What is Natural Ovulation study?
Natural ovulation study or follicular scan/study is the first step before starting any infertility treatment.
Ovulation study is done to check
- To check the follicular count & growth
- To check Endometrial lining / uterine lining thickness (embryo implantation area)
- To know the ovulation period window so that suggested Intercourse/IUI/IVF procedure can be timed accordingly
- To calculate the fertility drug dosage & to adjust further dosage as necessary & recommended.
It basically tracks one complete menstrual cycle of the patient without giving any medication for ovulation.
At Akruti IVF the Adance Natural ovulation study is done in AI (Artificial Intelligence) Based 5D Follucumetry study ultrasound machine.
What all features are monitored in ovulation study ?
The study monitors if the follicles are being formed naturally.
In case those are being formed, the size, count and progress of follicle.
As the ovulation cycle progresses, the monitoring helps decide the rupture time of follicle, changes to endometrial layer, any defects etc.
It also monitors the post rupture formation of corpus luteum, which is a structure formed to supply hormones for implantation of embryos.
Which is the best method for doing this study?
Transvaginal ultrasonography is the best method to do this study.
It gives a very clear view of pelvic structures to see the changes happening during ovulation.
What are the benefits of doing this study ?
Natural ovulation study gives the perfect idea of hormonal balance required for ovulation i.e. is there a harmony between the hormones?
Primarily, the study uncovers if there is an imbalance in hormones required for follicle rupture.
Secondly it tracks development of endometrial layer so that any defects (like fibroids) occurring during ovulation can be identified early.
Thirdly it tracks growth & size of the follicle, based on which further treatment can be decided.
Tracking all these help taking corrective action, thereby resulting in higher chances of pregnancy.
How much time is required for this study?
It requires 4-6 visits in a span of 20 days. This is so because, the entire cycle need to monitor. Roughly visits are required on following days of the cycle:
- Day 2 – To check the baseline condition of ovaries
- Day 5 – To check if the growth of follicle has started
- Day 7 – To check the progress of follicle
- Day 8 – May or may not be required depending on how robust is the growth of follicles.
- Day 9/10 – To decide the rupture plan of the follicle
- Within 3 days of Rupture – For Ovulation Induction, IUI procedure or IVF Pickup.
Every visit takes no more than 10-15 min for test. This study need to be done only once, to understand the ovulation pattern of the patient.
What is the future course of action?
Based on the result of Natural Ovulation Study, most likely course of actions are going for Ovulation Induction, IUI / IVF, ICSI, Advanced IUI etc.
These depend on the outcome of study. To know more about various treatments, call Akruti IVF centre Dombivli at the numbers mentioned on their website. If you are staying in areas like Thane, Kalyan Ambernath, Badalapur, Palava, Akruti is best bet for you.
Also if you want to know more about Ovulation study please refer to these videos.
Ovulation induction?
Ovulation induction means regulating the development of eggs in order to achieve pregnancy.
At AKRUTI IVF CENTRE DOMBIVLI this is the main module for starting any treatment
Ovulation induction is a procedure done for regularizing ovulation. It is done in case of following:
- Anovulation (irregular or no ovulation), where ovulation does not occur due to failure of egg to mature or failure of release of egg by follicle due to hormonal imbalance.
- To get multiple eggs, as it develops multiple follicles when used medicines in high dose
What are the benefits of ovulation induction?
It is cost effective, so always done before going for any other treatment plans.
Successful ovulation induction improves chances of natural pregnancy in 25% patients.
Ovulation induction, in single attempt, gives multiple eggs required for procedures like IUI & IVF. This improves success rate.
Improves the quality of eggs for formation of good quality embryos, resulting in healthy babies.
Ovulation induction helps in PCOS patients for successful ovulation which is not happening naturally.
What are the methods used for ovulation induction?
Ovulation induction is done using one or more of the following ways. If the first method does not work, doctors try second and so on.
Tablets like Clomiphene citrate or aromatase inhibitor drugs. These cause body to produce more Follicle Stimulating Hormone (FSH)
Injections of FSH LH hormones directly, If body is not able to produce FSH.
Injections of Human chorionic gonadotropin (HCG) hormone for follicle rupture.
Combination of tablet & injections of hormones
How the treatment of ovulation Induction is carried out & what is the time required?
Ovulation study is done with transvaginal ultrasonography. Progressive sonography tells the response of drugs used and dose variation is done accordingly.
When follicle reaches at around 18-20 mm in diameter, the next course of action is decided base on treatment planned:
For natural conception, rupture injection is planned.
For IVF, oocyte pick up is done within 34-36 hours
For IUI procedure, semen insemination is done after 36 hours.
One cycle of ovulation study requires 4-5 visits in one month.
Why rupture is planned with injection?
Rupture planning with HCG injection gives exact time of rupture so planning of natural intercourse is done & around 25% patients conceive naturally.
Planning of IUI is done as per the exact timing of rupture due to injection time plan
IVF has to be done with injection HCG as pick up is planned before follicles rupture naturally.
Are there any side effects of in ovulation induction?
Drugs used in ovulation induction can give minor side effects such as bloating, nausea, weight gain, headache, hot flushes, loss of appetite
One of the side effects like OHSS – Ovarian HyperStimulation Syndrome where ovaries swell and become painful, occur when drug dosage is higher than what body can tolerate.
But not to worry, at Akruti IVF Center, after doing more than 5000 IVFs, the doctors have become pretty experienced to give just the right dose to the patient.
Treatment is planned properly to avoid such complications.
What is colour doppler?
Colour doppler is nothing but ultrasound sonography (USG), to monitor blood supply of different organs in human body. It is useful in all stages of pregnancy.
Before beginning IVF treatment, growth of follicle can be traced
During infertility treatment growth of embryo can be tracked
And further during pregnancy, health of baby can be tracked.
However not all sonography machines are equipped to do Colour Doppler.
Only special sonography machines, which is available in few IVF centers can be used for this purpose.
Along with the machine, doctor also need to be trained to use that machine. Dr. Manik Kale, has done an advanced course in Colour Doppler and has been using it successfully in IVF treatments for past 20 years.
In which cases Colour Doppler is useful?
When reason for infertility is one of the following :
- Unruptured follicle syndrome – if rupture does not happen naturally.
- PolyCystic Ovaries Syndrome – Ovaries develop cysts which disturb the menstrual cycle.
- Unexplained infertility where both the partner’s reports are normal but no pregnancy happens
- Thin endometrium – not enough tissues formed in uterus which give cushioning for embryo to develop.
Monitoring the uterus through Colour Doppler gives good idea about the cause of infertility.
How colour Doppler study helps to improve success rate in infertility?
Colour doppler can monitor 3 key factors knowing which, planning can be done to give higher success rate of quality embryo formation & implantation.
1. Showing blood supply of mature follicle – this helps in taking rupture decision. Only when blood supply is 100% rupture should be planned, else egg will not be able to survive or get fertilized.
2. Blood supply of uterus – if poor, leads to miscarriages. Medicines can be given to have right level.
3. Endometrial blood supply – only when it has adequate level, will embryo be able to implant successfully. Hormonal injections can be given to correct this indicator.
What are the extra benefits of Colour Doppler over routine transvaginal sonography?
♦ Colour doppler in ovulation study gives perfect idea of blood flow of ovary to evaluate quality & capacity of ovary to give quality oocytes
♦ It gives idea of doses of drugs for ovulation induction
♦ It gives perfect idea of mature follicular blood flow to decide the rupture plan
♦ Helps in giving details of blood supply of corpus luteum to decide the hormone supplements for supporting embryo implantation mainly progesterone hormone
♦ Improves success rate of conception due to monitoring of blood supply of uterus
♦ Endometrial blood supply monitoring gives exact idea of environment of embryo for implantation
Any thing else I need to know about Colour Doppler?
There are no side effects in getting Colour Doppler. As it is ultrasonic method of monitoring, just the sound waves are sent inside the body which are harmless.
However you need to know following:
- It takes more time than routine USG. Because monitoring is complex, a session may go up to 30 min to show the output readings.
- For this reason, one may be required to pay extra charges for doing colour doppler.