Follicullar Monitoring – The Procedure & Result Interpretation (Part-3)

By now we know the ABC’s of follicular study in part-1 & part-2 of this 3 part article In part-3, we will delve into the procedure and interpretation of results in follicular monitoring.

The what, why and where of follicular scan includes:

What: Mostly four to six scans are carried out during a cycle, to predict the ovulation time. The initial scan is called the baseline scan and tells the initial stage of the follicle with accuracy. After this, the doctor schedules a series of scans at the best times and follow the development of the uterine follicles.

The scan checks:

  • the inner lining of the uterus
  • the growth of the follicle are checked during each cycle

These scans are done within an eleven-day window during the cycle of a woman.

Why: Women opting for an IVF treatment undergo the follicular study/scan and sometimes recommend it along with hormone blood tests to check for levels of Progesterone, Luteinising Hormone (LH), Oestradiol and Follicle Stimulating Hormone (FSH).

Where: The follicular scan is generally carried out on the 2nd day of menstruation (baseline scan). It would be advised to wear comfortable clothes for your benefit. No diet restrictions are indicated unless instructed by the doctor. It would be advisable to go to for the examination with an empty bladder. The scan is repeated alternatively/every another day until ovulation happens.

So, what is the procedure of a follicular scan?

The scan is done in a slightly dark examination room. It is a straight-forward procedure in which the patient will be instructed to lie down on your back and place your knees bent on a bed. Then they will be asked to undress waist down & be covered by a sheet. A rod-shaped sterile, lubricated, an electronic device (the transducer) is then gently inserted transvaginally to evaluate the uterus and ovaries. Depending on the patients’ comfort level, the test might last anywhere from 15 to 30 minutes.

What all can be evaluated in a follicular scan?

The follicular scan enables a doctor to evaluate the size, shape, and condition of the:

  • Uterus/womb
  • Size of the follicles (needs to reach between 18-24mm for ovulation)
  • Endometrium/lining of the womb (needs to be 7mm or above for a pregnancy to implant)
  • Ovaries
  • Pelvic area/adnexa

The entire scan enables to monitor:

  • the growth of the follicles
  • approximate rupture period of follicles (ovulation period)

So, using a follicular scan, the doctor identifies the follicles that do not grow properly and/or rupture at an early stage. As any alteration in the above-listed details may cause in the failure of conception or implantation.

Is a follicular scan harmful to a woman?

A follicular scan is a minimally invasive procedure that can be done with ease by a well-qualified doctor. The only issue that most couples face is that of judgment, fear, and shame – as a follicular test in most scenarios is indicated when a couple fails at conception after trying multiple times. But worry not, once you keep your apprehensions aside, by consulting a right doctor and getting a follicular scan, some light will be shed on the issue.

Apart from the emotional component, physically a follicular scan does not pose a threat (if done right) to the mother and her reproductive cycle.

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Aishwarya

Dr. Aishwarya Rajeev has completed her MDS degree and is currently pursuing her PhD. She is an avid reader and loves to teach and write!

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