Follicular Scan (Sonography)

Follicular sonography is important investigation for  fertility assessment and treatment. They involve using ultrasound technology to monitor the development and maturation of ovarian follicles in a woman’s ovaries. Follicular scans are significant in assisted reproductive technologies, notably In Vitro fertilization (IVF) and intrauterine insemination (IUI). In this blog post, we will discuss the importance of follicular scans in fertility treatment.

Before going  into follicular sonography, it’s essential to understand what is ovarian follicle? Ovarian follicles are tiny, fluid-filled sacs within a woman’s ovaries that contain immature eggs or oocytes. During each menstrual cycle, several follicles are recruited by the ovaries, but typically, only one will grow, mature, and release an egg during ovulation

What Are Follicular Scans?

FOLLICULAR  SCAN are a series of ultrasound examinations that track the growth and development of ovarian follicles throughout a woman’s menstrual cycle. A trained sonographer or a reproductive specialist typically performs these scans. The process involves:

1. Baseline Scan: Often done within the first three days of the menstrual cycle, this initial scan provides a baseline measurement of the ovaries and the number of resting (pre-antral) follicles. This scan is essential to know the antral follicular count. It also gives information about the baseline status of the uterus.
2. Serial Scans: During the menstrual cycle, ultrasound scans are conducted every 2-3 days to track the growth of follicles with the specialist’s assistance.
3. Rupture Scan: This is the final scan of the series that confirms the ovulation. It will check for the presence of free fluid and collapse of the follicle, indicating ovulation.

Why Are Follicular Scans Important?

1. ‍ Determine Ovulation Timing: Monitoring follicular growth helps predict the timing of ovulation accurately. This is essential for couples trying to conceive naturally and those undergoing procedures like IUI.
2. Assess Fertility Treatment Response: For individuals undergoing fertility treatments like ovulation induction or IVF, follicular scans help assess how the ovaries respond to medication. Medication dosages are adjusted based on scan results.
3. Identify Potential Issues: Follicular scans can identify medical conditions like polycystic ovarian syndrome (PCOS), where many small follicles develop, but often none mature fully. It can also help detect ovarian cysts or other abnormalities.
4. Maximize Pregnancy Chances: In assisted reproductive techniques like IVF, the goal is to retrieve mature eggs for fertilization. Follicular scans help ensure that eggs are collected at the optimal stage of development.

What Information Do Follicular Scans Provide?

In a follicular scan, commonly collected information includes:

1. Antral Follicle Count: The number of recruited follicles in each ovary.
2. Follicular Size: The size of each follicle, measured in millimeters.
3. Endometrial Thickness: The thickness of the uterine lining, which should be adequate for embryo implantation.
4. Endometrial Pattern: In addition to the endometrium’s thickness, the endometrium pattern is also crucial. A good endometrium should have a three-line pattern.
5. Dominant Follicle: Identification of the lead follicle, often the one that will release an egg during ovulation.

How is it performed?

The scan is performed with the help of a probe of an ultrasound machine. It is mainly performed using a transvaginal probe. The scan is performed vaginally. It is not painful. It takes a few minutes to complete it. It doesn’t require fasting or full bladder.

Conclusion

Follicular scans are an invaluable tool in the field of reproductive medicine. They provide critical information about a woman’s ovarian function, the timing of ovulation and the response to fertility treatments. Whether attempting to conceive naturally or undergoing assisted reproductive procedures like IUI or IVF, these scans are vital in optimizing your chances of achieving a successful pregnancy. A Fertility specialist consultation can help you determine when and how to incorporate follicular scans into your fertility journey.

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