In pursuit of ovulation: folliculometry

For many couples attempting to conceive, tracking ovulation is crucial, and folliculometry provides a detailed approach to tracking this process. With this technique, ultrasound is used to track the growth of follicles in the ovaries, giving important information about a woman’s ovulation cycle.

Folliculometry measures the size and growth of follicles to help identify the most fertile days. By precisely tracking the best time to engage in sexual activity or undergo assisted reproductive procedures, this monitoring can greatly increase the likelihood of conception.

We will examine the fundamentals of folliculometry in this article, as well as its advantages and reasons for being the best option for individuals navigating the complexities of ovulation and fertility.

#Kogda nachinat follikulometriyu?When to start folliculometry?

Generally speaking, if the menstrual cycle lasts exactly 28 days, the first ultrasound session should be performed on the eighth or tenth day. Why specifically these days? What about people whose cycles are longer or shorter, on the other hand? The illustration depicts the alterations that take place in the ovaries and uterus during the menstrual cycle.

The follicles are just starting to form in the early stages of the cycle, and the largest ones have a diameter of roughly 2 mm. It is impossible to predict whether ovulation will occur at this point, but you can spot a follicular cyst, which is a non-inoled follicle that is still growing from the previous cycle. It is easy to mistake the cyst for the dominant follicle if the primary ultrasound is performed right before ovulation.

As you are aware, the first phase alters the cycle’s length, but the second phase’s duration—which is typically 13–14 days—never changes. In this regard, the first ultrasound should be scheduled 4-6 days ahead of the estimated time of ovulation rather than 8–10 days into the cycle for women who have a regular, albeit longer or shorter, cycle. The doctor will decide how many sessions and how often to have them. Typically, two to three visits to an ultrasound cabinet spaced two to three days apart are sufficient.

Folliculometry should be initiated three to five days following the cessation of menstruation in cases involving lengthy irregular cycles. The physician will perform ultrasound endometrial control in addition to monitoring follicules. This will assist in correctly diagnosing the delay and helping to identify its cause more precisely. In this instance, each procedure’s quantity and frequency are different.

#Klassicheskaya Kartina Ultrazvukovogo Monitoring -classical picture of ultrasound monitoring

In the case of the classic cycle, one dominant follicle (less frequently two or more) with a diameter of 12–15 mm can already be seen after 8–10 days, while other follicles are noticeably smaller. After that, it keeps growing by 2-3 mm every day until it reaches a diameter of 18–25 mm during ovulation. The endometrium is now three layers thick, with a thickness of roughly 10–12 mm. Following the release of luteinizing hormone, the egg exits the abdominal cavity along with a tiny amount of follicular fluid.

The following "disappearance" of ovulation, along with a decrease in the dominant follicle and wall deformation, all point to the presence of fluid in the Douglas pouch and ovulation having taken place. Later in the cycle, on days 15–18, at the ovulation site, you can observe an irregularly shaped and contoured corpus luteum, measuring 15-20 mm in diameter. Its size gets smaller every day, and on the eve of menstruation, it is typically either not determined at all or not visualized well. These days, the endometrium’s echo density increases uniformly, and a homogenous structure replaces the previous three layers.

Folliculometry, a crucial instrument for ovulation tracking, tracks the growth of ovarian follicles to provide couples with information about their window of fertility. This technique measures the size and growth of follicles using ultrasonography, which provides vital information for precisely timing conception efforts. People can improve their chances of conceiving successfully and obtain a better understanding of their reproductive health by concentrating on these metrics.

#Vozmozhnye varianty anovulyaciiPossible variants of anovulation

Ovulation has not taken place if the dominant follicle grows at first, but then either regresses (atresia) or stops developing (persistence). The amount of progesterone in the blood will correspond to the first phase of the cycle because there is no corpus luteum secreting progesterone and no free fluid in the retrouterine space.

When this occurs, the follicle "collapses," preventing the release of the egg, and the blood progesterone level reflects the second half of the cycle. This is caused by the premature release of luteinizing hormone. Follicle luteinization is the term for this phenomenon. Alternatively, none of the numerous follicles may "grow" to be as large as the dominant one. Additionally, such a cycle will be anovulatory.

Folliculometry, therefore, does not take the place of basal temperature measurement, hormonal studies, and ovulation tests; rather, when used in conjunction with them, it provides a more comprehensive understanding of the processes taking place in a woman’s reproductive organs. Obtaining a timely diagnosis and effective treatment prescription is a crucial step towards becoming a mother.

#Indications for folliculometry

The menstrual cycle’s phases repeat and replace one another. A fresh dominant follicle containing a fertile egg is formed each month. The endometrium rejects if conception is unsuccessful, and a new cycle starts. There are several ways to monitor ovulation. One such example is folliculometry. Its assistance can be used to precisely determine the days on which the follicle exits the egg as well as to detect the presence of diseases.

Folliculometry is employed when:

1. Clarification of the day of ovulation and identification of fertile days.
2. Evaluation of ovarian function.
3. Diagnosing infertility.
4. Monitoring the function of the ovaries and their structure.
5. Evaluation of the menstrual cycle.
6. Detection of the effect of hormonal drugs on the ovaries.
7. Diagnosing cysts, PCOS, fibroids and other pathologies of the reproductive system.
8. IVF .

#Preparation for examinations

There are two ways to perform folliculometry: transvaginally and abdominally. For each method, the woman must first be made ready for the examination.

The abdominal method involves using ultrasound to examine the ovaries through the anterior abdominal wall. To get ready for an ultrasound, do the following:

1. Give up products that lead to gas formation.
2. 2 hours before the procedure, start drinking liquid (plain water, tea) so that the examination is carried out on a full bladder.

The intravaginal method involves using a transvaginal sensor to examine the ovaries. When getting ready, you must:

1. Exclude carbonated water, legumes, cabbage, bread from your diet – products that increase gas formation.
2. Empty the bladder.
3. Perform intimate hygiene.

Be aware that sometimes two different kinds of examination are applied simultaneously.

#Kakie priznaki ovulyacii vidno na UZI What signs of ovulation are visible on ultrasound

You can ascertain whether ovulation is occurring or not with a research using any type of sensor. In the event that it has happened, the monitor displays:

1. Absence of a dominant follicle, which was present during the previous examination.
2. Follicular rupture.
3. Accumulation of fluid in the cavity behind the uterus.
4. Presence of a corpus luteum.

#Ocenka poluchennyh rezultatov Evaluation of the results obtained

Different types of data are gathered during diagnostics. Folliculometry enables us to make inferences for further investigation, make a diagnosis, or suggest a course of treatment.

1. A dominant follicle reaches a size of 15-24 mm when fully mature.
2. After the rupture of the follicle, the egg enters the fallopian tube.
3. The follicle"s place is occupied by the corpus luteum.

If a woman receives an infertility diagnosis but her picture appears normal, obstruction of the fallopian tubes may be the cause.

1. Artresia. The follicle grows, can reach normal sizes. Then the regression stage occurs. The follicle decreases and disappears. There is no fluid behind the uterus, the corpus luteum is not visualized.
2. Persistence. Rupture of the follicle that has grown to normal does not occur. The egg does not exit, ovulation is absent. Persistence lasts from one to several menstrual cycles. Fluid and corpus luteum are absent.
3. Follicular cyst. With prolonged persistence, a cyst appears, which is formed due to the abnormal size of the follicle. It can grow more than 25 mm, the fluid is not visualized, the corpus luteum is absent.
4. Luteinization. A yellow spot appears at the site of the formed but not ovulated follicle. Luteinization occurs due to an increase in the corresponding hormone during the maturation of the follicle.

Another pathology where the follicle does not grow is absence of follicular development. The most common cause of this is polycystic illness.

Comprehending folliculometry can be immensely beneficial for individuals attempting to conceive. You can increase your chances of successfully conceiving by monitoring the development of your follicles, which can give you insight into the timing of ovulation. By using this technique, you can maximize your window of fertility and determine the best days for sexual activity.

Folliclography offers specific information, but it’s crucial to keep in mind that it’s only one element of a more comprehensive fertility plan. You can gain a more thorough understanding of your reproductive health by integrating it with other techniques and staying in constant contact with your healthcare provider.

Folliculometry is ultimately a helpful tool for managing fertility because it provides precise information and direction. You can take proactive measures in your quest to grow your family by adopting this strategy.

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