Unfortunately, not all women can quickly become pregnant. In some cases, when planning pregnancy prescribe testing, known as folliculometry. What is this study? In fact, it is an ultrasound monitoring that allows you to monitor the development and maturation of the follicle from the beginning to the end of the menstrual cycle.
To date, such a study is considered one of the most accurate methods to determine the days of ovulation and, accordingly, increase the chance of fertilization of the egg. This technique is widely used in gynecology, not only for tracking the menstrual cycle, but also for the diagnosis of certain disorders of the reproductive system.
Folliculometry: when to do? Indications for the procedure
First of all, a similar procedure is used in family planning centers. The most accurate results are what folliculometry helps to achieve. When to do this procedure? For a start, it is worth noting that monitoring makes it possible to determine the fact of ovulation, as well as its exact dates. This is extremely important for women who have an irregular menstrual cycle.
In addition, ultrasound is used to determine the cause of impaired normal functioning of the reproductive system and failure of the menstrual cycle. The same study is prescribed in order to trace the effect of hormonal drugs on the ovaries. And the procedure in combination with some other tests is used to diagnose female infertility. In addition, folliculometry is often carried out before in vitro fertilization.
Do I need special training?
Of course, many patients are interested in whether any special preparation is required before ultrasound. Folliculometry does not require complex preparations. For girls who have not yet had sexual intercourse, ultrasound is usually carried out through the abdominal wall - in such cases, shortly before the procedure, it is worth to drink 0.5-1 liters of water. A full bladder ensures maximum visibility of the pelvic organs.
In some cases, transvaginal ultrasound will be more informative. In order to ensure maximum accuracy of the study, women are recommended at least a day before the procedure to abandon products that increase the formation of gases in the intestine - this is primarily cabbage and legumes, as well as some fruits and dairy products. It is advisable to clean the intestines with piercing candles or an enema with overcooked water.
Folliculometry: on which day of the cycle is the study prescribed?
Naturally, in order to properly assess the condition and functioning of the reproductive system, it is extremely important to start on time and to make a diagnosis correctly. There is an extremely important question that interests all patients: on what day to do folliculometry? Immediately it is worth noting that the study will probably have to be repeated more than once. Women with a normal menstrual cycle, which lasts 28 days, as a rule, the first ultrasound is prescribed on the eighth or tenth day. Naturally, during this period it is difficult to isolate the desired follicle - however, it is possible to determine the presence of some abnormalities, in particular, to diagnose a follicular cyst.
For patients who have a stable cycle that lasts more or less than 28 days, the first examination is prescribed six days before the supposed onset of ovulation. In any case, in the future will have to repeat the procedure every two or three days. Repeated studies are carried out either until the period of ovulation, or until the end of the menstrual cycle.
How is the procedure?
As already mentioned, the study can be carried out both through the abdominal wall and transvaginally - the physician performing the test selects the appropriate method. Basically, the procedure is the same as the usual ultrasound. Folliculometry is a common examination of the pelvic organs. Follicle monitoring takes very little time, and the procedure itself is absolutely painless.
Of course, there are some data that allow you to determine how successfully folliculometry was performed. What are these indicators? As a rule, during the first study, the doctor may notice one, rarely several, enlarged follicles. In any case, only one egg matures - its dominance is determined after only a few days. On average, the diameter of the follicle is 12-15 mm. But its size is constantly increasing - at the time of ovulation, they often - 25 mm. It is these details and draws the attention of the doctor.
Moreover, immediately after the rupture of a ripe follicle and the release of an egg, a yellow body forms in its place, which can be examined for several more days during an ultrasound scan. After ovulation, a small amount of free fluid is present in the prostate area. In any case, after folliculometry, a control blood test for hormone levels is required - normally, an increase in the amount of progesterone is observed.
What disorders can a similar study help determine?
This technique helps to determine the exact time of ovulation. But the possibilities do not end there - there are a lot of other discoveries that folliculometry allows. What are these important facts?
First of all, continuous monitoring allows the doctor to evaluate the work of the uterus and ovaries. Using ultrasound, you can determine the presence of various tumors, including, for example, a cyst, etc. There are other diseases that can be detected during folliculometry. For example, some patients are diagnosed with myoma and other diseases. Using the results of such a study, the gynecologist has the opportunity to determine the cause of infertility. Moreover, the technique is used even during therapy, as it allows you to carefully monitor the impact of certain drugs on the reproductive system.
In fact, it is difficult to overestimate the value of this study, because it helps the specialist to make the correct diagnosis and select the best treatment methods.
Reviews and additional information
Today, more and more patients are prescribed folliculometry. Reviews of experts suggest that this is the most accurate and effective method of diagnosis and monitoring. This technique is indispensable for couples who want to have a child, as well as for patients suffering from certain violations. In any case, the procedure is painless and does not take much time. The disadvantages include the fact that the procedure must be repeated every two days (not everyone is comfortable). You can do it in special diagnostic institutions or family planning clinics. As for the cost, it varies depending on the city, the equipment used and the pricing policy of the institution. On average, one ultrasound procedure costs about 300-500 rubles.
The purpose of the folliculometry
The method is carried out to assess the work of the ovaries in the dynamics, state of the endometrium. Folliculometry monitors the process of maturation of follicles, reveals the dominant, makes it possible to determine the moment of ovulation, the formation of the yellow body during one monthly cycle. The study determines the state of the endometrium, predicts a successful or unsuccessful attachment of a fertilized egg - implantation into the uterus.
The indication for the use of folliculometry is:
- infertility along with the absence of obvious pathologies of the reproductive system,
- hormonal disorders, associated pathologies - anovulation, luteal phase deficiency, polycystic ovary syndrome.
The study is conducted in the process of stimulating ovulation, while preparing women for artificial insemination, IVF procedures.
Objectives of using folliculometry:
- ovarian performance evaluation,
- determination of the maturing follicle,
- identifying the moment of ovulation
designation of the optimal day of conception,
- determination of the feasibility of stimulating ovulation,
- impact on the sex of the unborn child (sexual intercourse a few hours, during ovulation increases the chances of having a boy, while sex a few days before it allows you to give birth to a girl),
- preventing or increasing the chances of multiple pregnancy,
- overall assessment of the menstrual cycle
- identification of causes of cycle irregularities, causes of infertility,
- identification of pathologies of the reproductive system, gynecological diseases associated with the inability to become pregnant,
- treatment control.
Ways of carrying out folliculometry
The study can be carried out transabdominal, vaginally. In the first case, the diagnosis is carried out as usual ultrasound. A woman lies on her back, her stomach is smeared with a special substance that allows you to better see the picture. The specialist drives the sensor along the belly from the sternum to the pubis. A picture appears on the monitor, after which the computer summarizes all the images and displays the results. The second method of research - vaginal, allows you to see a more complete picture.
The sensor is located in close proximity to the ovaries, uterus, endometrium. A special device is inserted into the vagina. The woman during the study may feel some discomfort, but in general the procedure is painless. What kind of monitoring will be carried out, determines the specialist. He also determines the timing of the procedure, since the time of the folliculometry has a certain framework.
Special serious preparatory activities are not carried out. On the eve of the study, the woman needs to perform a hygienic procedure for washing away. If folliculometry will be performed externally, you need to fill the bladder. To do this in about 45 minutes to drink tea, coffee, mineral water. Such drinks stimulate the production of urea. When conducting a vaginal examination, on the contrary, care must be taken to ensure that the bladder is empty.
In order to improve the effectiveness of the results of the study, a woman needs to stop using food for 1-2 weeks, which causes increased gas formation and bloating. This situation somewhat distorts the results of the study. Do not use:
- fresh cucumbers,
- black bread,
- carbonated drinks,
- whole milk.
In general, proper nutrition increases the chances of the normal functioning of the reproductive system; therefore, a woman must ensure the correct diet if there are problems with conception and a regular cycle.
Dates of folliculometry
A woman has to go through 6 research procedures for a complete picture of the menstrual cycle.
Folliculometry should be made on the 5–7th day of the menstrual cycle for the first time. Immediately after the end of menstruation. During this time, the development of the egg begins. In one of the ovaries, 2-3 follicles are detected, ranging in size from 5 to 9 mm. Already during this period it is possible to reveal the dominant one, but they are not in a hurry with the conclusions. The structure of the endometrium is uniform, the thickness reaches 2 mm.
- The second ultrasound is performed on days 9–11. It is recommended to do folliculometry for this day of the cycle for the following reasons. Of all the follicles formed, one begins to grow more confidently - it is commonly called dominant. During this period of the cycle, its dimensions reach 10 mm, while the others barely reach 9 mm. Every day the follicle will increase by 2-4 mm. At the end of the development of the egg diameter will be about 22 mm. The structure of the endometrium is linear, 5 mm thick. By the end of the maturation of the follicle, three layers will be clearly visible. If the second ultrasound study did not detect a dominant follicle, there is no point in doing folliculometry on the 13th day of the cycle. The menstrual cycle will be without ovulation.
- The third study should be conducted on the 13th day of the monthly cycle. The main goal is to determine the preovulatory state of the follicle. Its diameter is 22–32 mm. To do folliculometry on this day of the cycle is necessary in order to determine the moment favorable for conception. The thickness of the endometrium is 12 mm, there is a clear structure in 3 layers. If there is a deviation in the formation of the endometrium, the probability of pregnancy is low. Because the uterus will not be able to receive the egg. Conception happens, implantation is not.
Making folliculometry on the next day of the cycle is recommended for explicitly detecting ovulation. There is no expressive follicle. A free liquid is found instead. In this form, the egg after fertilization is a few days. The follicle is present - a study should be conducted every day until it becomes clear - ovulation will not occur.
- Do folliculometry on the 15-17th day of the cycle, subject to the implementation of ovulation. Instead of a bursting follicle, an asterisk-shaped yellow body is observed. The thickness of the endometrium is 11 mm, the structure of the three layers is lost. The uterus is ready to accept the yellow body.
- On days 21–23 of the monthly cycle, the implantation of a fertilized egg occurs. The purpose of the study is to determine the state of the corpus luteum, endometrium. The size of the yellow body increases, the lining of the uterus again becomes homogeneous structure. In this case, the implantation will occur successfully, which is the beginning of pregnancy. Deviations in the development of the corpus luteum are grounds for assuming that pregnancy will not occur.
It is necessary to do folliculometry on a certain day of the cycle in order to understand how ovulation occurs, the formation of the corpus luteum, the implantation of an egg cell. After a thorough diagnosis, experts decide to stimulate ovulation, if the ovary is not working properly, to take hormonal drugs to ensure the full development of the follicle, egg, and the readiness of the sexual organ for pregnancy.
The results of the study of the presence of ovulation
During a normal menstrual cycle, the follicle reaches a large size, the egg comes out, a special fluid is formed, it is found with the sperm cell, a corpus luteum appears, then implantation, pregnancy. However, the situation may develop in a different way, then the onset of pregnancy becomes impossible.
- The follicle reaches the desired size, but does not burst, but begins to decrease in size - atresia of the dominant follicle. Ovulation does not occur. In this case, hormonal stimulation should be carried out.
- The follicle reaches the dominant size, remains so until the end of the menstrual cycle. No ovulation. The situation is called the "persistence of the follicle."
- The follicle continues to grow after reaching the dominant size. Ovum does not go out, ovulation does not occur. Instead, a follicular cyst is formed, which may remain for several months, then disappear.
- The follicle fully develops. And at the moment when ovulation should occur, begins a gradual wrinkling. There is an early luteinization of the follicle.
Folliculometry allows you to determine all these deviations. To draw conclusions, to conduct a full-fledged treatment or artificial insemination. In any case, the diagnosis should be carried out if, with full sexual intercourse, pregnancy does not occur within 1 year.
What is folliculometry, how and when is it performed?
This is a study of ultrasonic sensors, which allows you to track the folliculogenesis in dynamics during one menstrual cycle. The doctor may use a transabdominal or vaginal probe. Women need to know how folliculometry is performed by various sensors in order to properly prepare for it.
The doctor examines the surface of the abdomen, examining it from the pubis to the sternum, so you should choose clothes that allow you to quickly expose the desired surface.
For the procedure, you need to grab a towel or diaper, they are laid on a couch, and a package of paper napkins to wipe off excess gel. Immediately before the examination, it is necessary to fill the bladder, for this purpose, over an ½ liter of plain water is drunk for an hour and does not urinate.
The sensor is inserted invaginally, with some discomfort.
Before the study it is necessary to hold a toilet of the genitals. It is not necessary to fill the bladder, it is recommended to urinate before starting the procedure. They take a towel or diaper with them, a disposable condom (special for ultrasound, or the usual smooth).
To clarify some parameters, you may need to use both sensors. An increased amount of gas in the intestines can make diagnostics difficult, so a special diet should be followed before the study: excluding legumes, all types of cabbage, black bread, alcohol, and carbonated drinks.
How does follicle maturation
For the first day of the cycle take the first day of menstruation. At the beginning of folliculogenesis, several follicles grow, all of them do not exceed 2 mm in diameter. В десятый день цикла уже можно увидеть один или несколько фолликулов, которые превышают остальные по диаметру (до 15 мм) – они называются доминантными.The remaining follicles begin to regress (the opposite of the development process) and soon decrease to their original level.
The dominant follicle continues to develop and reaches 18–25 mm in diameter by the time of ovulation. Next, luteinizing hormone is released, under the action of which the egg leaves the follicle and exit into the peritoneal cavity with a small amount of follicular fluid. In place of a ripe follicle, a yellow body is formed.
Dates of the study
On which days of the cycle folliculometry is performed, depends on the menstrual cycle. To determine favorable days for conception in women, whose cycle lasts 28 days, the first ultrasound should be performed between 8 and 10 days from the start of menstruation.
With a longer or short cycle, the date is calculated based on the following data: the cycle length varies due to the first phase (the duration of follicle maturation), the second phase is 13-14 days, the study should be carried out 5-6 days before the estimated ovulation date .
Example: the woman has a stable cycle, its duration is 32 days. Calculate the date of the first ultrasound for folliculometry: 32 - 14 = 18 (estimated date of ovulation), 18 - 6 = 12 - on the twelfth day of the cycle, the first study is conducted.
If the cycle is irregular, the date of onset of folliculometry is given 3-5 days after the onset of menstruation. In total, it may take from 3 to 6 visits to the doctor, examinations are appointed with an interval of 2-3 days.
Signs of ovulation
The doctor notes the changes in the follicle and determines the date of ovulation from their dynamics. The release of an egg occurred if:
- There was a steady growth of the follicle to a size of 18-24 mm.
- The follicle has disappeared, in its place in the ovary a yellow body has formed.
- Free fluid is visualized in the abdominal cavity.
- One week after the expected ovulation date, there is a high level of progesterone in the blood.
The persistence of the follicle can transform into a follicular cyst. In this case, the enlarged follicle does not stop growing, but continues to grow (at the same time there is an accumulation of follicular fluid). If the follicle exceeds 25 mm in diameter, the doctor can make such a diagnosis during folliculometry.
Lack of follicle development
In some cases, the follicles may not develop at all, or begin development at the beginning of a cycle, and then regress without the formation of a dominant.
In the absence of ovulation, pregnancy cannot occur, because the egg does not enter the uterine cavity and cannot meet with the spermatozoon. Women who are diagnosed with anovulation should undergo a comprehensive examination to identify the cause of the pathology. It is rather difficult to restore the childbearing function, but with a great desire, normalization of nutrition, lifestyle change and compliance with medical recommendations, a woman has a chance to become a mother.
What is the purpose of folliculometry?
Folliculometry - what is it, and when is the need for this study? The answer to this question concerns women during pregnancy planning. Especially if they fail to conceive a child for quite a long time.
Folliculometry is a research method by which you can monitor the growth of follicles and confirm the fact of ovulation. Most often, this procedure is prescribed to women who can not get pregnant for 6 months or longer.
According to the study, you can assess the condition of the ovaries, determine the usefulness of the ovarian-menstrual cycle. When conducting a study daily or after 1-2 days, you can confirm the fact of ovulation and thus increase the chances of a successful conception.
In some cases, the study needs to be done not 1 cycle, but several months in a row. This will give the opportunity to decide whether a woman can become pregnant independently, whether she is ovulating. With this method, you can determine the need for stimulation of ovulation.
Indirectly, this study can even help conceive a child of the desired sex. After all, if sexual intercourse occurred shortly or on the day of the release of the egg from the follicle, there is a high probability of the boy's birth.
In addition, an ultrasound method of research will help determine the presence of diseases of the female genital organs.
On which day of the ovarian-menstrual cycle do you need folliculometry?
This procedure cannot be done at any time. The date of diagnosis should be prescribed taking into account all the features of the ovarian-menstrual cycle in women.
If you are assigned folliculometry, on which day of the cycle should it be done with regular menstruation, the interval between which is exactly 28 days? In this case, the study is carried out mainly from 10 to 14 days of the cycle with an interval of 1-2 days. To be safe, the first ultrasound can be done on the 7th day of the cycle, the next study date will be prescribed by the doctor according to the results of diagnosis.
If the dominant follicle is not yet determined, the following procedure is prescribed after 2 days. In the case of its clear visualization and with sufficiently large sizes - a maximum of 1 day or the next. As a rule, it is necessary to do ultrasound 4 to 7 times. During this time, you can trace the onset of ovulation or make sure it is not present.
When to do folliculometry with irregular ovarian-menstrual cycle? Calculate the required time for the study in this case is much more difficult. The average duration of the ovarian-menstrual cycle in a woman is taken as a basis, and 14 is subtracted from this number.
After all, the second phase of the cycle is exactly 14 days, while the first can be lengthened or shortened. Therefore, if the average cycle duration is 35 days, folliculometry must begin 5 days before the intended ovulation, that is, from the 21st day of the cycle.
Where do folliculometry? This study is carried out on an ultrasound machine in an ordinary clinic, private clinics, specialized reproduction centers, etc. If possible, diagnostics should be done on good equipment, which will eliminate erroneous results.
If folliculometry is prescribed to stimulate ovulation, it is advisable to conduct a study directly in the clinic where you were done this procedure. This will provide an opportunity to accurately evaluate the results and interpret them in accordance with the stimulation.
How is the research done?
Folliculometry is performed by a conventional ultrasound probe. Special training before the diagnosis is not needed. On the eve, it is recommended to limit the use of foods that promote increased gas formation in the intestines.
It can be legumes, black bread, alcoholic or low alcohol drinks, cabbage and other products. The increased amount of gas in the intestine may prevent the ovary structure from being well examined, the presence of follicles detected, their growth growing, and the ovulation of the egg being recorded.
Ultrasound for folliculometry is done in two ways - transabdominal and intravaginal. Both methods are highly accurate, but using intravaginal ultrasound, you can verify the reliability of the results obtained in case of any doubt.
Transabdominal folliculometry is a common ultrasound of the uterus and ovaries. To obtain reliable results, it should be carried out correctly - with a full bladder. Therefore, 50-60 minutes before the diagnosis, it is necessary to drink at least 1 liter of non-carbonated water or any other liquid so that the bladder is well filled.
Intravaginal ultrasound is performed on an empty bladder, moreover, it is recommended to empty it before the diagnosis.
Interpretation of results
The interpretation of the results is carried out on the basis of regular studies and monitoring the growth of the follicle in the dynamics. In the first procedures, the presence of a dominant follicle is determined; its growth rate is noted in dynamics.
Basically it reaches sizes in diameter 18-24 mm. If ovulation occurred, during the ultrasound, it is clear that the dominant follicle has disappeared, and a yellow body has formed in its place. A small amount of free fluid can be found in the abdominal cavity.
Whoever did this procedure and became pregnant, the problem of infertility was in the irregular ovarian-menstrual cycle. As a result, it was very difficult to determine the most favorable days for conception, since they did not fit into the generally accepted boundaries.
In addition, if the cycle is anovulatory, the chances of successful conception are zero. The older a woman is, the more anovulatory cycles she may have per year. Accordingly, the chances of successful conception are diminishing every year.
In addition to tracking ovulation and follicle growth control during stimulation, this state of research can determine the following conditions:
- Atresia of the follicle. The dominant follicle stops growing prematurely, and its reverse development begins.
- Persistence of the follicle. It reaches a size of 18-24 mm, but it does not break and the release of the egg.
- Follicular cyst. An enlarged follicle with a diameter of more than 25 mm begins to accumulate in it.
- Luteinization of the follicle. The corpus luteum is formed before the release of the egg.
- Lack of follicle development, or anovulatory cycle. It is characterized by the fact that follicles do not develop, or their growth stops at the very beginning of the cycle.
All these states indicate that pregnancy cannot occur in this cycle. Therefore, several ovarian-menstrual cycles may be needed to determine ovulation and decide on the need for stimulation.
What it is?
Folliculometry is an ultrasound diagnosis method.which during the entire menstrual cycle allows you to monitor folliculogenesis.
This means that through such monitoring can monitor maturation follicle and the way the dominant one develops among them. Thanks to observations, it is possible to obtain data on each phase of the local cycle.
One of the main tasks of follicular diagnosis is to determine the appropriate day. for conception. Folliculometry helps to find out the date of ovulation, identify the presence of pathologies and find out if artificial stimulation is required.
It also monitors the development of the endometrium.
When to do?
Folliculometry is prescribed by a gynecologist to confirm or exclude the presence of abnormalities, as well as to track the development of ovulation.
The most common indications for diagnosis are:
- Unsuccessful attempts to get pregnant for a long time,
- Determining the most appropriate time for conception,
- Evaluation of the ovaries,
- The need to stimulate ovulation,
- Hormonal disruptions,
- Determining the structure of the ovaries,
- Counting the approximate number of eggs in the "stock"
- Planning the artificial introduction of sperm into the uterus (insemination),
- Planning the fertilization of the egg by the sperm outside the body (in vitro fertilization).
Folliculometry is performed and in order to diagnose some genital diseases (the presence of hypoplasias, myomas or cysts). It is used to determine the usefulness of the menstrual cycle.
Therefore, the reason for the procedure may be:
- Lack of ovulation
- Minor menstrual blood loss, less than the permissible rate (hypomenorrhea),
- Menstruation less than once every forty days (oligomenorrhea),
- Dysfunction of the gonads.
Preparation for the procedure
A woman does not need special training.. It is enough to follow a few simple instructions. The main thing is nutrition. Before the procedure and at the time of its implementation can not eat foods that contribute to flatulence. When gas formation in the intestines is more difficult to watch the follicles.
These products include:
- All kinds of cabbage
- Black bread.
There are two more recommendations which are carried out on the basis of the chosen method of the procedure. An hour before transabdominal folliculometry, you need to drink at least one liter of water without gas and do not urinate.
If the diagnosis will be performed vaginally, the opposite should be done, empty the bladder before the procedure.
Sometimes, for more accurate diagnosis, the study is carried out and transabdominal and vaginally. In this case, an hour before the first procedure, the woman drinks water. At the end of the first study, the bladder needs to be emptied. Only after this is monitored by the vaginal sensor.
How to catch ovulation?
One of the main conditions for a successful conception is ovulation. The process of maturation and release from the follicles of the egg occurs in healthy women about the same. But the moment of occurrence of this important event is different for everyone. This is due to the different duration of the first phase of the menstrual cycle. Therefore, for the onset of a planned pregnancy, future mothers begin to calculate the best days for conception, that is, the period of ovulation.
For calculations using several techniques:
- Measurement of basal (rectal) temperature,
- Special tests to determine ovulation,
- Hormonal blood tests,
The latter technique is the most accurate and efficient. After all, it allows you to track not only the time the egg from the follicle, but also deviations in its development and maturation. The ultrasound will “see” anovulatory cycles (when the egg does not mature at all), the general condition of the pelvic organs and changes in the endometrium.
The older a woman becomes, the less her full-grown eggs mature. Accordingly, there are more problems with ovulation.
What "see" ultrasound
Folliculometry is prescribed to patients who have a failure in the menstrual cycle, or conception does not occur within a year, provided that there is regular intimate life.
The study reveals the following important points:
- The presence or absence of the ovulatory cycle,
- Days of ovulation,
- Causes of irregular menstruation,
- When ovulation is stimulated with special drugs, an ultrasound scan will tell you if these drugs work,
- Ovarian function
- Hormonal changes,
- Endometrial condition
- Pathological changes in the uterus.
An indisputable advantage of folliculometry is the “calculation” of a possible multiple pregnancy. After all, there are cycles during which two or three eggs mature. During this period, the probability of conceiving several children at once is very high.
In addition, it is believed that with the help of this study, you can plan the floor of the future baby. When planning a girl, PA should occur a few days before ovulation. When planning a boy - exactly on the day of ovulation.
Preparation for the study
Preparation for the study does not cause difficulties. However, there are a few rules that you should follow before starting the diagnosis:
- For 2-3 days to provide a balanced diet, minimizing the amount of unhealthy food in the diet: fatty, smoked, spice-filled dishes, sweets. After all, constipation and swollen intestines will impede the work of the uzist,
- For the same reason, it is necessary to exclude all products that cause increased gas formation: cabbage, legumes, alcoholic and carbonated drinks, black bread,
- Drink a day before the diagnosis of a laxative, if your doctor recommended it,
- Before the procedure, carry out hygiene procedures for the genitals.
Most often, folliculometry is carried out in the morning, an hour after a loose breakfast. Further preparation for the procedure will depend on the method of the diagnostic study. They are two: external and vaginal.
If the ultrasound is done externally, an hour before the test, you need to start drinking water without gas. By the beginning of the procedure you need to drink in small portions about half a liter of water.
By this time, the bladder will fill and close the bottom of the uterus. As a result, a kind of window is formed through which the necessary research data can be seen. Diagnosis begins as soon as the urge to urinate appears.
In the case of using the vaginal way to drink the liquid is not necessary. On the contrary, immediately before the ultrasound it is important to empty the bladder.
In difficult cases, when the doctor needs extremely accurate results, both methods are applied in turn. First fill the bladder and examine the uterus by external means. After emptying the bladder, the reproductive system is studied using a vaginal examination.
How and on what days the diagnosis is carried out
We have already mentioned how folliculometry is performed. Both methods are painless and safe for the patient, allowing the doctor to obtain all the necessary data.
- Transabdominal (external) method is carried out by moving the sensor throughout the abdomen, starting from the region of the sternum and ending with the pubis.
- Transvaginal (internal). For the examination, the patient needs to take off her underwear and lie on her back, having bent her knees. A vaginal probe is inserted into the vagina on which a condom is dressed.
On which day of the cycle, the doctor decides to take folliculometry, given the duration and regularity of the patient's cycle. При цикле в 28-29 дней диагностические исследования обычно начинают через 7-9 дней после менструации. Приведем пример расчетов дня первого исследования.
У пациентки зафиксирован регулярный менструальный цикл, равный 32 дням. The duration of the initial phase can vary, and the duration of the second reaches two weeks. Diagnosis should begin 5-6 days before ovulation. Consequently, folliculometry is appointed on the 12th day after menstruation begins.
The number of procedures for each woman will be different. On average, ultrasound monitoring is performed 3-4 times per menstrual cycle. The date of the next study is also prescribed by the doctor, based on the general picture of the patient's reproductive system. Most often, the diagnosis is carried out once a week. If necessary - every other day.
In the case of irregular, too short or excessively long cycles, folliculometry can be prescribed on the first day of the end of the menstrual flow.
Natural work of reproductive organs
The patient is recorded correct ovulation, which occurs on the desired days of the cycle. Ultrasound detects such signs:
- Before ovulation occurs, several follicles grow,
- After some time, one of them stands out, one dominant, which is much larger than the others,
- The follicle disappears (its rupture occurred at this time, and the released egg passes into the fallopian tubes),
- During the ovulation period, the yellow body begins to develop in its place.
- For the uterus traced accumulation of a small amount of fluid.
You should know that using ultrasound to fix the time of release of the egg is not possible: its size is too small. For this reason, confirm ovulation on the accompanying signs.
The test results record an increase in progesterone, which indicates that the corpus luteum began to function.
Atresia (improper development of the follicle)
In normal graphs, the bubble resizes by the days of the cycle upwards. In the case of follicle atresia, the reverse occurs. The follicle begins natural growth, but before it reaches maturity, it decreases. Due to the fact that in such a short period of time the egg did not have time to mature, ovulation does not occur. Such a violation is called anovulatory cycle. Due to the lack of ovulation, the patient cannot become pregnant.
Characteristic symptoms on ultrasound:
- The appearance of a dominant follicle was not detected or its rapid decrease was recorded,
- The corpus luteum and fluid behind the uterus are absent.
The amount of progesterone in the blood remains unchanged.
If the anovulatory cycle is fixed once, it is still early to talk about pathology. Each woman faces a similar situation several times a year. However, the systematic absence of ovulation indicates infertility, which should be treated.
In this case, the follicles develop correctly before ovulation. However, having reached a mature state, the dominant does not “release” the egg, maintaining its size during the entire cycle.
Diagnostics captures such changes:
- The presence of a dominant follicle, existing for a long time,
- Lack of a yellow body and fluid behind the uterus.
Analyzes capture an increase in estrogen, while the amount of progesterone steadily decreases.
The follicle matures to the desired size, but does not break in due time. Instead, a yellow body begins to form.
Obvious signs in the diagnosis:
- The matured dominant follicle begins to slowly decrease,
- The presence of a yellow body,
- Lack of fluid behind the uterus.
Considering the work of the corpus luteum, progesterone growth is observed in the analyzes.
Cystoid follicle changes
The dominant, having begun a natural increase, does not stop its growth. By the time of ovulation, the size of the “main” follicle significantly exceeds the norm. Inside it appears fluid, which turns the follicle into a cyst.
Symptoms on ultrasound:
- Dominant follicle exceeds natural size,
- Lack of fluid behind the uterus and corpus luteum.
According to test results, an increase in estrogen is observed with reduced progesterone.
What to do if pathology is found
Any deviations from normal indicators require additional studies: a general analysis of blood and urine, smears, etc. On the basis of all indicators, a diagnosis is made and treatment is given the appropriate situation.
In conclusion, I would like to note that folliculometry is an effective, accurate and safe way to diagnose, which allows you to track the development of important cyclical changes in the reproductive organs of women.
However, this study has one drawback: the cost is quite high. The price of folliculometry varies from 500 to 1000 rubles per session. Recall that they will need at least 3-4 per month. At the same time, diagnostics in private clinics will cost much more than in public ones.
Physiological development of the reproductive system in women
After birth, there are more than a thousand immature follicles in a woman’s ovaries. Until puberty, these follicles grow, but none of them reach the maturity stage.
During puberty, under the influence of certain hormones, the following processes occur in a woman's body, which determine her ability to conceive:
- During one cycle, several follicles begin to mature.
- By the influence of hormones one (rarely two, three or more) the follicle reaches the stage of maturity.
- During the period of ovulation, the mature follicle, from which the egg cell is ruptured.
- The ovum enters the fallopian tube and, with its normal patency, moves towards the uterus.
- At this stage, it can be fertilized by sperm. If this does not happen, the egg cell dies and dissolves within 24 hours.
This process is normally repeated almost every month. But there are cycles when the maturation and release of the egg does not occur (anovulatory cycle). With age, the number of viable eggs decreases, and there are more and more problems with ovulation.
To conceive a child, you need to know exactly when ovulation occurs. If there are problems with conception, you need to make sure that ovulation does occur and find out if there are other problems for a woman that prevents her from getting pregnant. For this purpose, and held folliculometry, which allows to answer these and other questions.
How does fertilization take place?
Who does this procedure and why?
Folliculometry is prescribed to women with irregular menstrual cycles, as well as those who can not get pregnant within a year during normal sex life.
The main points you can find out by doing this study:
- Does a woman have ovulation or not?
- on which day of the cycle it comes,
- determine the days of ovulation
- calculate the optimal time for conception,
- find out the regularity of the menstrual cycle
- control the effects of drugs on reproductive organs,
- clarify the indications for stimulating the process of ovulation,
- identify the pathology of the uterus (fibroids, polyps, etc.).
According to unverified data, with the help of folliculometry, you can predict the sex of the child (sex after ovulation has occurred increases the chances of a girl becoming pregnant). Doctors this fact is not confirmed, but such a probability, of course, is.
In addition, when it is carried out, it can be seen when not one but several eggs mature. In this case, the chances of becoming pregnant with twins or even triplets are high.
The disadvantage is the inability to check the condition of the fallopian tubes, the presence of adhesive processes and foci of endometriosis.
When do this research?
On what day the examination is determined by a gynecologist. When calculating the appropriate time take into account the duration of the cycle and its regularity.
With a standard regular cycle of 28-30 days, the first ultrasound scan is performed about a week after the cessation of menstruation.
The first ultrasound is done on a 7-10 day with a normal cycle.
Such ultrasound may need 3 or more. On each subsequent ultrasound, the doctor prescribes when the next procedure is performed. As a rule, between subsequent examinations stand an interval of a day or two.
Important!If the cycle is longer or shorter than the average, as well as in women with an irregular cycle, the doctor may prescribe an ultrasound immediately after the end of menstruation.
How to prepare for the survey?
Specially prepare for ultrasound is not necessary. If a woman is planning a pregnancy, then you should stick to a healthy diet and eliminate alcohol. After determining ovulation on this day, an attempt is made to conceive a child.
If an ultrasound scan is performed through the abdomen, then an hour before the procedure, you need to drink a lot of fluid to fill the bladder. So you can better consider the uterus.
When the test is done through the vagina, the bladder must be emptied.
How does folliculometry go?
Ultrasound of the pelvic organs can be done in two ways:
- through the anterior abdominal wall (transabdominal). The sensor smoothly slides down the abdomen,
- through the vagina (transvaginally). The sensor on which the condom is dressed is slowly inserted into the vagina and the examination is performed.
This procedure is painless and has no side effects or contraindications. After the first ultrasound, the doctor determines the date and time of the next examination.
The ultrasound procedure is safe and painless.
How to evaluate the results of the study?
To make correct conclusions about the presence or absence of a problem, in addition to an ultrasound examination, a woman undergoes tests for sex hormones during this period. Based on all the data, the doctor can set the following diagnosis:
- Normal ovulation. It means that a woman is capable of conceiving and in the absence of other problems (obstruction of the fallopian tubes, etc.) may become pregnant in the near future. Characteristic features on ultrasound:
- before ovulation, several follicles increase to a certain size,
- the disappearance of the follicle (it breaks and an egg comes out of it, it can be found in the fallopian tube),
- after ovulation, a yellow body begins to form at the follicle site, and a small amount of free fluid is detected behind the uterus,
Progesterone levels increase in blood tests (meaning that the corpus luteum works). The corpus luteum is an endocrine temporary gland that forms on the site of a bursting follicle. Its function to produce progesterone is a pregnancy hormone.
- Atresia (reverse development) of the follicle.
In this case, the follicle first grows in size, but not reaching the stage of maturity, the reverse process begins. It is reduced in size and ovulation does not occur. Such a cycle is considered anovulatory. Get pregnant from a woman will not work. Signs on ultrasound:
- the dominant follicle is reduced in size,
- no signs of corpus luteum and fluid behind uterus.
In the blood, the level of progesterone does not change. This situation can be a one-time, but it can happen all the time. In case of unsuccessful attempts to get pregnant, look for the cause and prescribe treatment.
This follicle grows to the desired size, but it does not break and the egg leaves. The follicle exists during the whole cycle, and in some women it is determined after ovulation. Ultrasound signs:
- enlarged follicle, which exists for a long time,
- no yellow body and fluid.
Estrogen levels are elevated in the blood and progesterone levels are lowered.
The follicle increased, but did not break, but in its place a yellow body formed. On ultrasound:
- visible follicle, which gradually decreases,
- there are signs of yellow body,
- no free fluid.
Progesterone levels rise in the blood because the corpus luteum works.
- Follicular cyst.
In this case, the mature follicle enlarges above normal size. Cystic fluid begins to accumulate in it and it turns into a cyst without tearing. Ultrasound signs:
- follicle enlargement is greater than normal parameters
- no corpus luteum and free fluid.
There is a low level of progesterone in the blood and an elevated estrogen level.
- Lack of follicle development
Ovulation does not occur and the follicles do not increase in size. On ultrasound:
- no signs of follicle growth,
- no yellow body.
Blood is low in progesterone.
All cases, except the first, suggest that there are problems with the reproductive health of women that can prevent her from conceiving a child. To eliminate the cause of the problem, you need to reconsider your lifestyle and strengthen reproductive health.
Folliculometry will help calculate the favorable time for conception.
Reviews of the procedure
Folliculometry should be carried out only by a competent specialist who will be able to assess and notice all the nuances of the ovulatory cycle and support the woman in her desire to become a mother. Here is what the patients themselves say about the study:
Ekaterina, 29 years old
Could not get pregnant for two years. My husband and I went to a private center where we were prescribed folliculometry to find out how and when the egg matures. She had to do 5 times a day. It turned out that ovulation does not occur every month. It turned out to get pregnant after six months, when I was calculated a favorable period for conception.
Svetlana, 31 years old
The folliculometry took place first in the private center. For 3 procedures I gave about 2,000 thousand rubles, but they did not tell me the exact result. I applied to the state infertility treatment clinic. It turned out to be several times cheaper, the study went to the end and found out that the reason was not in ovulation, but in violation of the patency of the fallopian tubes. Now I am undergoing treatment.
Goals of folliculometry
Folliculometry is a study that is conducted in order to:
- assess whether the ovaries function normally
- confirm ovulation
- calculate the days of the cycle corresponding to ovulation
- choose the best day for conception
- to conclude whether it is necessary to stimulate ovulation
- affect the sex of the future baby (sex shortly before ovulation or immediately after it increases the risk of becoming pregnant with a male fetus)
- prevent or, conversely, increase the chances of multiple pregnancies
- evaluate the usefulness of the menstrual cycle
- determine the causes of cycle irregularities
- diagnose some diseases of the reproductive organs (fibroids, cysts), differentiation of their types (luteal, follicular cyst)
- to control the treatment, even if the latter was carried out with the help of a homeopathic remedy.
How is the procedure
How is folliculometry done? The study can be conducted in two ways:
- Transabdominal. In this case, you lie on your back, opening for the study the entire abdomen from the sternum to the pubis. The sensor will move along the wall of the abdomen.
- Vaginal sensor. Such an ultrasound of the folliculometry is done like this: the patient takes off her underwear, lies on her back, bending her legs at the knees. A condom is put on a special sensor and is inserted into the vagina. This study is painless.
Regardless of how the folliculometry is done, this research can be done not when you are mentally prepared for it. Date must be set in advance, depending on your menstrual cycle.
Dates of the procedure
On what day to do folliculometry, you should tell your gynecologist or sonologist, who will do this on the basis of your cycle.
With a cycle of 28 days, the first study (4 or more of them are made) is assigned between 7 and 10 days. That is, at least a week should pass from the first day of menstruation.
Next, the doctor immediately ultrasound prescribes when to do folliculometry. Usually you need a few studies with an interval of 1-2 days (according to the results of the previous study).
If the cycle is longer than 28 days, the first study is scheduled for 10 days or later, the interval between examinations is maintained the same.
Physiology of the female reproductive system
The follicular apparatus is a few hundred immature follicles. They are laid by a woman in the prenatal period in the amount of several thousand, some of them die in the process of cultivation, and about half a thousand remain for their birth.
Each menstrual cycle, the process of preparing for ovulation begins to go through several follicles. Then, under the influence of hormonal background, only one of them becomes the main candidate for egg producers (less often - several).
It is called dominant. It comes out of its “shelter” in the ovary into the abdominal cavity, it must be caught by the villi of the fallopian tubes and get into their cavity, where they can meet with the spermatozoon. The process of the release of a mature egg from the ovary is called "ovulation."
In place of the follicle, which burst as a result of ovulation, a yellow (luteal) body develops - a temporary endocrine gland. It functions either before the onset of menstruation, or, if the pregnancy has arisen, before the appearance of the placenta (at 12-16 weeks).
There are cycles when the maturation of the egg does not occur. They are called "anovulatory", with age they become more and more. During such a cycle it is impossible to get pregnant.
The conclusion of the ultrasound "depleted follicular unit" means that under the influence of such reasons:
- harmful factors
- drugs taken
- diseases of the genital or endocrine system,
- less often - congenital causes
in the ovaries there are few follicles. In order for a pregnancy to occur, it is necessary to detect and treat this cause (or eliminate the influence of harmful factors, to cancel the drugs).
How to decipher the folliculometry
Это исследование включает в себя не только наблюдение за эхографической картиной изменений в матке и яичниках. Проводится также лабораторное определение уровня женских половых и некоторых других гормонов (например, тех, которые вырабатывает щитовидная железа). Based on ultrasound and laboratory tests, the doctor issues a report, which may be as follows:
1. Normal ovulation. It is characterized by such signs:
- Before ovulation, there are 1-2 dominant follicles (their size is not less than 15 mm, but not more than 24 mm)
- follicle disappears
- after ovulation, signs of the corpus luteum are visualized in the ovary
- also after the release of the egg, a certain amount of free fluid behind the uterus is visualized
- in the blood a week after ovulation there is a high level of progesterone (it works the yellow body)
2. Persistent follicle. This diagnosis means that although the dominant follicle has fully matured, it did not ovulate. This situation may persist after menstruation. Signs of this condition:
- a follicle with a size of 18-24 mm has existed for a long time
- there is no free fluid in the space behind the uterus
- the yellow body does not form
- in the blood: high levels of estrogen, low - progesterone.
3. Cyst follicular. This is a condition where the follicle not only did not ovulate, but also grew in size (more than 25 mm). Symptoms of such a cyst:
- follicle diameter 25 mm or more
- there is no free fluid behind the uterus
- no yellow body formed
- hormone levels: low - progesterone, elevated - estrogen.
4. Luteinization of the follicle: the follicle was formed, did not ovulate, but in its place a yellow body still formed. Signs:
- follicle of any size
- he gradually shrinks
- no free fluid
- progesterone - as in the second phase of the cycle (increased).
5. No follicle development:
- follicles are there, but they do not grow
- no yellow body
- no dominant follicle
- progesterone is low.
What women say about the study
Reviews of folliculometry indicate that the study is useful for those who want to get pregnant. “Thanks to such monitoring, one cannot hope for hopelessly,” they write. - After all, during lutealization of the follicle, the basal temperature will behave in the same way as during a normal ovulatory cycle. But in this case it is impossible to get pregnant. ”
Also, folliculometry allows you to monitor the effectiveness of treatment for infertility. Many reviews indicate that the procedure is quite expensive. In private clinics, the price of folliculometry is 500-700 rubles for 1 session (you need at least 4 of such procedures).
You can make folliculometry in the State Reproductive Centers and on the basis of women's consultations (in which the cost of the procedure is much lower). This study is also conducted in multidisciplinary clinics and specialized gynecological centers that treat infertility.
Thus, folliculometry is the type of research that will help you learn how the ovaries and uterus work, how ovulation occurs, whether the cause of infertility lies precisely in the disruption of egg maturation. The procedure is simple, carried out without much preparation, safe and painless. Its disadvantages are that it requires repeated use and should be carried out strictly on schedule, and not at will.
In the video, an expert talks about folliculometry.
How to decipher the result of ultrasound?
The data that the doctor receives as a result of ultrasound diagnosis can be very diverse. With the help of folliculometry, you can immediately establish a diagnosis or give a "push" for further examination and treatment.
For example, upon detection persistent follicle, drugs are assigned to restore the second phase of the cycle. If an egg is required at IVF, the most optimal day for taking material is determined with the help of monitoring.
It becomes clearDoes a woman need additional stimulation of ovulation and, if so, how should it be performed?
Research allows you to follow not only folliculogeneses, observation is also carried out on the level of hormones. Based on the diagnosis, the doctor may issue a conclusion on normal ovulation or, on the contrary, on the presence of abnormalities.
What to take as the norm?
With normal ovulation, mature dominant follicle has a size of 15 to 24 mm, after which the egg breaks it and goes into the fallopian tube. In place of the disappeared follicle, a yellow body appears. Some liquid appears behind the uterus. During this period, the amount of progesterone in the blood increases.
What deviations can be diagnosed?
Sometimes ovulation does not occur at all. The phenomenon can be both single and systematic. Consider the main reasons for the lack of ovulation.
Violation occurs when the follicle immediately grows and then, for unknown reasons, begins to regress. Often it can reach 18 mm or more, but then stops in development, decreases and disappears altogether. The corpus luteum and fluid that should form behind the uterus are absent.
With this deviation, the follicle develops as “normal”, it also reaches 18-24 cm in the same way, but the gap does not occur. Ovulation is absent, since there was no release of the egg. This state can persist throughout the entire menstrual cycle, and sometimes even several. Yellow body and no fluid.
Reviews - what they say about the study of women?
Numerous reviews of folliculometry suggest that the procedure helps women who want to get pregnant.
There are reviews that systematic ultrasound helps to monitor efficacy fertility treatments. The girls point out that by resorting to folliculometry, one can not just hope and wait, as in ordinary temperature measurements, but act.
After all, with many violations, the temperature can remain the same what should be the period of ovulation. However, pregnancy does not come. The ovulation test also does not give such a reliable result as ultrasound diagnosis.
“Of course, not to hide the fact that the procedure is quite expensive. It takes a lot of time and money. In a private clinic, which I regularly visited, one procedure cost 700 rubles per session. In my case, they took 5. However, the result was worth it. After long attempts at getting pregnant, I finally succeeded, now I am 7 months pregnant, ”writes user Natalia in one women's forum. It is worth noting that the procedure can be carried out in public institutions, where it will cost less.
Folliculometry will help to learn about the work of the ovaries and uterus, will track how comes and passes ovulation. With the help of such a diagnosis you can find out if the reason for the absence of pregnancy is not hidden in the abnormal development of the follicles. The procedure is very easy to use and does not require special training. It is absolutely safe and painless. The only drawback is only one: repeated visits to the ultrasound examination room and strictly on the dates indicated by the doctor.
When the procedure is performed
On which day of the cycle to appoint the first folliculometry determines the attending gynecologist, depending on the phase of the menstrual cycle of a particular woman. If menstruation comes regularly and the frequency is 28 days, then the study is carried out for 7-10 days from the beginning of menstruation. If the cycle is longer or shorter, then the day for the examination is calculated by the doctor individually.
For example, the cycle is 32 days. The first phase varies depending on the maturation of the follicle, the second phase usually lasts 13-14 days, and folliculometry should be performed 5-6 days before the start of ovulation. Then the diagnosis is done on day 12 after the start of the critical days. If the cycle is irregular, then monitoring is carried out for 3-5 days from the beginning of menstruation.
After the first examination, the date of the second (after 1-2 days) is immediately assigned to observe folliculogenesis in dynamics. On what day to do further folliculometry, decides the gynecologist, depending on the situation. Usually spend at least 4 examinations (daily or every other day).
The essence of folliculometry is to fix the fact and the exact day of ovulation. If it did not happen (i.e., the anovulatory cycle), then an ultrasound scan is performed until the next menstruation. More on menstrual disorders →