FOLLICULAR STUDY

Follicular Study Overview

A follicular study can also be referred to as follicular monitoring or tracking is a term that describes the process of a few ultrasound exams done with the intent to check growth of the follicles within the ovaries. This is particularly useful to assess ovarian reserve and fertility potential in women with menstrual cycle irregularities or fertility problems.  

What Is A Follicular Study? 

It involves ultrasound and transvaginal imaging of the ovaries and the follicles. The test is done using a transvaginal ultrasound, which involves placing a small probe into the vagina that produces sound waves at a high frequency. These waves bounce off of the inside structures and form images on a monitor. Those monitoring the images are able to evaluate how much a follicle has grown, when ovulation occurred, and how thick the lining of the uterus is. 

Types of Follicular Study 

In the adherence to the objectives of the study, two main types of follicular studies are identified:  

• Basal follicular study: Growth and development of follicles as seen on day two or three in the cycle.  
• Serial follicular study: Ultrasound checks done at set times (usually with intervals of 2-3 days) to see development in follicles and ovulation. 

List of Parameters Considered During the Follicular Study

Healthcare professionals need to check on the following points for better evaluation of follicular study results.  

• Number and Dimensions of Follicles 
• Both volume and texture of the ovaries 
• Endometrial Thickness 
• Identification of cysts or tumours of an ovarian nature. 
• Blood supply to the ovaries and uterus. 

Reasons for taking a Follicular Study

Then are some common reasons or other criteria which are known to require this form of imaging.  

• The major one includes absolute infertility or other related factors which may make pregnancy a challenge. 
• Irregular patterns with menstrual cycles or issues with ovulation. 
• Hormonal disorders like PCOS 
• Tumours or cysts at the ovary level.  
• Fibroids or other tumour-like tissue growths in the uterus. 

Benefits of taking the test

The benefits of follicular study are: 

• Differentiating the stage of the cycle by looking at the anatomy reveals that the ovaries have been functioning, and there has been ovulation. 
• Better diagnosis or management of fertility problems. 
• Increased fertility rates for patients undergoing assisted reproductive technology (ART) services. 
• Ovarian cysts or tumours can be diagnosed early. 

When and who should take a Follicular Study? 

A healthcare practitioner may recommend a follicular study based on the following: 

• Dysmenorrhea or anovulation 
• Secondary infertility 
• Polycystic ovaries syndrome (PCOS) 
• Use of artificial reproductive techniques (ART) like in vitro fertilisation (IVF) 
• Women who have chronic pelvic pain or unusual vaginal discharge 
• Women with a past medical issue of ovarian cysts or tumour 

In most cases, women in the childbearing age bracket (18 to 45 years) with persistent abnormal cycles or those having reproductive issues are referred for a follicular study. 

Illnesses diagnosed with Follicular Study

Conditions usually found with the aid of follicular study encompass: 

• Cysts at the ovaries i.e. tumours 
• Endometrial implants. 
• Uterine growths. 
• Complex infertility. 

Preparing for a Follicular Study

On the day of the breakthrough test, it is advisable to: 

• Arrive at the clinic with a full bladder, this helps in getting better images. 
• Not drink or eat anything for 30 minutes prior to the test 
• Let the doctor know if you are allergic to latex or any ultrasound gel. 

Pre-requisites 

There are no criteria for the follicular study test, however, the following may be suggested by the doctor: 

• Specific days of the menstrual cycle may be selected - day 2 or 3 and days 10-12. 
• Discontinue any prescription drugs or dietary supplements that may interfere with follicle stimulation. 

Best Time to Take the Follicular Study 

The optimum time to perform this study depends on individual factors, but it is typically done during certain days of the menstrual period. 

Eligibility 

Women within the reproductive age bracket, specifically those aged 18 to 45 years and who have some sort of fertility complications or have absent menstrual cycles, are usually suitable candidates for a follicular study. However, there's a possibility that some medical issues like severe pelvic pain or infection can contraindicate the test.  

Procedure for Taking a Follicular Study 

The procedure of the test is standard and follows these steps: 

1. Remove any clothing and jewellery that would obstruct the test: Preparation.  
2. Lie on an examination table, placing feet in stirrups: Positioning.  
3. Gently place a transvaginal ultrasound probe into your vagina: Ultrasound probe insertion.  
4. Use the ultrasound machine to take pictures of the ovaries and uterus: Image acquisition.  
5. A healthcare professional checks and analyses follicular size and number, ovarian volume, and uterine lining thickness: Measurement and evaluation. 

Caution Before Taking the Test 

Make sure to inform your doctor about any concerns you may have with:  

• Active infections or pelvic pain.  
• Past pelvic surgeries or injuries.  
• Sensitivities or allergies to latex, as well as ultrasound gel.