Contents
Successful conception will occur only if there is a mature sperm and egg in the woman’s fallopian tubes. Some people have the belief that you can get pregnant any day, but in fact, without ovulation, the fertilization procedure is simply impossible. Ovulation is a period that occurs only once in the entire menstrual cycle. The egg appears due to the maturation of the follicle in the right or left (or both at the same time) ovaries of a woman. Usually, the process occurs in the first phase of the menstrual cycle, and to increase the chances of successful conception during this period, a woman undergoes folliculometry – monitoring the maturation of the follicle.
Procedure Algorithm
The procedure is carried out through the use of ultrasound diagnostics and involves repeated visits to the gynecologist. A woman will have to see a doctor at least three times in the first phase of the menstrual cycle and once in the second (approximately three days after ovulation) to control its onset.
An ultrasound doctor will be able to determine the presence of fluid in the retrouterine space, corpus luteum, deviations in the growth and structure of the follicles, the dominant follicle with its size, follicles in the egg and their number. It also allows you to determine the size and condition of the ovaries themselves.
Folliculometry is usually prescribed starting from the 9th or 10th day of the menstrual cycle, but if a woman has a tendency to early ovulation, the timing can be shifted.
It is important to see a doctor for several months. The procedure itself does not need special preparation, the only condition for a woman is an empty bladder. Folliculometry is carried out using a special sensor that allows you to conduct a study inside the vagina.
The procedure is completely painless. For greater comfort, a small pad is placed under the buttocks of the patient to acquire the optimal angle for viewing the ultrasound probe.
Follicular state at the beginning of the menstrual cycle
In the first days of the menstrual cycle, antral follicles are already visualized in the ovaries, which will gradually increase and mature. Their development requires hormones, especially follicle-stimulating hormone and estradiol.
If the amount of hormones in the blood of women is normal, then ovulation is stable in the body, and there are no more than 2 anovulatory periods per year.
Antral follicles:
- are small in size – up to nine millimeters;
- in each ovary, up to nine pieces are visualized normally;
- during the development period, the dominant follicle increases by 2,5 times.
If the folliculometry procedure will be performed for the first time, it is recommended to visit an ultrasound scan in the first days of the menstrual cycle in order to determine the condition of the ovaries and the number of antral follicles in them.
There are cases when the follicular reserve is depleted much faster than desired – in this case, the woman is diagnosed with “infertility”.
Follicular Growth Monitoring
If the menstrual cycle is normally thirty days, already on the tenth day it will be possible to determine the dominant follicle. During the first ultrasound procedure, the size of the dominant follicle reaches 12-13 centimeters, and just at this time the number of dominant follicles is determined by the diagnostician. Most often, one ripens, but there are cases with the simultaneous maturation of several follicles, which can lead to multiple pregnancies.
The second visit to ultrasound diagnostics is scheduled in three days. The diagnostician re-examines and confirms the growth of the dominant follicle, the size of which should already be within 18 millimeters.
There are cases of follicle regression, and on examination, the doctor can say that there is no visualization of the dominant follicles.
The third visit to the ultrasound should normally show the peak state of the follicle – up to 25 millimeters in diameter. In combination with the normal hormonal background of a woman, it is an indicator that soon the capsule will break through and the mature egg is ready for fertilization. It is important to understand that the egg is viable for only one day.
Each woman’s body is special, and the rate of development of the follicle is different for each, therefore, more than three passes of ultrasound examinations may be needed. Folliculometry can be prescribed for more than one month, in order to determine the scope of egg maturation.
Control ultrasound
In order to know as accurately as possible whether ovulation has occurred or not, it is necessary to perform a control ultrasound examination, because the presence of a large follicle that has already matured does not guarantee the breakthrough of its capsule and the release of the egg. Control diagnosis is carried out on the third day after the planned ovulation. The specialist carefully examines the condition of the ovaries and determines whether ovulation has taken place or not according to the following signs: the absence of a mature follicle, the presence of a corpus luteum, a small amount of fluid is formed in the retrouterine space.
It is important to understand that the control ultrasound must be done strictly after 3 days, otherwise it will no longer be possible to visualize the fluid and the corpus luteum.
Medical appointments after ultrasound diagnostics
Usually, if the work of the ovaries does not occur normally, this is an indicator of the presence of a hormonal failure in the female body. In this case, the doctor prescribes additional blood tests to confirm the state of the hormonal background. According to the results of the tests, drug therapy is prescribed, which after a certain period of time will help the woman become pregnant, endure and give birth to a baby.
In cases where there is a violation in the corpus luteum, the gynecologist may prescribe the use of drugs based on progesterone. During anovulatory periods, drugs are prescribed to stimulate ovulation. When determining endocrine infertility, when drug stimulation did not show positive dynamics, the patient is offered IVF (in vitro fertilization).