase
Ovarian follicles are tiny sacs that have oocytes (immature eggs). When a girl is born, she has several thousand follicles, and as she ages, the number declines through a process known as atresia. During every menstrual cycle, follicles grow and develop, but only one follicle is fully mature and the egg is released.
The first part of your menstrual cycle is called the follicular phase.
Days 1 to 5 are called the menstrual phase, where the uterine lining is shed if you are not pregnant in your previous cycles. The LH (Luteinizing hormone) and FSH (follicle-stimulating hormone) are low during this time.
Days 6 to 14 are the follicular phase. FSH stimulates follicles to start growing, with a single follicle becoming dominant and maturing. There will be a noticeable rise in estrogen.
Day 14 is ovulation day. The dominant follicle breaks, and a mature egg is released. Estrogen and LH trigger ovulation.
Regular follicular monitoring through ultrasound scans can help track ovarian follicle growth and identify the follicle that releases a mature egg.
What is Follicular Monitoring and Why is It Done?
A follicular monitoring fertility scan is a series of tests performed at various stages of a menstrual cycle to assess follicular development in the ovaries. If a mature follicle develops, it is a sign of upcoming ovulation, which means a mature egg is available for fertilisation. This helps determine the precise timing of ovulation to increase conception chances. Also called follicle monitoring test or follicle tracking, it is used for both natural conception as well as fertility treatments like IVF and IUI.
Reasons are:
To find out if ovulation is happening
Track the number and size of growing follicles
Determine the best time for insemination or intercourse.
Guide medication timing for fertility treatments
Determine the presence of ovulatory dysfunction that needs correction.
Whether you are taking the help of fertility treatments or want to conceive naturally, an ovulation tracking ultrasound offers a clear view of the ovulatory cycle.
How Does It Help Track Ovulation?
Ovulation typically happens in the middle of your menstrual cycle. Doctors use USG follicular monitoring to track follicular growth. This tracking of follicles is done from the early stages of the menstrual cycle until it reaches an ideal diameter of 18 to 24 mm, which is deemed mature.
This procedure enables specialists to determine the ovulation window by observing the rupture of the follicle, a sign of the release of a mature egg. This tracking is highly beneficial for natural conception.
How Does It Help in Conception?
Follicular tracking aids conception by:
Identifying the ideal time for insemination or intercourse
When a follicle matures and ruptures to release a mature egg, it creates the perfect environment for fertilisation. The chances of conception increase drastically if the normal range of follicular study is achieved.
Why is It Needed for Fertility Treatment?
Follicular monitoring is an indispensable tool in fertility treatments as it helps:
Evaluate the number and size of follicles in the ovaries
Determine ovulation timing
Helps adjust and control hormone medications
Reduces ovarian hyperstimulation risks
Identifies tumours or ovarian cysts
Determine the endometrium thickness (uterine lining)
Check for fluid accumulation in and around the pelvis or ovaries
Helps decrease multiple pregnancies by controlling the number of follicles that mature.
Whether it is an IUI or an IVF cycle, having follicle monitoring test results allows fertility experts to make important decisions to maximise outcomes.
How Does Follicular Monitoring Work?
Follicular monitoring uses transvaginal ultrasound to measure and visualise ovarian follicles. This scan uses high-frequency sound waves to create pictures of the reproductive system. To get a peek into the ovaries, a probe is slid into the vagina.
Follicle number: Normally, 10 or fewer develop in a cluster together. Too many follicles may indicate complications.
Follicle size: The size indicates maturity, and a follicle grows 1 to 3 mm per day. Follicles of greater than 18 mm release mature eggs.
Dominant follicle: One of the follicles is dominant and grows to release an egg. The others do not mature.
Endometrial lining: The uterine lining thickness is determined for adequate growth.
Ovulation: Follicles collapse after ovulation, and the egg is released. Blood or fluid is visible.
Based on the purpose, follicular monitoring is conducted every 1 to 3 days until ovulation. A series of measurements is taken to determine the dominant follicle and ovulation. The best time to start is around 9 to 10 days if your cycle is regular. It detects the follicular growth phase to time ovulation and provides accurate treatment. For irregular cycles, the doctor may recommend personalised hormonal patterns based on treatment response.
Who Should Get Follicular Tracking Scans?
It is helpful for:
Women who are trying to conceive naturally and time intercourse
Women using oral medications for ovulation induction
Undergoing IUI or IVF
Women who have irregular periods or PCOS
By determining the fertility window, follicular monitoring optimises conception chances and aids ART (Assisted Reproductive Technology) procedures by giving insightful information for diagnosis as well as treatment.
What's Next After Follicular Study?
The next steps depend on the results and include:
If ovulation happens, timed intercourse
If mature follicles are available, an ovulation trigger injection is given
If undergoing ART treatment, IUI is done during the ovulation phase
If in an IVF cycle, egg retrieval is performed after follicle maturation
Progesterone supplements may be prescribed after ovulation for implantation.
Timing ovulation with ultrasound helps determine the best fertility window for those trying to conceive naturally or through fertility treatments. This allows perfect timing for intercourse, egg retrieval or insemination. The results also help adjust fertility medication and treatment, making it an invaluable tool that improves the chances of conception and pregnancy.
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