follicle detection

Infertility patients often need to understand whether ovulation is normal, if ovulation disorders, drug treatment, need to do follicle detection, monitoring follicular development, to guide clinical medication, guiding sexual life, artificial insemination and follicular puncture. At the beginning of each menstrual cycle, multiple follicles develop at the same time, but generally only one or two follicles develop to maturity, which is called the main follicle (preferred follicle), and the remaining follicles are successively locked. Basic Information Specialist classification: gynecological examination classification: ultrasound Applicable gender: whether women are fasting: not fasting Tips: Follicle testing time requirements are more stringent, pay attention to go to the hospital on time. Normal value Ultrasound performance of follicular development during normal menstrual cycle: (1) Follicle appearance time There are multiple follicles at the beginning of each menstrual cycle, but only one or two follicles develop to maturity, which is called the main follicle (preferred follicle), and the other follicles are successively locked. Some authors have reported that only one follicle grows to maturity in more than 90% of the cycle, and two main follicles develop in 5%-11%. The earliest time of follicular ultrasound imaging can be on the 5th-7th day of the menstrual cycle, showing a minimum diameter of 4-5mm. (2) Follicular growth rate Ultrasound In the 3-5 days of the menstrual cycle, small follicles can be found in the ovary, and then gradually grow up, the average on the 14th day, ovulation can occur. On the fifth day of menstruation until ovulation, the main follicles increased by an average of 1.5 mm per day; on the 10th day, the average daily growth was 1.2 mm, and the average increase of 1.9 mm on the 4 days before ovulation, until the follicles matured. Mature follicles can show the following characteristics: 1 The follicles are round or elliptical, with a diameter of 15-30 mm (21.2+-0.53 mm). The follicles are anechoic-free, clear and pure, with clear boundaries and thin walls. 220% of mature follicles one day before ovulation, the image of cumulusoophorus is visible, and there is a short strong echo in the near wall of the follicle. (3) Ultrasound image of adjacent ovulation follicles 1 The incidence of cumulus is about 20%, mostly in >18 mm mature follicles, and ovulation is predicted to occur within 24 hours. 2 The pericardial ring around the follicles, with the lh value rising, the membrane tissue edema, and the granulosa cells are separated from the membrane cells. Predicting ovulation occurs within 24 hours. The current ultrasound display rate is very low. 3 The follicular layer cells of the follicle were completely separated from the underlying layer of the membrane tissue, and the follicular wall was dentate. Clinical significance Abnormal results: monitoring follicular development can be used for clinical guidance medication for follicular dysplasia, guiding sexual life, artificial insemination and follicular puncture. People who need to be examined: need to guide clinical medication, guide sexual life, artificial insemination and follicle puncture. Precautions Taboo before inspection: 1, generally in the menstrual cycle 9-10 days; the normal cycle can be monitored in 10-11 days, the drug induction cycle requires 1-2 days to monitor follicular development, so choose the correct date according to your own menstrual cycle. 2, the patient must be moderately filled with the bladder. Poor bladder filling or excessive affects the vocal display of the ovary, and it is even more difficult to see the internal structure echo, which will not meet the clinical requirements. 3, the patient empty stool before the examination, especially for patients with constipation, it is best to give laxatives the day before the examination, so as not to interfere with the ovarian imaging. Requirements for inspection: 1, follicle detection time requirements are more stringent, pay attention to go to the hospital on time, it is best to use the book to record the date of the check to prevent forgetting. 2. If the drug induces periodic follicular ultrasound, if there is any discomfort, the medical staff should be informed in time so that the medical staff can make timely and correct treatment. Inspection process Under normal circumstances, from the 8th day of the menstrual cycle, B-ultrasound is monitored once every 2 days. When the follicle diameter is 17 mm, it should be monitored once a day. When the follicular development matures to a diameter of 20-23 mm, If necessary, measure twice a day until ovulation. The frequency of B-ultrasound probe was 3.5MHz. The size and shape of bilateral ovaries were observed during each monitoring. The number and size of follicles were recorded, and the days of menstruation were recorded. Not suitable for the crowd A patient who is allergic to clomiphene aldehyde, urinary gonadotropin, and gonadotropin-releasing hormone agonist. Adverse reactions and risks No complications.