Guidelines for Follicular Study - Ovulation study - By Dr. Nitin Gupta, Radiologist, Kolkata, India.

1. Baseline scan is done on day 2/3 of cycle where u are supposed to mention Antral follicle count (2-9mm) and any retained follicular cyst from previous cycle .. it determines ovarian reserve as well help gynaec to decide stimulation dose 

After day 8 they want to know how many dominant follicles are growing ...

If IUI or OI/TI CYCLE  one or two dominant follicles are recruited 

If IVF cycle multiple follicles are recruited 

Mention number of follicle and sizes .. measure in two dimensions at least (each follicle)

2. Till the follicle size reaches 17-18 mm .. time to go for pick up in IVF cycles or for trigger in IUI or oi and ti cycles

Usually follicles grow at speed of 1-2 mm per day 

3. Regarding endometrium when u do day2/3  scan endometrium should be thin (<5mm) ... if it is thick than do see endometrium again once period is over (day 5-6) ... I’d still thick than gynaec usually do some scratching or they don’t proceed in same cycle

4. Endometrium has got more roel in IVF cycles as IUI or ti cycles u proceed irrespective of thin endometrium 

In IVF patients they follow endometrium thickness 

7.5 to 11 mm thickness with trilayered hypoechoic appearance with zone 3-4 flow is favourable ..... if thickness is <7 or > 13 they cancel the cycles 

In persistent thin endometrium patients we also consider endometrial volume at times 

It is measured by VOCAL ... volume more than 3 is considered good 

No transfer of <2

That’s what we practically see 

Regarding zonal endometrial flow just Google and read applebaum scoring.

 

It’s easy we Radiologist are not trained during our PG times but those who are doing USG in private segment must orient themselves as increasing ART and sub fertility patient we need to upgrade ourselves so we can help our gyanec colleagues and also the outcome of assisted fertility treatments.