For some couples, conceiving a child may take longer than expected, even when everything appears normal. The inability to get pregnant can be emotionally draining, especially when there's no obvious reason for the delay. In such cases, doctors may need to look closer, even at the tiniest parts of a woman’s reproductive system, to figure out what the actual issue is. Often, these small details hold the answers that routine tests might miss. Follicle tracking for conception-related issues is one such insightful approach that can significantly improve the chances of a successful pregnancy.
In order to understand the significance of follicular scan for pregnancy, we need to first understand what follicles are and how they function in the female reproductive system.
Follicles are small fluid-filled sacs found inside the ovaries. Each follicle contains an immature egg. During the early days of the menstrual cycle, which typically lasts anywhere from 21 to 35 days, a woman’s pituitary gland releases follicle-stimulating hormone (FSH). This triggers the follicular phase of the menstrual cycle, whereby the ovaries produce multiple follicles. However, a single follicle will start to grow much faster than the others. This is the dominant follicle, and it is the one that holds the most viable egg.
When the dominant follicle reaches the right size, usually around Day 14 of the menstrual cycle, a surge of luteinizing hormone (LH) triggers it to rupture and release the egg. This egg then travels from the ovary to the fallopian tube, where it waits for a sperm to fertilise it.
Now that we have understood what a follicle is, let’s see what is a follicular scan. Also called follicle tracking, a follicle scan is a vital diagnostic tool that’s useful in detecting issues with ovulation that may hinder pregnancy. It is a series of ultrasound scans that track the development of follicles during a menstrual cycle.
Follicular scans help doctors observe:
This information helps fertility specialists better understand a woman’s menstrual cycle, thus enabling them to figure out the best time for conception, either naturally or through assisted methods like IUI.
With advanced diagnostic techniques like follicular monitoring, fertility issues can be detected. This scan is usually recommended for women facing the following issues:
A follicular scan is carefully timed to track the growth and rupture of the dominant follicle in a woman’s ovary. Follicular scans are scheduled based on key cycle days to monitor follicle development and ovulation. The following cycle days are an approximation, and the actual test days will vary based on the length of the patient’s menstrual cycle.
Menstruation begins, marking the start of the cycle. This date will be noted to predict the days on which the follicle scanning will be done.
This is the mid-follicular phase. A follicle scan, either transvaginal or transabdominal, will be performed on both ovaries to detect the presence of the dominant follicle. If the dominant follicle is detected, its size is assessed, and the patient is asked to return for a follow-up repeat scan after 2-3 days. This is to check if the dominant follicle’s size has increased.
In case a dominant follicle has not been detected via the scan, the patient will be asked to return after 4 or 5 days. If the dominant follicle is detected in the subsequent scans, then the patient will be given a modified time schedule of the scans that better align with the newly observed follicular growth pattern.
During these days, the follicle will prepare to rupture. A follicular scan will be done to monitor the growth of the dominant follicle, as well as the thickness of the endometrial lining of the uterus. If the dominant follicle’s size has increased, the patient will be asked to return after a day or two for a repeat scan.
During these days, if the dominant follicle’s size reaches around 18–24 mm, then it is ready to rupture. A follicle scan will be performed to assess the size of the follicle. Sometimes, the follicle would have already ruptured and released the egg, and ovulation may have already begun. In such cases, the follicle scan will show the ruptured follicle as well as the corpus luteum. The follicle scan will also detect changes in the endometrium that are due to ovulation.
While it is natural to be concerned about the effects of repeated scans on the body as well as on the eggs, follicular scans are considered to be very safe. These scans have no adverse effects on the quality of the eggs or the health of the woman and her unborn child. So, rest assured, these tests can be taken within days of each other.
A follicular scan is a valuable diagnostic tool that helps detect issues with ovulation, specifically those related to the growth and rupture of follicles in the ovaries. These repeated scans will help pinpoint fertility issues that hinder successful conception.
However, it’s important to understand that follicular scans do not directly cause pregnancy. Instead, they provide critical information that can guide doctors and couples in choosing the right time for intercourse or fertility treatments like ovulation induction or IUI. This will lead to better chances of getting pregnant.
A follicular study can be vital in cases where couples have no apparent fertility issues, or where women suffer from disorders like PCOD that make it difficult to predict ovulation dates. Following the doctor’s recommendations and adhering to the prescribed schedule can help ensure accurate findings, which in turn will greatly increase the chances of successful conception.
