Follicular Study: Why and How is it Done?

If you are planning a pregnancy, your doctor might advise you to undergo a follicular study to monitor your ovulation cycle.

A follicular study is a series of scans that helps to monitor the ovulation cycle. The test is also helpful to know the best time for intercourse if you want to conceive.

Ovaries are two reproductive organs that are located in the pelvis. They comprise numerous sacs that are filled with fluids. These sacs are referred to as follicles. Eggs grow in follicles. Follicles begin to grow at the beginning of a woman’s menstrual cycle. There are numerous follicles that are developed.

But by the time you are in the middle of the menstruation cycle, out of the many follicles, only one follicle develops completely. This one developed follicle is termed ‘dominant follicle’, which eventually releases a mature egg. Ovulation refers to the process of releasing an egg.

There are numerous eggs that develop and can be fertilised. Out of these numerous eggs, only one egg is released in the Fallopian tube. In case the fertilisation does not take place, then the dominant egg is released through your menstruation.

Why is a follicular study done?

Your doctor may recommend follicular study in the following cases:

To rule out any complications

• If you are under 35 years of age and trying to conceive for a period of 12 months, your doctor may recommend you to do the follicular study.
• If you are over 35 years of age and trying to conceive for a period of six months, your doctor may recommend doing the test.

PCOD or PCOS

• If you have irregular menstruation cycle or have been diagnosed with polycystic ovarian syndrome (PCOS) or polycystic ovarian disease (PCOD), it would be a little difficult for you to conceive. In such cases, follicular study helps in the calculation of the ovulation cycle.

Fertility procedures

• If you are undergoing treatment like Intrauterine insemination (IUI) or in-vitro fertilization (IVF) for fertility, then your doctor may recommend a follicular study test to check the effectiveness of the treatment.

Miscarriages in initial weeks

Women who have miscarriages in the initial weeks of pregnancy are also recommended the test. In such cases, the test is helpful to understand the reason for miscarriages.

It is said that even though the follicular study helps to track the ovulation cycle, it may not always be helpful. In certain cases, follicular study tests can add more stress to your life. You may require visiting a doctor’s clinic for several days for the tests. This frequent commute to the hospital, sitting in hospital, and then going through the test might add to the stress level. You may also need to take frequent leaves from your job, and this can have an impact on the work-life balance.

The actual way to perform follicular study is through transvaginal scans. In some cases, abdominal scans are also recommended to reduce the inconvenience to the woman. However, it must be noted that the transvaginal method is more accurate as compared to abdominal scans.

Prerequisites

• Follicular study is usually done after the second day of your menstruation cycle. You do not need to observe an overnight fast for the test. In some cases, your doctor may ask you to avoid certain foods and drinks.
• If your doctor has prescribed certain medications to take before the test, make sure you take them.
• The preferred method for monitoring follicles is transvaginal ultrasound. It is usually done on the 3rd day of the menstrual cycle.
• The transvaginal scan is usually done on an empty bladder, hence do as advised by your doctor.
• Wear comfortable and loose clothes.
• It is advised to take a shower before you visit the hospital for the test.

Understanding its results

Your doctor will be able to explain to you the results more accurately.

Your doctor will be able to calculate your ovulation time based on two parameters:

• The size of your follicles, which must be between 18 mm and 25 mm.
• The thickness of the endometrium, which must be more than 10 mm.

When should it be repeated?

The number of times you need to repeat this test is different for all the cases. Based on your age and previous follicular study results, your doctor will recommend the total number of times you may need to undergo the test. In most cases, the test is repeated for five to six cycles. Even after repeated tests, if you are not able to conceive, then your doctor may prescribe you certain fertility drugs. He/she will then schedule your next tests.

Your doctor may ask you to take the fertility drugs for around six cycles. If fertility drugs are not effective, your doctor may recommend a more aggressive approach.

If you are undergoing IVF, then you may probably need to undergo a follicular study test more frequently.

Procedure

Follicular study is done in two ways – abdominal ultrasound and transvaginal scan. Both the tests will be conducted either by an ultrasound expert of an infertility expert. Your doctor may ask you to undergo either one or both methods of the test for a detailed analysis. Your doctor may recommend the type of test you must undergo based on your cycle and the cause of the test.

The procedure for abdominal ultrasound is similar to any other sonography. The healthcare professional will apply the conductive gel on your abdomen and do the test. The test is not painful at all.

For a transvaginal scan, the healthcare expert will insert a tube-like structure with gel on it inside your vagina. The images captured by the ultrasound machine will be displayed on the monitor. The test may take 15 to 20 minutes. The test is not painful, but at times, can cause some discomfort.