Why does follicle size matter

Objective: To determine the optimal size of the leading follicle before human chorionic gonadotropin hCG administration in cycles with clomiphene citrate CC and letrozole, and to examine any differences in the optimal leading follicle size between cycles with CC and letrozole. Design: A retrospective study. Setting: University hospital-based reproductive center. Patient s : 1, women undergoing intrauterine insemination cycles with CC or letrozole.

Intervention s : Leading follicle diameters and endometrial thickness were recorded 24 hours before hCG administration, together with other cycles parameters, and were compared between pregnant and nonpregnant patients.

Higher quality eggs are the first to be selected as with the passage of time, the eggs of the successive cycles have inferior quality. This explains why older women have more difficulty getting pregnant and have higher miscarriages rate. Within the study of female fertility it is essential to know what your ovarian reserve is. Currently is still counting ovarian follicles, the truest estimate of ovarian reserve in a given patient.

This reserve is expressed in number of follicles per ovary observed in the first days of the cycle 2nd to 5th by performing a vaginal ultrasound. Ultrasound also allows us to follow the evolution and growth of follicles both in spontaneous cycle as in a stimulated cycle fertility treatment. Depending on the number of antral follicles, a woman is considered to have adequate or normal ovarian reserve if the count is Low ovarian reserve , if the count is less than 6 ovarian reserve and high ovarian reserve if is greater than Follicular size in this cycle phase is 2 to 10 mm.

Women with low ovarian reserve are more likely to not respond to treatment and women with high ovarian reserve are responding in an exaggerated way. In both cases, it is more likely that the treatment cycle is cancelled than when the follicular count is normal.

As in a semen sample not all spermatozoa have enough quality to fertilize an egg and not all follicles contain mature eggs, or not all eggs have the same quality. In a very small percentage of cases, it can be produce a called empty follicle syndrome.

Once a treatment plan has then been decided upon by your physician, the new protocol begins. This visit is very important because it provides your physician with baseline readings of hormone levels as well as an opportunity to view the uterus and ovaries via ultrasound. Once your physician has reviewed the results of your blood work and ultrasound, you will receive a phone call from your nurse, typically in the afternoon, to confirm your medication protocol and to make an appointment for your next monitoring appointment.

This is a question that is commonly asked by patients when they start their treatment protocol. A patient who is using oral ovulation stimulation medication such as clomiphene citrate Clomid or Serophene with an IUI cycle may require only 2 to 3 monitoring sessions, whereas women using injectable medications in conjunction with either an IUI or IVF may need to be seen up to seven times in a two-week period.

Robert Stillman. In contrast, patients on stronger, injectable medications need to be watched much closer in order to make adjustments in the amount of medication being given for safety and effectiveness.

As a treatment cycle progresses, many patients wonder what the ideal follicle size and proper uterine lining thickness needs to be before triggering for IUI or egg retrieval. At each visit, our physicians look for a balance between hormone levels and ovarian response. And since the hormone estrogen is the prime factor in both increasing follicle size and building up the uterine lining, making sure that levels continue to rise throughout the cycle is a key factor.