Oi & Follicle Monitoring
Ovulation Induction is a common fertility treatment used to stimulate the ovaries to produce and release eggs. The process typically involves the following steps:
- Initial evaluation: The first step is a thorough evaluation of the patient’s medical history, physical examination, and possibly some diagnostic tests. This helps identify any underlying causes of infertility and determines the most appropriate treatment plan.
- Baseline hormonal assessment: Before starting ovulation induction, hormone levels such as Anti Mullerian hormone(AMH) and estradiol are measured to establish a baseline. Semen analysis and Tubal testing are also advised.
- Ovarian stimulation: Ovarian stimulation involves taking medication to promote the development of multiple follicles within the ovaries, each containing an egg. This is typically achieved by using oral medications (such as clomiphene citrate or letrozole) or injectable gonadotropins (such as follicle-stimulating hormone or human menopausal gonadotropin). The specific medication and dosage depend on individual factors and the treatment plan recommended by the fertility specialist.
- Monitoring: During ovulation induction, regular monitoring is necessary to assess follicle development, hormone levels, and endometrial thickness. This monitoring usually involves transvaginal ultrasounds and hormone blood tests. The frequency of monitoring visits will vary depending on the patient’s response to the medication. In Follicular Monitoring we check the total number of follicles the rate at which they are growing and the endometrial thickness. We also look for structures like cyst formation, hydro salpinges, fluid in the endometrium formation and polyp. We follow the lead follicles till they reach 17 to 20 mm in size. The trigger injection is then given and then IUI is done 42 hours later or the couple is advise to try naturally. Many studies have shown that follicle rupture is strongly associated with ovulation, however other studies have also indicated that ovulation may happen even without evident follicular collapse because the oocyte which is a microscopic structure can eject out of the follicle and be accepted by fimbria of the fallopian tubes and go inside the fallopian tubes for fertilization and future implantation of the fertilize eggs.
- IUI is best done about 40 to 42 hours after the HCG injection. Along with this, the sperm preparation should be good. which means more than 10 million active motile sperm per ml and the absence of any other factor like large fibroids, polyps, hydro salpinges, and young women with good ovarian reserve, ensures good results.
- Luteal phase support: After ovulation, luteal phase support may be provided to help optimize the chances of successful implantation and pregnancy. This support can involve progesterone supplementation or other medications.
- Pregnancy testing: Approximately two weeks after ovulation, a pregnancy test is performed to determine if the treatment was successful.
It’s important to note that the exact steps and medications involved in ovulation induction may vary depending on individual circumstances and the recommendations of the fertility specialist. Close monitoring and guidance from a qualified healthcare professional throughout the process are crucial to maximize the chances of a successful outcome.