Conception

What are ultrasound follicular monitors?

Follicular monitoring is used to check if and how ovulation occurs or if the woman responds well to the drugs she may be taking to stimulate ovulation (such as Clomid ) .

Follicular monitoring is performed by ultrasound. They are useful for assessing the size of the dominant follicle that contains the maturing egg cell and for determining the thickness of the uterine lining (endometrium).

See also: how the thickness of the endometrium varies  in the various phases of the menstrual cycle

When and why are follicular monitoring done?

When there are difficulties in having a baby, before moving on to invasive treatments it would be advisable to do some ultrasound monitoring with which the doctor can observe if there are maturing follicles, evaluate their size and indicate to the woman the best time to have targeted intercourse for maximize the chances of conception.

These monitorings are also important for those who are taking fertility drugs, monitoring in these cases is essential to understand if the woman responds correctly to the treatment.

Generally 2-3 checks are enough to track ovulation and identify the most fertile days.

The optimal would be both to monitor the maturation of the follicles but also to evaluate the level of estradiol in the blood: each mature egg cell should produce between 150 and 200 pg/ml of estradiol. Knowing both the value of estradiol in combination with the size of the follicle allows us to best determine the woman’s response to treatment.

For example, if the estradiol level becomes very high, a woman may be at risk of developing ovarian hyperstimulation syndrome.

In assisted fertilization treatments, monitoring is necessary to understand when to proceed with intrauterine insemination or to collect mature oocytes which will then have to be fertilized in vitro.

At the same time, ultrasound allows us to understand the overall state of the uterus, endometrium and ovaries. If abnormalities are found these could help explain why a woman may have difficulty conceiving (such as polycystic ovarian syndrome )

How big does a follicle grow?

During a normal cycle the egg cell develops inside a follicle in the ovary. The dominant follicle grows at a rate of about 1-2 mm per day and is ready to release the egg cell when it measures between 17 and 25 mm in diameter.

In conjunction with the size of the follicles, the thickness of the endometrium is also measured, which must be such as to allow the implantation of any fertilized embryo.

The anomaly

Monitoring the follicles allows you to identify some anomalies that could occur and which could be the cause of the non-arrival of pregnancy.

The problems that can be detected are:

1. Follicles that do not reach the correct size before rupturing

2. follicles not growing at all.

3. follicles that don’t rupture at the right time.

4. The lining of the uterus is not large enough to allow a fertilized egg to implant.

As you can see, monitoring can give a clear picture in those suffering from fertility problems and often having a clear picture helps to find the best treatment to be able to get pregnant.

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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