Follicular Monitoring

May 2, 2024
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It is a simple technique used by gynaecologists for assessing ovarian follicles at regular intervals for tracking and documenting ovulation in women who are trying to get pregnant.

It is a serial ultrasound done mostly by transvaginal route.

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Follicles are not oocytes. The follicle is a functional anatomical structure which forms part of the ovary and the egg is the cell that will mature in a microscopic part of the inner wall of a follicle over spontaneous or stimulated ovarian cycle in normal conditions .It also contains other cell types which produce oestrogen required for normal development of egg maturation

Follicular phase and luteal phase:

Follicular phase is the part of the menstrual cycle before ovulation. It can vary for each woman, also can vary from cycle to cycle in the same woman.

Luteal phase is the part of menstrual cycle from ovulation till the next menses. It is 14 days and it is constant for all women.

So it becomes important to monitor follicular phase till ovulation to accurately predict ovulation, as incorrect monitoring of fertile period or ovulation phase can be a frequent cause of infertility.

Anovulation also can be documented.

How is it done?

  • Follicular monitoring begins from day 2 or day 3 of cycle.
  • To rule of follicular or hemorrhagic cysts.
  • To assess the number of follicles(antral follicle count) which gives a rough idea about the ovarian reserve or the reproductive life span of a woman.
  • Gives an idea about the dose of medicine to be started for ovulation induction.
  • So follicular monitoring becomes an important tool for ovulation induction.
  • 2 or 3 dimension measurement of the follicle is taken.
  • When the follicle is 16mm, it grows 2mm per day.
  • After it reaches 19 to 20mm, HCG injection is given to trigger ovulation.
  • The egg is said to rupture in 36 hrs, but it vary in people.
  • That is why documenting ovulation is important.

Follicular monitoring is a simple tool which can aid in fertility treatments in natural cycle , IUI  and in IVF where the ovaries are stimulated with high dose of injections. It has no harmful effects.