follicular monitoring

Follicular Study: Purpose, Procedure, and Success Rate

Follicular monitoring or follicular studies are undertaken to see the progress of growing follicles. This can be done on a natural or hormonal stimulation cycle. The monitoring is preferably done with transvaginal ultrasound, although some women may prefer to have an abdominal ultrasound to monitor the follicles. The procedure is usually started on Day 1 or Day 2 of the period and continues till documentation of ovulation or till the day of oocyte retrieval.

Everything you need to know about Follicular Study

Why is follicular monitoring done?
When is follicular monitoring necessary? 
How does follicle tracking work?
Who needs follicle tracking?
Success Rate
Side effects
A mature follicle ranges from 16 to 20 mm. The maturity and size depend on the type and amount of medication used and the woman’s age. Moreover, it is noted that couples who have intercourse during the follicular study will have a much higher chance of conceiving. In this blog, we’re going to talk about the purpose, procedure, who needs it and success rate of the follicular study. Let’s dive right in.

Why is follicular Monitoring Done?

The purpose of a Follicular study are as follows:

  • To track the growing follicles and document ovulation so that planned Intercourse or IUI can be performed at the appropriate time.
  • It helps in understanding the effectiveness of a treatment on a woman’s body.
  • Checks the hormones involved with ovulation and the condition of the eggs the woman produces during that time
  • Doctors can determine which medications to change to boost the chances of conceiving
  • You can use it to diagnose problems associated with ovulation, some of which may be affecting your pregnancy as well.

Read more: What is the difference between IUI and IVF?

Role of follicular study during IVF assessment and timing

It is a very important part of the IVF cycle. Based on the daily findings, the fertility expert will suggest,

  • The dose and type of hormonal stimulation,
  • What dose to continue as the follicles develop and
  • When to stop the medication in preparation for ovulation or oocyte retrieval.

The procedure is not painful. In some women, there may be a feeling of discomfort when the probe is inserted into the vagina.

When is follicular monitoring necessary?

It is necessary for many procedures like planned intercourse, IUI and, IVF, ICSI. Here are some of the top reasons justifying the necessity of follicular monitoring:

  • It helps in determining the appropriate dosage of hormonal medication.
  • It also helps if women have a low AMH or diminished ovarian reserve and in PCOS when they produce too many eggs.
  • Appropriate follicular monitoring combined with assessment of Estradiol levels can guide the doctor in preventing Ovarian Hyperstimulation Syndrome.

The fertility doctor suggests the Follicular scan. The follicular scan starts on Day 1 or Day 2 and may be repeated on Day 6 onwards until ovulation. The treating doctor decides the frequency of the scans.

How does follicle tracking work?

It is preferable to monitor follicles with transvaginal ultrasound, but some women prefer to use abdominal ultrasound instead. Most procedures begin on Day 1 or 2 of the period and continue until the oocyte retrieval and documentation of ovulation is completed.

Who needs follicle tracking?

Follicular tracking is done for women who are undergoing planned intercourse, IUI, IVF, and ICSI.  This may be continued after ovulation to ensure the follicle has appropriately ruptured and to look for the corpus luteum. The corpus luteum formation suggests that ovulation has occurred correctly.

The success rate of follicular study

Although many researchers suggest that the success rate of follicular study is just 10%, it can vary depending on the patient’s age, hormone levels, and other factors. For example, a woman in her 20s may have a higher success rate than a woman in her 60s. Moreover, the medical history of a woman also affects this rate.
There are alternatives like LH kits to measure the LH surge and calendar apps, but those are not very reliable. It is more efficient to do more follicular monitoring as that increases the chances of Pregnancy and decreases TTP (Time to pregnancy).

What are the advantages of folliculometry?

Here mentioned are some of the advantages of folliculometry:

  • Scans are essential for monitoring follicles’ growth to decide the dose and type of hormonal stimulation. They form an integral part of ART procedures.
  • It is possible to diagnose follicles that do not grow until rupture.
  • For assisted pregnancy, scans can provide an accurate time of ovulation.
  • The findings help doctors to prescribe the right ovulation-inducing drugs or injections.
  • OHSS, luteal phase deficiency and other complications can be detected through this procedure.

Every visit takes about 20 minutes to half an hour, including waiting time. The actual monitoring takes less than 5 minutes. No preparation time except emptying the urinary bladder is required. A baseline scan is carried out between Day 1 and Day 3 of the period.

Side effects of follicular ultrasound scan

The scan does not involve any physical side effects and can be performed without any discomfort for the patient. But, it’s just a lot of information to process, and it can be pretty stressful for couples already struggling to get pregnant.

Frequently Asked Questions (FAQs)

When does a follicular scan have to be done?

Women undergo several follicle scans during their menstrual cycle, usually between days 9 and 20.

What should be the size of the follicle to get pregnant?

A mature follicle to get pregnant is between 16 to 20 mm. Also, remember that the medication type, dosage, and the woman’s age determine the maturity and size of the follicle.

How does a Follicular Study Work?

Follicle Study involves a series of ultrasound scans of the vagina that take approximately 5-10 minutes.

Can follicular monitoring help me conceive?

It is possible to identify the exact time of ovulation using follicular monitoring. Thus, there is a much greater chance of getting pregnant if intercourse is planned during that period.

Is follicular monitoring painful?

This procedure does not cause any pain. Inserting the probe into the vagina may cause discomfort in some women.

Can follicular studies confirm pregnancy?

If the scan is continued in case the woman misses her period and the bHCG goes above 1000 units, then the ultrasound scan can confirm a pregnancy. At that time, it is no longer called a follicular scan.

What is ET in the follicular study?

ET stands for Endometrial thickness.

What is MSF in the fallopian study?

MSF stands for Multiple small follicles, usually seen in women with PCOS.

Can follicular studies detect fallopian tube blockage?

If there are distinct hydrosalpinges, follicular studies may be able to pick up hydrosalpinges but not other types of tubal blockages.

Read more: Top IVF failure reasons

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