A follicular study, or follicular monitoring, involves tracking the growth of ovarian follicles from the start of the menstrual cycle until ovulation. This process is crucial for assessing fertility and timing, especially in IVF procedures. It involves regular ultrasound scans to observe follicle development and estimate the optimal time for egg release, thereby increasing the chances of conception if timed with intercourse.

Follicular monitoring is a key component of fertility treatments. It helps evaluate how well a woman’s body is responding to treatment, especially in IVF cycles. By assessing the number and condition of developing eggs and hormone levels, adjustments to medication can be made to improve conception chances. It also helps identify the precise timing for intercourse, thereby enhancing the probability of pregnancy.

A follicular scan is a non-invasive procedure that involves placing a small plastic probe in the vagina to visualize follicle growth. Monitoring is recommended in the following scenarios:

• Women under 35 who have been trying to conceive for over a year.

• Women over 35 who have been unable to conceive for six months.

• Those with PCOD, irregular cycles, or anovulation.

• Individuals undergoing fertility treatments like IUI or IVF. Scans are typically conducted on days 6 or 7 of a 28-day cycle, with follow-ups every two to three days.

Follicle tracking uses vaginal ultrasounds to monitor follicle growth from around day 9 of the cycle until ovulation occurs. The procedure, which takes 5-10 minutes, involves measuring follicle size and endometrial thickness. A mature follicle usually measures 18-25mm, and a normal endometrial lining is over 10mm. Doppler scans may also be used to check blood flow to the follicle and endometrium.

 Follicle tracking is beneficial for women who:

• Are unsure of their ovulation timing.

• Have experienced early miscarriages.

• Are using ovulation-inducing medications. It helps in diagnosing ovulation issues and assessing the effectiveness of fertility treatments.

The success rate of follicular studies in predicting ovulation is around 10%. While these scans are helpful, they can be stressful and may not always lead to pregnancy. It is advisable to undergo follicle tracking for one cycle to learn how to correlate scan results with physical signs of ovulation, rather than relying solely on the scans.

Side Effects of Follicular Ultrasound Scans 

Follicular ultrasound scans have no physical side effects, but they can be emotionally taxing. The pressure to conceive within the optimal window may impact sexual intimacy and cause stress for couples. Managing expectations and considering discreet home ovulation tracking might be beneficial.

Follicular scans offer several benefits:

• Detection of follicles that fail to mature or rupture.

• Identification of follicles that do not grow.

• Assessment of the endometrial lining quality and thickness.

• Prediction of ovulation timing to optimize assisted reproductive treatments.

• Monitoring for complications like OHSS and luteal phase deficiency. Regular scans help in promptly identifying and addressing potential issues.

A typical follicle scan lasts around 15-20 minutes, with preparation taking a few hours. The procedure itself may be completed in about 10 minutes if instructions are followed. Multiple scans, usually four to six per cycle, are required to accurately track follicle development and ovulation timing. The initial baseline scan establishes the starting point, with subsequent scans assessing follicle and endometrial changes leading up to ovulation.