With the liberalization of the three-child policy, many pregnant mothers who fight for "second child" and "third child" come to monitor follicles, and ultrasound has become a common, routine and indispensable means of imaging examination.
But how much do you know about the knowledge and precautions related to ultrasound follicle monitoring and examination?Today, experts from Hunan Provincial Hospital of Traditional Chinese Medicine will take you to understand the relevant knowledge of ultrasound follicle monitoring.
Every normal woman has two ovaries, whose main functions are egg production, ovulation, and secretion of female hormones. Women generally have only 400-500 follicles that mature and ovulate in their lifetime.
Each menstrual cycle is calculated from the first day of menstruation, and the ovaries will recruit 3-11 sinus follicles (10 mm), but generally only 1 follicle develops into a growing follicle (10 mm), and then further becomes the dominant follicle, and finally becomes a mature follicle (18 mm), and finally, ovulation!
1. What is ultrasound follicle monitoring?
The monitoring of follicle development and endometrial morphology has become a popular method by color ultrasound, which can dynamically measure the diameter of follicles, observe the rupture of follicles, endometrial thickness and morphology, etc. Convenient, accurate, reproducible, inexpensive, non-invasive, guide the time point of insemination, and improve the success rate of conception.
2. What are the contents of ultrasound follicle monitoring?
1.Number of follicles;
2.Follicular morphology;
3.Follicle size – the main indicator of follicle detection;
4.Follicle growth rate;
When monitoring ovulation, through the dynamic comparative evaluation of the growth rate of follicles, you can understand the growth and development of follicles, whether they can ovulate and when they ovulate.
The natural cycle follicle growth rate ranges from 17〜3.0 mm days, in which the growth rate of the dominant follicle is 10〜2.At 0 mm days, the maximum growth rate of follicles near before ovulation can reach 20〜3.0 mm days;The follicle growth rate of the ovulation induction cycle is faster, which is 25〜2.7 mm days.
5.Echo inside the follicle;
6.Presence or absence of ovulation.
3. The time of follicle monitoring.
1.Women with regular menstruation: The monitoring time should be around the 9th-10th day of the menstrual cycle (i.e., around 3-5 days before ovulation). For women with regular menstruation, ovulation is usually about 14 days before menstruation.
2.Women with irregular menstruation: follicle monitoring should be done from the 3rd to 30th day of menstruation, alternate days or continuous long-term monitoring. Since the follicular phase and menstrual period cannot be determined, the monitoring time should be advanced.
4. Which women need ultrasound follicle monitoring?
1.Endocrine disorders: polycystic ovary syndrome, etc.;
2.Immune infertility;
3.Infertility due to premature ovarian failure;
4.Xi inertial miscarriage;
5.Menstrual irregularities;
6.Women who want to conceive naturally and increase the pregnancy rate, etc., when both husband and wife have normal examinations.
5. What are the characteristics of sonograms of normal or dominant follicles close to ovulation?
1.The maximum diameter of the follicle is 20 mm (the range of mature follicles is 17-24 mm), and those with a diameter of less than 17 mm are immature follicles.
2.The follicles are full in shape, round or oval, with thin and clear walls, or "pyramidal" hyperechoic mounds on the inner wall can be seen, which are easy to show 24-30 hours before ovulation. Occasionally, a hypoechoic halo around the dominant follicle (usually due to edema of the membrane tissue before ovulation) may also be seen.
3.The follicle moves toward the surface of the ovary, and there is no ovarian tissue on one side and protrudes outward.
6. What are the ultrasound signs of ovulation?
1.The follicles disappear or shrink, which may be accompanied by the collapse of the inner wall.
2.There is a weak light point echo in the narrowed follicular cavity, followed by the enlargement of the original cavity cavity, and there are more strong echoes, indicating early luteal formation.
3.The presence of a small amount of fluid anechoic area in the uterorectal fovea, which accounts for more than 50% of cases, may be a sign of the accumulation of follicular fluid after follicular rupture or the peritoneal response to ovulation.
7. What are the common abnormal follicle growth and development?
1.Follicular dysplasia or absence of follicular development.
Slow follicular growth or no follicular development is observed, or there is only a small circular anechoic area less than 5 mm in diameter in the ovary, and the gradual enlargement of the follicle is not seen during monitoring.
2.No dominant follicle formation.
There are no follicles with a diameter of 15 mm, and the morphology is irregular, and the tension is low. It is generally believed that the diameter of the follicle must be more than 17mm for the oocyte to be able to conceive, otherwise the released egg is an immature egg.
3.Unruptured follicle luteinization syndrome.
After the formation of the dominant follicle, the follicle continues to enlarge, with a diameter of more than 40 mm, the capsule thickens, and the sac gradually becomes uneven and hypoechoic, until the vesicle decreases or disappears after menstruation. Unruptured follicles can also continue to grow and form follicular retention, but the cyst has a thin wall, high tension, and a typical anechoic zone inside.
4.Delays ovulation.
The time of formation of the dominant follicle is generally 10-16 days of the menstrual cycle, and ovulation is 12-18 days, while the ovulation of delayed ovulation can be on the 21st-40th day of the menstrual cycle, and sometimes the originally confirmed dominant follicle atrophies and the other follicle develops and grows into a new dominant follicle, resulting in the phenomenon of clinical delayed ovulation and the failure of contraception during the safe period.
5.Multivesicular ovaries.
It is an anovulatory menstrual disorder in adolescent females, with clinical manifestations of infrequent menstruation and amenorrhea. The sonogram showed that the ovaries were slightly larger, not full, and there were more small vesicles in it, about 10 with a diameter of about 5 mm.
6.Polycystic ovary syndrome.
8. Precautions for ultrasound monitoring of ovulation.
1.Time. It is important to monitor the timing of ovulation according to your doctor's arrangement.
2.Continuous monitoring is required.
Only continuous monitoring can find better follicles, and you must not go once and stop insisting!After the initial monitoring, follow the doctor's instructions for the next monitoring, and be sure to follow the doctor's instructions for follow-up!
3.Adopt yin supersound.
*The ultrasound probe is closer to the uterus and ovaries, the image is clear, the resolution is high, and the examination results are more accurate, so it is recommended to use ultrasound to monitor ovulation.
Hunan Medical Chat Special Author: Hunan Provincial Hospital of Traditional Chinese Medicine Ultrasound Medicine Department He Can Follow @Hunan Medical Chat to get more health science information!
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