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What Does This Follicular Monitoring Test Report Indicate?

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Posted on Sat, 6 Jun 2015
Question: I am attaching my detail question with this mail
doctor
Answered by Dr. Manisha Jain (33 minutes later)
Brief Answer:
Intercourse advised today too

Detailed Answer:
Hello mam, thanks for trusting health care magic.
I understand your health concern and anxiety related to the same.
I have seen your report attached with the query, and in my opinion the follicle in left ovary is growing well but the decreased size once in between was just an observational error which occurs many a times due to position of ovary or the position of probe of ultrasound.
So take the injection ad advised and get the ultrasound repeated tomorrow.
But in my opinion you should have intercourse today too as there is certain amount of free fluid which signifies impending ovulation so an indication for having the sperms present at the site of requirement.
Moreover if the semen count of your husband is good there is no need to follow abstinence.
Abstinence is advised in couples where there are decreased sperms in the semen and thus a day of abstinence adds some amount of sperms for the final day.
I basically practice infertility and always ask for intercourse a day prior and on the day of follicle rupture.
As regards right ovarian follicle, it will not grow and regress by itself soon.
It is common and thus nothing to worry.
Take care
Regards
Dr Manisha
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Manisha Jain (18 hours later)
I had HCG 10000 units injection last night and the follicular monitoring observations made today is as below:

DATE : 14.05.2015 DAY OF CYCLE : 17th

RIGHT OVARY:
· Largest follicle 15X11mm.
· One collapsed attretic follicle is also seen.

LEFT OVARY:
· Largest follicle 19X10mm with echoes & septa.

ENDOMETRIAL THICKNESS :
· 10mm

REMARKS :
Either right ovary has one follicle ovulated prematurely. The one we followed is same in size.


As the endometrial thickness has decreased, I don’t know where is it all heading. The fluctuating size of Left ovary follicle is also a cause of concern and it’s viability considering the septa and echoes. My consultant was following the right ovary follicle which is almost stagnant in growth. I have been advised to take Duphaston 10mg twice a day for 12 days and to have relation tonight and tomorrow morning.

Considering the whole follicular monitoring, please give your analysis and advice, so that we may have right approach and understanding.
doctor
Answered by Dr. Manisha Jain (4 hours later)
Brief Answer:
Take medicines as advisef

Detailed Answer:
Hello mam, after correlating all the findings I think either the collapsed follicle was missed when it was growing or there has been some miscalculation of the size of the follicle in left ovary.
In either case it seems this cycle is not progressing in a proper way because the fluctuations in size of the follicle in left ovary is not a good thing.
You can have relation with your partner today and day after and also start duphaston as advised (hoping for the follicles to mature and rupture or the one that has ruptured might also yield pregnancy).
But from next cycle on along with clomiphene you will need FSH injections too, you can discuss this aspect with your gynecologist.
Take care and all the best.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Manisha Jain (2 days later)
I am taking Duphaston 10 mg twice daily since 14.05.15 evening and had relation as advised. However, I had instances of spotting yesterday morning and today evening along with mild pain in back, lower abdomen and pelvic region. I also observed slight prolapse. Today is 19th day of my cycle. What could be the reasons? And what care I should take? Few months back, I had complete follicular monitoring with Fertomid and HCG and had ovulation of two follicles measuring 19x12 mm and 17x12 mm with FSH. Do I still need to have FSH as advised by you if I have to follow the same next time?
doctor
Answered by Dr. Manisha Jain (11 hours later)
Brief Answer:
Mid cycle spotting

Detailed Answer:
This spotting can be due to the sudden fall of estrogen levels after ovulation and is a common phenomenon and is known as mid cycle spotting.
Nothing to worry about but keep taking duphaston as advised and don't skip any tablet otherwise there will be breakthrough bleeding and thus can distort your cycle.
In case you conceive this time well and good but in case you don't then from next cycle FSH injections are must along with clomiphene for regular growth of follicles and thus increasing the chances of conception many fold.
All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Manisha Jain

OBGYN

Practicing since :2007

Answered : 5136 Questions

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What Does This Follicular Monitoring Test Report Indicate?

Brief Answer: Intercourse advised today too Detailed Answer: Hello mam, thanks for trusting health care magic. I understand your health concern and anxiety related to the same. I have seen your report attached with the query, and in my opinion the follicle in left ovary is growing well but the decreased size once in between was just an observational error which occurs many a times due to position of ovary or the position of probe of ultrasound. So take the injection ad advised and get the ultrasound repeated tomorrow. But in my opinion you should have intercourse today too as there is certain amount of free fluid which signifies impending ovulation so an indication for having the sperms present at the site of requirement. Moreover if the semen count of your husband is good there is no need to follow abstinence. Abstinence is advised in couples where there are decreased sperms in the semen and thus a day of abstinence adds some amount of sperms for the final day. I basically practice infertility and always ask for intercourse a day prior and on the day of follicle rupture. As regards right ovarian follicle, it will not grow and regress by itself soon. It is common and thus nothing to worry. Take care Regards Dr Manisha