It happens that a couple who wants to have a child cannot conceive it. There are problems with this. They can not reveal the signs, when you can most likely conceive a baby, although they do not determine the signs of any health disorders in your body. After each monthly cycle, seeing signs that a woman does not become pregnant, such couples gradually lose hope. Then, if possible, the determination of the time interval when the probability of conception will be greatest can come to the rescue. This will significantly increase the chances of achieving the goal.
To determine whether ovulation has occurred, check whether the signs of it have appeared, but this is actually quite complicated. Therefore, recently the method of folliculometry has been used. This is the name of the examination of the reproductive organs of a woman by means of an ultrasound scan. This allows you to determine the dynamics of changes in follicles and the causes of difficulties in conceiving a child.
The follicle is a "capsule", where the maturation and development of the egg. During ovulation, the follicle is torn, after which the mature egg begins to move inside the uterus. This moment should not be missed.
Women often ask: when is it better to do an ultrasound on ovulation: before or after it? And what are the signs of its approach? Many are also interested in the problem of the perfection of the method, how reliable is it? Are there any signs to track the onset of ovulation? This article is trying to answer these and other problematic issues.
How to find out when it is more effective to do ultrasound monitoring?
In modern society, many couples need such assistance in conception. The specialist to whom they come, conducts surveys, gives direction to various analyzes and examinations. The study of follicular behavior, namely, ovulation monitoring using ultrasound, is also included in the list of appointments. Folliculometry allows you to accurately determine the day of the beginning of ovulation, when the chances of successfully conceiving have a very high probability. With the help of such folliculogenesis, it is possible to find out whether there are any irregularities in the work of the reproductive organs system. Ultrasound also helps the doctor to choose the right course of therapy in case of problems.
So, when is it necessary to do an ultrasound scan for ovulation? To know the answer to this question, you must clearly know the monthly cycle of the fair sex. Each has its own, but on average it lasts a couple of days less than a month. It is accepted that the cycle begins on the first day of menstruation.
If the patient's cycle is constant and does not have any particular abnormalities, only two or three ultrasound sessions will be needed to get answers to questions about the days of ovulation.
You can go to such a study on the 8-10th day after the start of your period. If the female body has its own characteristics or a cycle that differs from the standard, the doctor invites you to the first ultrasound five days before the possible day of ovulation.
It happens that a woman's menstruation is irregular or the cycle is unstable. In this case, it is recommended to start a visit to the doctor-visitor from the third day after the end of the “critical days”. Then, in addition to folliculogenesis, an additional check of the endometrium is carried out, the ovaries are examined to determine why the cycle is broken.
How is the procedure of folliculometry?
The examination is carried out in a transvaginal way, in which a special sensor is inserted into the vagina. He will not bring harm, will not deliver pain.
The study of folliculometry by ultrasound is carried out on certain days of the monthly cycle. An ultrasound specialist provides a description of how egg maturation proceeds.
The first time ultrasound is carried out on the eighth or tenth day after the end of the "critical days". It accurately identifies the follicle that will dominate. It is usually larger than the others and measures more than a centimeter.
Three days later, re-ultrasound is performed and the dominant follicle is again determined. If for any reason the follicle ceases to develop, there can be no ovulation.
The third visit designates the uzist, which is based on the results of the first two studies. Procedures are repeated next month, if the pregnancy has not occurred.
Signs of ovulation
The onset of this moment in the cycle can be determined by fairly clearly defined "symptoms". Signs of ovulation are:
- the appearance of mucus from the vagina,
- symptoms of pain around the ovaries,
- increased libido,
- swollen breasts,
- increased basal temperature
- changed hormones,
- changes in the cervix.
There are many different methods for determining the day of ovulation. It:
- daily basal temperature measurement
- application of various tests, etc.
However, the method of ultrasound tracking is determined as the most accurate.
During the ultrasound procedures, the doctor tracks changes in the thickness of the endometrium. A single procedure does not provide all the data about what is happening in the female body.
Abnormalities detected while controlling ovulation
A cohort of growing follicles after 8 days of controlled ovarian hyperstimulation
During the ultrasound, the doctor monitors the thickness of the endometrium. In the case of an ideal monthly cycle (28 days), it is recommended to do a study for the first time on the 8-10th day after the end of menstruation. However, one procedure will not give all the information about how the process looks. And if the couple does not succeed in conceiving, they expect to diagnose deviations that prevent it. For example:
- follicle regression (This means that the development of the dominant follicle goes to a certain point, and then stops, and the process unfolds to the side to decrease. There can be no ovulation then)
- the persistence of the follicle (there is no rupture of the follicle),
- follicular cyst (he matured but did not come out),
- luteinization of the follicle (the corpus luteum was formed, but there was no rupture of the follicle),
- follicles production process does not occur.
Ovulation during the last rejection does not occur at all.
If the ultrasound detected one of the described abnormalities, the doctor prescribes additional tests and examinations. Then, after receiving all the results, a course of therapy is prescribed to normalize the ovulation process.
The decoding is carried out only by a specialist in gynecology, using information obtained by ultrasound, determining hormonal levels, and examining the patient. After studying all the results, the doctor can make a diagnosis.
To assess the state of the reproductive system, the following ultrasound results are taken:
- the parameters of the follicles, especially the dominant vesicle,
- the presence of fluid behind the uterus
- the presence and size of the yellow calf,
- hormonal background.
The dimensions of the ovaries and other organs of the female reproductive system are compared with normal parameters, which are calculated for each day of the monthly cycle.
Confirmation of ovulation with an ultrasound machine
Ovulation captured by ultrasound
What results confirm ovulation?
- on the eve of ovulation, growing and maturing follicles were recorded,
- there was a rupture of the follicle, which developed to the desired size,
- fluid found behind the uterus after the follicle has matured,
- after the rupture of the mature follicle, a yellow body has formed, which is visualized with an ultrasound device,
- After ovulation, a lot of progesterone is detected in the blood.
The amount of this hormone in the blood surrenders in the second half of the cycle, or rather a week after the end of ovulation. If the hormonal balance is normal or slightly higher, ovulation was normal. The only exceptions are cases when the follicle does not break due to the large thickness of the ovarian membrane. As a result, the egg gets "out", but this pathology can be easily detected by ultrasound.
Advantages and disadvantages of the method
Ultrasound control over ovulation allows you to identify the pathology of the reproductive system. With its help, monitor the development of follicles, and especially the dominant, the process of ovulation.
He also helps to determine the causes of violations of the monthly cycle, to determine whether there are violations in the endometrium. Research can be done at any time.
The disadvantage of ultrasound folliculogenesis is the fact that the examination session should be repeated at least four times during one cycle, and at least two cycles should be taken for the study. It turns out that in two months it will be necessary to go through about 8 procedures, which is quite expensive and inconvenient, because such an ultrasound scan should be performed on strictly defined days.
Ultrasound control of the ovulation process allows you to fully describe all problems with conception, to identify signs of impaired reproductive process in women. Often, having received answers using other methods of examination, a woman convinces herself that she is incapable: “Ovulation is not determined? Its signs are not shown. It means that it is not, and never will be. ”
If a woman undergoes an ultrasound and gets a complete picture of the state of her reproductive system, she will not be visited by such thoughts. Ultrasound of folliculogenesis, helps a woman to gain self-confidence, if the deviations in her body are correctable. The study will show it.
In the video, a gynecologist will talk about how to determine ovulation:
The advantages of ultrasound
There is a widespread belief that the presence of menstrual bleeding (even irregular) is a guarantee of ovulation. This opinion is fundamentally wrong. The appearance of a ripe egg from the follicle is preceded by a series of hormonal changes that stimulate the growth and release of the egg. An increase in the level of estradiol produced by the growing follicle affects the growth of the endometrial layer of the uterus and stimulates the production of the pituitary hormone that causes the follicle to rupture and the release of the egg.
After ovulation has occurred, a broken follicle is transformed into a temporary gland producing progesterone, the main purpose of which is to prepare the endometrium for implantation of a fertilized egg and create conditions for its development. How to determine ovulation? All non-invasive methods used to confirm ovulation occurred are based on registration, using laboratory tests, hormone levels and basal temperature measurements, which are raised and lowered due to the influence of estradiol and progesterone.
Functional tests, such as visual assessment of the elongation of cervical mucus, the degree of dilation of the cervix and the presence of mucus plug in the cervical canal, requires repeated visits to the gynecologist and relies on the physician’s subjective feelings, therefore, does not guarantee reliable results.
In contrast to all the above methods, ultrasound shows not only all stages of follicle development, but also changes in the endometrial layer and the presence of the corpus luteum, after ovulation has occurred. You can confirm the data obtained by ultrasound using a laboratory analysis to determine the level of progesterone. As a rule, a single hormonal test is sufficient, which can significantly reduce the cost of the examination.
The information content of the ultrasound method is much higher than all others, which is confirmed by numerous studies. When a discrepancy between the ultrasound data and data obtained by other methods was found, the outcome of the examination always corresponded to the ultrasound data. It should be noted, and this aspect of ultrasound diagnosis, as the possibility of predicting the likely time of onset of ovulation.
When determining ovulation using other methods, a negative result only indicates that it does not exist, but it cannot be judged later whether it does not exist at all. Ultrasound also shows the follicles at different stages of development, which allows to calculate the estimated time of the final formation and release of a full-fledged egg. A prerequisite for obtaining complete and high-quality diagnostic information is an ultrasound scan with an intravaginal sensor on the latest generation equipment.
The main purpose of using transvaginal ultrasound is the need to monitor the development and release of a naturally formed follicle with a disturbed or normal menstrual cycle.
The indications for the ultrasound monitoring of folliculometry are the following states:
- irregular menstrual cycle
- lack of menstruation for a long time
- pregnancy planning,
- lack of pregnancy after a year of regular sexual activity without the use of contraceptives,
- hormonal disorders (endocrine sterility).
One of the most important criteria for assessing the functional performance of the ovaries is the ovarian reserve, which determines the ability of the ovaries to produce a healthy follicle with a viable egg cell. Since under the influence of estradiol several growing follicles are formed at once, their number, determined by ultrasound, reflects the quantitative indicators of the work of the follicular apparatus and allows us to get an idea of the reproductive potential of the patient.
The assessment of ovarian reserve is also relevant when folliculogenesis is stimulated, prior to the collection of eggs for IVF. It is known that a large number of high-quality follicles (from 7 to 15) is necessary for IVF, which significantly increases the chances of developing a healthy embryo with a high probability of implantation after placing it in the uterus. At the same time, excessive stimulation, with a good ovarian response, can lead to the development of a large number of defective follicles.
Since the induction of the ovaries in each individual patient proceeds according to an individual scheme, constant monitoring of the reproducibility of the follicles is necessary. Ultrasound, combining non-invasiveness, speed and ease of implementation allows you to track the number and quality of the eggs. The need for a large number of follicles is due to the further selection of the best oocytes (7–10), and then the embryos, of which 5–7 remain. The highest quality (class A or B) is transferred into the uterine cavity.
A single ultrasound scan does not allow to evaluate all the stages of follicle development, to state the fact of ovulation that has occurred and to assess the quality of the follicle formed in place of the corpus luteum. It is especially difficult to find out the time of ovulation in women with an irregular menstrual cycle, since one survey does not show the dynamic changes occurring in the reproductive system of a woman.
How many times is it necessary to do an ultrasound examination to get the maximum amount of useful information? Ultrasound monitoring of folliculogenesis is done 3–4 times during one menstrual cycle. The specific days of diagnosis are determined individually for each individual patient, based on the duration and regularity of the menstrual cycle. In the classic 28-day cycle, the first examination is scheduled for 10 days from the start of menstruation.
During the examination, determine the number of follicles in preovulatory stage of development. The number of follicles detected is crucial in assessing the ovarian reserve of the ovaries. At this time, it is advisable to conduct a general assessment of the state of the uterus and ovaries, especially for the presence of tumors (cysts, fibroids, polyps). The second procedure is performed in 2-3 days. The main purpose of the study at this time is to determine the presence and size of the dominant follicle.
In terms of its size and growth rate, it is possible to assume the time of ovulation (usually it is the 13-14 day of the cycle) and the following diagnostic procedure is carried out at this particular time. The purpose of the third study - a statement of the fact of the rupture of the follicle and the release of the egg. The fourth study is not always carried out, since, quite often, the first three procedures are enough. To confirm the usefulness of the ovulation that occurred, the study is carried out after 1 day, during which the presence and size of the corpus lute are evaluated.
When to do an ultrasound scan on ovulation for an irregular menstrual cycle, the doctor decides based on information obtained after an unscheduled ultrasound scan, and directly from the patient, on the frequency of menstrual bleeding and the date of the last menstruation. As a rule, the first study is prescribed on the 5th day of the cycle. Since the duration of an irregular menstrual cycle can vary widely (from 23 to 35 days), more or less ultrasound may be required to obtain complete information.
On the scan of the ovaries obtained during the first ultrasound, you can see several small anechoic formations - follicles. К моменту исследования, уже определяется доминантный фолликул, выделяющийся среди прочих более крупными размерами, достигающими 0,8–1,2 см. Одновременно с осмотром придатков, оценивают толщину эндометриального слоя матки, который в норме должен составлять 0,6–0,8 см.
Второе сканирование позволяет оценить темпы роста доминантного фолликула, ежесуточный прирост которого, составляет около 2 мм. В зависимости от временного интервала между процедурами диаметр фолликула достигает 1,6–1,8 см. The endometrial thickness at the time of the second study should be 1.5–1.7 cm. Evidence of the ovulation that occurred by ultrasound during the third scan is the disappearance from the field of view of the anechoic mass and the appearance of fluid in the dorsal (douglas) space.
In place of the follicle, the corpus luteum is determined, and the ultrasound characteristics of the endometrial layer change. If it was possible to visualize the dominant follicle immediately before ovulation, then, first of all, its size is estimated, which is one of the indicators of the usefulness of the matured egg cell. The normal size of the pre-ovulatory follicle should be 2.0–2.4 cm.
Along with the statement of the fact that ovulation occurred, ultrasound helps to see pathological conditions that lead to impaired reproductive function. One of the signs of the presence of anomalies in the development of the follicle is an increase in its diameter, in the pre-ovulatory phase, more than 2.5 cm. As a rule, with a large follicle, the ratio of produced hormones is disturbed, which leads to premature formation of the corpus luteum before the onset of ovulation (luteinization of the neovulatory follicle) .
The detection of abnormalities leading to impaired ovulation depends on which day the test is conducted. The absence or insufficient size of the dominant follicle found during the first studies indicate hormonal deficiency (endocrine sterility). If, in the third and fourth examinations performed to determine whether ovulation has occurred, the neovulatory follicle is still determined, its size, the presence of the corpus luteum and the level of progesterone and estrogen are considered.
The decrease in diameter indicates atresia (cessation in development and reverse regression), maintaining the same size for a long time indicates the persistence of the follicle, and an increase of more than 2.6 cm in diameter indicates the formation of a follicular cyst. In all cases, a careful analysis of all related changes (endometrial thickness, hormone levels) is required.
Despite the many advantages of transvaginal ultrasound in monitoring folliculogenesis, its results cannot be considered absolutely perfect. This is due to the fact that the diagnostic criteria on which the information content of the method relies, to a certain extent, are considered indirect and are not able to reflect the degree of maturity of the egg, which is a determining factor in the advisability of prescribing a particular treatment.
When it is necessary to do an ultrasound for ovulation
The study of ultrasound for the maturation of the egg is carried out most often with the purpose of pregnancy planning. It is actively used by couples who can not get pregnant for a long time. In this case, constant attempts do not give the desired results.
There are many ways in which the maturation of an egg is monitored - this is the construction of a graph of basal temperature, the calculation of the necessary days on the calendar, and the use of special tests.
Developed and special devices that determine the level of the necessary hormones in the composition of saliva. But the most effective is considered to be a pelvic ultrasound, and it is this monitoring with little or no error that determines the period most suitable for fertilization.
None of the indirect signs can accurately indicate when to wait for a positive result. Only an ultrasound study, decoded by a specialist, will determine the upcoming pregnancy.
Also folliculometry is necessary in the following situations:
- planning conception after a failed pregnancy, miscarriage or abortion,
- preparation for artificial insemination - IVF needs careful preparation, and computer diagnostics is the most important planning stage,
- lack of menstruation for a long time (the phenomenon is called amenorrhea),
- infertility treatment
- irregular menstruation: for many girls, menstruation occurs with long delays, and any abnormalities indicate problems in the body or hormonal disruptions,
- painful periods: severe pain during menstruation - indicators of problems in the body, this phenomenon sometimes harms the entire reproductive system,
- in identifying diseases associated with impaired hormonal levels.
As you can see, the list of indications when it is necessary to make a diagnosis is great. Ultrasound damage is minimal compared to the results obtained in the process.
Important details about the procedure you will learn from the video:
When is the most effective procedure?
There are only a few days for fertilization in a month. It is during this short period that an ultrasound scan for ovulation should be performed.
The gynecologist prescribes several sessions, each of which is carried out 2-3 days after the previous one. With the help of research various processes are revealed - from the maturation of the follicle to the formation and development of the ovum.
In total, it is necessary to do 4 ultrasound procedures:
- The first procedure is carried out 3-4 days before the expected rupture of the follicle. If the cycle lasts 30 days, then the first study occurs on day 10 of the start of the cycle. During this period, the dominant follicle is already visible.
- 12-13 day. A scan will show the presence of dominant education in the ovary.
- 14-15 days. The onset of the ovulatory phase. Phase lasts only a day, after it the egg does not fertilize.
- 18-19 - the control. Confirmation of the occurrence of an egg in the uterus. The monitor will clearly show the formation with blurred outlines - the yellow body.
Such time intervals are set only for a regular cycle. The ideal is the 28 day menstrual cycle.
Features of preparation for the survey
Folliculometry is done transvaginally and does not require special preparation. The main condition is an empty bladder. For a better view, a small pillow is placed under the patient's buttocks. Thus transvaginal ultrasound is performed, the sensor is placed in the cavity of the vagina. This is the most productive option.
The only thing that should be done is to take a shower before going to a specialist. The same is done to prepare for the visit to the gynecological office.
In addition to transvaginal, there are 2 more types of ultrasound studies, but they are rarely used to determine ovulation:
- external - transabdominal, the lower region of the abdomen is smeared with gel, after which it is carried by the sensor. The image is clearly visible on the monitor. Preparation for such an ultrasound is simple - just come to the procedure with an empty bladder.
- transrectal, the sensor through the anus explores the uterine cavity. This is a less effective way. In the process, the woman is experiencing unpleasant pain. At the reception you need to come with an empty bowel.
How is the ultrasound for monitoring ovulation
Monitoring for detection of the release of the egg and its readiness for fertilization is carried out by an intravaginal sensor of high sensitivity. On the appointed day, the patient comes to the doctor. The first session is prescribed based on the duration and characteristics of the menstrual period.
The process is completely painless and does not give the girl inconvenience, and on the screen is an image that decrypts the diagnostician.
Is it possible to detect any abnormalities on such an examination?
Ultrasound examination is intended not only to detect ovulation, but also to diagnose pathologies that a woman has. If the menstrual cycle is irregular and at the same time there are long monthly delays of one to two months, then an ultrasound can be used to identify the causes of violations.
Not every pregnancy is perfect. Some girls face such a problem as premature termination of pregnancy, miscarriages. It is also possible to find out the cause of the failure that occurred through monitoring.
Is there a chance of medical error with ultrasound
Women are often interested in the question - can a doctor on ultrasound not notice ovulation?
Errors are common to all people, and doctors are no exception. But not always the accuracy of the results depends on the human factor. The reason for missing the "day X" sometimes becomes faulty equipment.
In some cases, the rupture of the follicle and the growth of the yellow body does not occur at all and the competence of a specialist does not matter here.
The release of the egg can be missed due to late ovulation, when using the monitoring it was not possible to catch it, because the process could occur later, after all the ultrasounds done. In this case, all surveys are postponed to the next month.
Is it possible to notice the time of release of the egg without ultrasound
Some women accurately determine ovulation by their sensations and changes in the body. Home-made methods are less informative, but sometimes they become decisive, you just have to listen to your body.
Medical and home methods will not be effective if a woman takes oral contraception. Hormonal coil is another obstacle. If it is installed, then it is pointless to determine the moment of rupture of the follicle.
We now turn to methods for detecting the release of an egg at home.
The most informative of them:
- Pulling and pain in the uterus. A small part of women without problems determine the period when ovulation occurs. At this time, they have pain of a different nature in the lower abdomen. In some cases, persistent unpleasant feelings indicate the presence of serious violations. Therefore, with prolonged discomfort, you should consult a doctor.
- Characteristic vaginal discharge. If the cycle lasts 28 days, then by about day 14 the woman has a change in the consistency and smell of the discharge. The excreted fluid resembles a cork that separates from the cervix at the beginning of labor. The amount of mucus increases markedly, and this indicates the onset of ovulation.
- Tests. The price of such devices is not as high as many think. It is worth acquiring them by a set on 5 pieces as it is necessary to do them through a certain interval of time. They act like pregnancy tests, that is, they use a high concentration of hormones. The lithinizing hormone is produced in the body several hours before the release of the egg. It is important not to miss this moment. The device will show the highest level of substance in the morning, before that you should not drink a lot of liquid. The cost of one test is about 25 rubles.
- Basal temperature. This common method is used by women at home and by medical professionals. To measure the temperature is best rectal. A jump in temperature indicates ovulation. The temperature drops slightly just before the release of the egg. It is during this period that sexual intercourse is necessary. Immediately after ovulation, the temperature rises to 37 degrees and higher.
- Sexual attraction. Surprisingly, nature itself tells a woman that she is ready for pregnancy. During the maturation of the female reproductive cell, the woman's body experiences the strongest attraction to its partner. Premenstrual syndrome (week to menstruation) is characterized by an unbalanced mood, and by the middle of the cycle, the state changes radically, the libido increases.
Ovulation ultrasound is the most effective method of pregnancy planning. Sometimes a girl experiences a number of indirect signs of the onset of an egg's release, but none of them guarantees a one-hundred-percent hit.
If you have a regular cycle, calculate the days favorable for conception on the calendar, in other cases it is better to use ultrasound diagnostics for ovulation. For decoding results, contact only specialists. With the help of qualified doctors you can quickly achieve a positive outcome.
When to do an ultrasound to determine ovulation
The duration of the menstrual cycle is generally 23–35 days, with the counting starting from the first day of the onset of menstruation. If its duration is longer or shorter, then this is a sign of a failure in the production of hormones or various disorders of the fertility function in a woman.
- The menstrual period lasts 3–6 days, during which the endometrium located in the uterus cavity is rejected and leaves the body along with the blood.
- Follicular - duration 2 weeks with a deviation of 1-2 days in each direction. During this period, the ovaries produce follicle-stimulating hormone, which affects the maturation of the egg.
- Ovulation - lasts about 3 days, during which a special luteinizing hormone is released in the body, which releases the egg from the follicle.
- Luteal - lasts 6–12 days, but sometimes its duration reaches 16 days. During this period, the body produces progesterone, which prepares the uterus to anchor the egg.
If conception does not occur, progesterone production decreases, and the endometrium leaves the uterus during menstrual bleeding, which is the beginning of a new cycle.
In case of failure of one or several phases of the menstrual cycle, ovulation will not occur, which means that pregnancy will not occur. The main cause of female infertility is the long absence of an egg from the ovary.
A study that allows you to determine ovulation using ultrasound waves is called folliculometry. During the ultrasound, the development of a dominant follicle in the ovary is monitored.
This study is carried out several times, so that the doctor can completely track the process of maturation of the egg. Begin it in the middle of the cycle - before the expected date of ovulation. All subsequent procedures are carried out with a frequency of 2-3 days, which allows for monitoring of the ovaries.
The second procedure confirms the presence of a dominant follicle about 20 mm in size, and the ovary contains a corpus luteum. These ultrasound ovulation symptoms suggest that this process is approaching.
The third ultrasound examination is performed after 2–8 days. If there is no follicle in the ovary, and in the small pelvis you can notice an accumulation of fluid, this indicates a successful completion of ovulation. To confirm, the doctor may prescribe a woman's blood test for progesterone level, which increases several times during ovulation.
In the case when the egg has not left the follicle, ultrasound monitoring can be continued until the onset of menstruation. For irregular menstrual periods, the first ultrasound scan is performed 4–5 days after the end of menstruation.
Basal Temperature Measurement
To obtain reliable results, basal temperature measurements need to be introduced into the thermometer every morning by the rectal method and wait 8–10 minutes. The received data must be recorded every day. If after the completion of menstruation, the average value is 36.6–36.9 ° C, then before ovulation it decreases slightly and then increases to 37.0–37.3 ° C, remaining at this level until the beginning of the next menstrual period.
The results obtained in this way are distorted for the following reasons:
- inflammatory processes in the body,
- hormonal drugs
- drinking alcohol
- inadequate sleep (less than 6 hours),
- intimacy 1–6 hours before the ovulation test.
When determining the favorable time for conception in this way, you will need a calendar, as well as knowledge of the woman's menstrual cycle. This method can only be used with a regular menstrual cycle. The calculation of the menstrual cycle is performed in the following way:
- allocate the start date of the monthly for the last 3-5 months,
- calculate the cycle length, which is the period from the start of one menstruation to the next,
- subtract 14 from the total cycle time. As a result, the day will be determined, which will be the beginning of ovulation - it should be noted in the calendar. For successful conception, intimacy is recommended 1–2 days before and after the follicle is mature.
The latter method is quite simple, its main disadvantage is low accuracy, since various factors — climate, illness, stressful situations — affect the cycle time.
If a woman has a stable menstrual cycle, then she does not need to take monthly tests to determine ovulation. It is enough to carry out observations for 2–3 months, and in the future to rely on the results obtained. Thanks to the planning period, it will be possible to accelerate the onset of the desired pregnancy.
Is it possible to determine ovulation by ultrasound
Ovulation is usually determined by ultrasound using a transvaginal ultrasound transducer. The task of the doctor is to determine the growth of the main follicle, the state of the endometrium and the development of the corpus luteum.
Normally, the ovulation period occurs every month approximately in the middle of the menstrual cycle.
Each ovary contains 10–12 follicles; approximately 3 days after the end of menstruation, a dominant, one or more follicles appear. He releases an egg cell, perhaps several, if both are fertilized, then pregnancy occurs with twins or several embryos. The ultrasound method helps to understand whether the process of release of an egg occurs at all.
Как делают исследование на овуляцию
УЗИ для определения овуляции выполняют двумя способами: путем введения датчика во влагалище или проводя им по поверхности живота. Женщина не при каком из методов не испытывает дискомфорта, полученные результаты высвечиваются у доктора на экране.
When tracking ovulation by ultrasound in the first way, the woman lies on her back, after removing the panties. Next, the knees are tightened, legs should be apart. The doctor puts a condom on the device and inserts it into the vagina. In the second case, the patient exposes the surface of the abdomen and pubis.
When to do an ovulation test
Ultrasound monitoring allows you to determine the ovulation period with maximum accuracy and identify the causes of failures in the reproductive system, respectively, correctly and promptly cure the patient. To understand when to perform the procedure, it is necessary to take into account a woman's menstrual cycle, the duration of which is on average 28-30 days. The beginning of the cycle is considered to be the first day of the last menstruation. If a woman has it without failures, then 2-3 procedures are enough to accurately determine the release of the egg.
With regular menstruation, women undergo the first procedure for 8-10 days from their beginning. In case of failures, the patient is prescribed a study 3-4 days before the expected number of the egg's release. In the latter case, additional studies are conducted on the ovaries and endometrium, according to which the causes of irregular menses are established.
Repeated ultrasound can be done on day 3, in which the doctor once again checks the dominant follicle, it can reach a size of 2 cm. Termination of its development indicates that ovulation does not occur for any reason.
Based on these analyzes, the specialist determines on which day to do an ultrasound scan for the third time, the procedure is carried out when the follicle reaches its maximum size, then it is broken and the period of ovulation begins.
Corpus luteum on ovulation examination
The corpus luteum appears on ultrasound after ovulation, it is considered to be an auxiliary gland in the ovaries, which appears immediately after the rupture of the follicle. The unique name was given due to the presence in the composition of lutein, with a characteristic yellow tinge.
The appearance of the gland is noticeable in the second phase of the menstrual cycle. Its main function is the development of progesterone to maintain a normal pregnancy. The hormone prepares the endometrium for attachment of the ovum. If fertilization has not occurred, an ultrasound scan after ovulation will not show a yellow body.
How is the corpus luteum determined?
Diagnostics ultrasound with high accuracy detects the corpus luteum, which has the form of an extraordinary bag with a liquid inside. Its size is 12-26 mm, in pregnant women 20-30 mm. If the value exceeds the indicators and changes its usual rate, the patient may have a cyst. The process of subsequent ultrasound monitoring will help to recognize the pathology.
What does the yellow body look like on the ultrasound right after ovulation?
On examination, on the monitor, the uzist sees a yellow body near the ovary, in the absence of ultrasound conception, after ovulation, shows the gland as a white mass, then a scar remains on the ovary and nothing more is visible. When the cycle without failure gland appears at the same time, the absence of the body indicates the presence of failures of the reproductive system and pathologies. With irregular menstruation, the absence of a gland may indicate their delay.
Doppler signs of hypofunction of the corpus luteum
If the macula is smaller than the norm, it indicates its insufficiency, which can provoke a miscarriage or bring other problems due to a lack of progesterone production. External signs of hypofunction of the corpus luteum are manifested:
- recurring miscarriages at 2-4 weeks of pregnancy.
Typically, treatment consists of stimulating the corpus luteum and maintaining progesterone levels in the blood. But this therapy does not always produce results, since hypofunction is more often a symptom of any pathology than an independent disease.
Folliculometry - we understand the details
The procedure of folliculometry allows to determine the presence of failures with the ovulation period and to identify the cause. Using this method, a specialist traces the whole process of egg formation and obtains accurate data on the cycle of a woman.
- determine a suitable day for conception,
- to characterize the performance of the ovaries,
- control hormones,
- diagnose pathology
- monitor the state of health after the appointment of therapy.
Ultrasound of the ovaries to determine ovulation gives almost 100% results in contrast to measurements of basal temperature, the use of test strips and the calculation of days on a calendar.
Preparation for the procedure involves not only a thorough hygiene of the genital organs before the visit to the doctor, but also proper nutrition several days before it and the intake of laxatives the day before. Usually the study is carried out in the morning, the patient is allowed a light breakfast for an hour.
With a woman you need to take 1.5 liters of plain water and use it an hour before the inspection, if the diagnosis is carried out by the external method. When using a vaginal sensor, it is not necessary to drink, in case of carrying out the procedure in two ways at the same time, first drink the liquid and urinate before inserting the device.
Folliculogenesis disorders - what is it
Ovulation and the process of the onset of fertilization directly depend on the folliculogenesis process. The follicles appear in the body from birth, when puberty begins, during the month of the girl about 300 pieces begin to develop and grow.
In the course of their development, they will have to go through periods:
Only a small part reaches the last stage of development, in the very period of ovulation only one follicle acts. Thus, the process of transition from the primordial stage to the pre-ovulatory stage is called folliculogenesis, during which the structure changes. In it, a space is formed for keeping an egg cell, during the period of ovulation its walls break. Having fulfilled its functions, the bag disappears, a yellow body appears instead.
When violations of these functions, the patient can not get pregnant, the pathology can manifest itself as follows:
- Complete lack of follicle development.
- Cyst formation is follicular growth larger than its size due to the accumulation of large amounts of fluid in it.
- Luteinization, in which the corpus luteum is formed, but the bubble with the egg does not break. This happens when hormonal disorders or disorders in the structure of the ovaries.
- With atresia, the uzist discovers that a dominant follicle is formed, initially everything happens as expected, but suddenly there is a decrease in size and then disappearance. In this case, the ovulation period does not occur at all.
- Persistence is characterized by the fact that the bubble, having reached its size, does not burst and the egg does not come out, being in the body for some time, it disappears.
Ultrasound for ovulation if conception occurred
Ovum fertilization occurs in the fallopian tubes, after which a zygote is formed in the female body, which after 5 days turns into a blastocyst. Next, the embryo searches for attachment to the endometrium for a period.
If conception occurred, the woman will feel the first signs immediately after the attachment of the ovum.
When an ultrasound shows the corpus luteum on the first day of the delayed menstruation, this indicates pregnancy. The device fixes the body for up to 2 weeks of its course, after which the formation of the placenta occurs, the gland disappears, the size of the ovaries increases.
Sometimes women say: that there was no ovulation, and the pregnancy has come. Such an assertion is not true, and the conception occurred at the moment when the woman did not notice the onset of this period, which could have happened due to incorrect diagnostics by KB, test strips or calendar calculation.
Ultrasound for late ovulation
Determination of late maturation of the egg can only be determined by observing for several cycles in a row. On this basis, the gynecologist determines the date of the study for ovulation. Ultrasound data for late ovulation is very important, because if the doctor incorrectly determined the time of release of the egg, using the calendar method, he could make the wrong diagnosis. Accordingly, to appoint the wrong or unnecessary therapy at all. If the fact is established, the doctor should register these pregnant women by recording 2 expected periods on their card, focusing on the day of ovulation and the last menstrual periods.
When will show pregnancy on ultrasound with late ovulation
Diagnosis during late ovulation will show the embryo 3-4 weeks after fertilization, respectively, there is no sense in an early visit to the uzost. The date of the visit is calculated approximately as follows: another 2-3 weeks are added to the deadline set by the gynecologist, after which they are sent for examination. Thus, when the doctor sets the period of 8 weeks, the study will show 11-12 weeks.
Indications for ultrasound on ovulation
When experts recommend doing an ovarian ultrasound to determine ovulation, it is important not to delay this process, but try to do it as quickly as possible. After all, pathologies in the body and diseases, in which monitoring is necessary - a lot.
Ultrasound to determine the presence of ovulation is mandatory in such cases:
- Painful menstruation. Stabbing, cutting pain in the lower abdomen,
- Lack of menstruation for two months or more,
- Pregnancy planning,
- The absence of a ripe egg cell or its incomplete maturation,
- Follicle growth stimulation
- Conception through IVF,
- Diagnosing infertility, its treatment,
- Preparing to conceive a child after a miscarriage or abortion,
- Hormonal imbalance, poor blood test for hormones,
- Choosing contraceptives.
The monitoring of the ovaries will help not only to fully examine them, but also to find out the size and dominance of the follicle. Ultrasound is designed to determine the time of exit of a ripe egg cell and allows you to see the corpus luteum.
Methods of conducting a survey to determine ovulation
You can monitor the ovaries in several ways. The method of conducting is chosen by the attending physician based on the patient's complaints and the presence of certain diseases.
Ultrasound of the ovaries happens:
- Transvaginal - standard monitoring for the study of the pelvic organs. When a woman needs to do an ultrasound of the ovaries to determine ovulation, most often an ultrasound specialist will perform it in a transvaginal way. A condom is put on the sensor and inserted into the vagina. The procedure is painless and lasts about 20 minutes. Preparing for it in advance is not necessary, the main thing is an empty bladder. Therefore, a woman should definitely go to the toilet before performing an ultrasound,
- Transrectal - The study is conducted to determine the infection or diseases of the genital organs in virgins and women of advanced age. The technique for conducting such a scan is identical with the tranvaginal method,
- Transabdominal - ovulation is determined by monitoring the wall of the abdominal cavity. The specialist applies the gel to the pubic part of the abdomen and examines the ovaries with a sensor. This method of determining ovulation is uninformative compared to transvaginal and requires preparation for:
- Do not overeat or eat food that is able to cause gas in the large intestine,
- Drink a lot. The larger the bladder, the more reliable will be information about the ovaries,
- Empty intestine
This ultrasound monitoring is often done to pregnant women after the 12th week.
Transabdominal Ultrasound Method
When to do ovarian monitoring?
You need to perform this scan at least four times. This is how it is possible in detail to determine the rupture of the follicle membrane, the maturation of the egg cell and its release into the uterus, corpus luteum and the beginning of the ovulatory process as a whole.
If a woman has a classic menstrual cycle of 28 days, then monitoring should be carried out every 3 days:
- The first ultrasound is on the 10th day of the cycle. The general condition of the uterus and ovaries is determined. Identify certain violations that may contribute to the lack of ovulation,
- The second monitoring is conducted on days 11-13. The specialist identifies the presence of the follicle, its dominance, shell, and full development. Sets the regression level
- The third diagnosis should be done in the middle of the menstrual cycle, about the 14th day, when the follicle membrane rupture should occur. The course of the ovulatory cycle and the release of a ripe egg cell are determined.
- Fourth ultrasound - control. The specialist must make sure whether the ovulation actually took place, and whether a yellow body appeared after it. It is at this time, when the egg comes out of the follicle, the woman can ache all over, become aggravated with a migraine, sharp pains in the lower abdomen and other unpleasant sensations.
Special attention should be paid to the latest ultrasound diagnosis. Only after it can be done can we speak with confidence about the success of ovulation. A significant role is played by the corpus luteum. After all, it is responsible for the production of progesterone hormone. If a mature egg does not reach the uterus or is completely absent, the specialist most often recommends that the ovaries continue to be monitored until menstruation begins.
This is important to know!If a woman has a regular menstrual cycle, then the beginning of the scan is shifted, and should take place only four days before the middle of the cycle. In the case of irregular menstruation, ultrasound is carried out after the end of menstruation after 3-4 days.
The purpose of ultrasound of the ovaries. What can be seen?
Many women determine the start of ovulation with a special test. However, it happens that the test is not always able to show true information and accurately identify the presence or absence of the ovulatory cycle. Such unreliability is associated primarily with the quality of the test itself and the individual characteristics of the woman’s body.
Properly conducted monitoring at a certain time gives true information about the status and readiness of the genitals for ovulation.
When ovulation has occurred, an ultrasound scan will show:
- Lack of follicle and its sheath,
- The presence of a ripe egg in the uterus,
- The corpus luteum, formed from follicular residues,
- The presence of fluid behind the uterus.
When the release of the egg did not take place and ovulation did not occur, monitoring will reliably determine the cause and identify possible irregularities:
- Stop the development of the dominant follicle, its decrease in size. Regression,
- Full maturation of the follicle, the absence of rupture of its shell and not releasing an egg into the uterus,
- The corpus luteum, which can form not only after ovulation. So, with luteinization of the follicle, when it is fully developed, matured, but not burst, can develop into a corpus luteum,
- Cystic follicle formation. May occur if the egg does not come out,
- Lack of follicular production by the ovaries. Ovulation occurs only after the full maturity of the follicle.
Ultrasound for ovulation and pregnancy
If the married couple fails to conceive a child for a year, the gynecologist may advise the woman to undergo an ovary scan to determine if it is a favorable day for conception — ovulation. Of course, you can use other methods - measurement of basal temperature and plotting a graph, calculating the days on a calendar, special test. But as mentioned earlier, very often there are errors in the results obtained, so the most reliable and reliable method for determining ovulation is ultrasound, which is especially important when planning pregnancy.
It is worth paying attention to the psychological side of the scan. Only after the monitoring, the specialist will accurately tell the day when the fertilization of the egg and the upcoming pregnancy should take place. In other methods, this is impossible to do.
The decision on how much ultrasound is needed is taken by a specialist. In addition, it is possible if the patient herself expressed a desire.
The procedure is recommended in the following cases:
- gynecological examination for prophylaxis,
- painful periods,
- menstrual disorders,
- abnormalities in the development of genital organs,
- increase in the abdomen in volume, which may indicate the presence of cystic formation,
- pain during intercourse,
- conception planning
- pathology of the cervix,
- adrenal and thyroid diseases,
- determining the time of ovulation,
- premature abortion,
- hormonal disorders,
- control of artificial insemination,
- sexually transmitted diseases
- other pathological processes.
The need to determine ovulation occurs when there are the following points:
- failures of the menstrual cycle
- lack of menstruation,
- violation of the concentration of sex hormones in the composition of the blood fluid,
- preparation to receive the egg cell involved in the process of in vitro fertilization,
- stimulation of ovulation if the menstrual cycle is not accompanied by the release of a ripe egg cell.
When it is more effective to do ultrasound
To detect ovulation, ultrasound should be done about four times. It is during this period that the specialist will be able to track the entire process during which the egg matures.
The procedure is carried out every 2-3 days:
- первую делают на десятые сутки менструального цикла (необходимое условие: классический цикл составляет 28 дн.),
- вторую – на 13 день с целью подтверждения наличия фолликула доминантного типа,
- третью – на 14 сутки, когда должна быть овуляция,
- the fourth is a control procedure and is carried out after three days, it is necessary in order to finally be convinced of the appearance of ovulation.
The time of the first ultrasound session can be slightly changed. With a regular menstrual cycle (but it is longer or shorter than usual) The first procedure is carried out four days before the middle. When the cycle is intermittent, the diagnostic study can be performed four days after the end of menstruation.
The second procedure determines the dominant follicle, in which the maturation of the egg or regression occurs. In the presence of an undeveloped germ cell, there is no possibility of detecting it on the monitor screen. The third scan is performed immediately before ovulation.
The survey is carried out through the internal sexual organ of a woman. A disposable condom is put on the sensor. The device is inserted into the vagina, which allows for a few minutes to display the result on the monitor.
The main positive point of this technique is the lack of need to carry out special training. It is important to note that the procedure is carried out after bowel movements. At the end it is not recommended to eat foods that can cause gas formation.
The method is considered one of the most informative. However, it is not used during pregnancy for 2-3 trimesters and is not assigned to virgins.
The ovaries are examined through the peritoneal wall. For the procedure on the pubis is applied a special gel. Then, the specialist performs a circular motion with an ultrasound sensor. This time is enough to get a result.
This technique is carried out only after preliminary preparation, the essence of which is to fill the bladder with fluid. It is important to note that the more water it contains, the more accurate the final result will be. But also before the procedure, it is necessary to empty the intestines and refuse food that causes increased gas formation.
The main disadvantage of this technique is that it is not informative.
How it goes folliculogenesis, ovulation and the onset of fertilization will directly depend. Follicles are formed from the moment of birth. When puberty occurs, about 30 pieces develop and grow during the menstrual cycle.
The formation process takes place in several stages:
The last stage of development is only a small proportion of follicles. In the period of ovulation only one takes part. The space that contains the egg cell begins to form. During ovulation, its walls are broken. When all functions are completed, the pouch disappears. In its place a yellow body is formed.
However, if they are violated, then all chances of getting pregnant are reduced to a minimum. The pathological process is manifested, as a rule, by the following conditions:
- follicle development is completely absent,
- a cystic neoplasm is formed: the follicles are of considerable size as a result of the presence of a large volume of fluid,
- luteinization develops, accompanied by the formation of the corpus luteum, but there is no rupture of the membrane in which the female reproductive cell is located,
- atresia is detected: the process proceeds as usual, but at the end there is a sudden disappearance of the follicle,
- Persistence is a condition characterized by the presence of a vesicle with an egg, but there is no rupture and escape, after a while it disappears.
When is it most effective to monitor the ovaries on an ultrasound?
Having decided to carry out folliculometry, the woman will have a preliminary consultation with a gynecologist to find out what are the problems that may hinder the development of the follicle. The doctor will clarify which cycle women have, the nature of their periods and whether there are problems with other female organs. Depending on her answers, the doctor will set the date for the ultrasound monitoring. There are three periods of conducting, which depend on the cycle:
- If the cycle is 28 days without interruption, then the folliculometry procedure is prescribed exactly in the middle of the cycle. This is 9-10 days after the start of menstruation.
- If the cycle is regular, but its duration is more or less than 28 days, then the examination will be 4-5 days before the middle of the cycle.
- If the cycle does not have a sequence at all and the pattern in menstruation is difficult to catch, then an ultrasound scan for ovulation is performed for 3-4 days after the end of the menstrual period.
In what other cases will the doctor send a woman for an ultrasound of the ovaries and establish the exact date of ovulation? With concomitant diseases that do not allow the inception of the child independently:
- Dysmenorrhea - acyclic menstruation,
- amenorrhea - the absolute absence of menstruation,
- if ovulation is not observed during menstruation,
- infertility during 2 years of joint efforts with a partner,
- the failure of hormones in the body
- ovarian disease.
All these associated problems make adjustments to the date of ovarian monitoring.
How is ultrasound going to monitor ovulation?
After the doctor has determined the day for the procedure, the woman comes to the ultrasound on her day. The procedure itself is quite simple and painless. Ultrasound monitoring of the ovaries is carried out by three methods:
- Transvaginally. The state of the follicles is examined through the vagina. A condom is put on a special sensor with a camera and inserted into the vagina. So after a few minutes, the doctor on the screen sees the state of the internal organs and follicles. This procedure does not apply to pregnant women, virgins. Special training does not require, but still it is desirable to do it on an empty intestine.
- Transbdominal. This is the so-called external ultrasound. Gel is applied to the pubic area and driven through it with a special sensor. The result is perfectly visible on the monitor screen. This method requires little preparation. Ultrasound should be done on a full bladder. If we compare this method with the first method, it is less informative. It is usually applied to pregnant women and virgins.
- Transrectally. This monitoring method is carried out by means of inserting the sensor into the anus. So, too, it is possible to examine the ovaries, but compared to tranvaginal ultrasound, the procedure is painful and more unpleasant. Apply to elderly patients and virgins.
Of course, if a woman is doing an ultrasound scan to get pregnant and control ovulation, then the first monitoring method will do for her. Pass this procedure more than once. Usually there are 4 visits with a difference of several days.
- The first ultrasound is prescribed by the doctor depending on the cycle. Take an average cycle of 28 days, that is, folliculometry will occur on day 10 of the cycle.
- After 2-3 days, that is, on days 12-13, a second procedure is done to confirm the presence of yellow body growth,
- After another 2 days, that is, on the 14th day of the cycle, another procedure occurs. At this time, ovulation should come soon.
- After another 3 days, namely, on day 17, a control procedure is performed. It indicates whether the release of the egg occurred. If at this stage she did not come out, the doctor may advise you to continue monitoring on the ultrasound until the next menstruation. If during the cycle ovulation was not observed, then folliculometry continues on the next cycle.