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What Does This Follicular Study Report Indicate?

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Posted on Thu, 8 Oct 2015
Question: Hello mam . I got Follicular study done on day 9th of my cycle. PFA the report. Can you please advise when should I get the next sitting for follicular study? My menstrual cycle is quite iregular ranging from 35 to 45 days. Please advise.
doctor
Answered by Dr. Manisha Jain (1 hour later)
Brief Answer:
Repeat Ultrasound after 3-4 days

Detailed Answer:
Hello dear, hope you are doing well.
I have seen the attached report which is giving only multiple small follicles (MSF) in both the ovaries and no dominant follicle on either side.
This is not a good finding as far as chances of pregnancy in this cycle are concerned as by day 9 of the cycle usually there is a dominant follicle which will eventually grow and release egg to form a baby after meeting sperms
So get a repeat scan after 3-4 days on day 12 or 13 to see if there is a dominant follicle, and in case still there are no follicles then drop this cycle and start with new cycle after periods.
I know this is disheartening but most likely you will have to drop this cycle and in next cycle take proper ovulation induction drugs viz clomiphene and FSH injections along with follicular monitoring.
Multiple small follicles are common in PCOD patients and need outside support for forming a good sized mature follicle.
In case you have any questions about it, please feel free to ask.
All the best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (5 minutes later)
Ok. I want to understand this - If the egg forms a little late say on around 20th day, even then it won't be possible to conceive if we try during that time? And also how much time does it generally take for PCOD patient to conceive?
doctor
Answered by Dr. Manisha Jain (7 minutes later)
Brief Answer:
Next Ultrasound finding will decide

Detailed Answer:
Yes dear in case your egg matures at 20th day or even 22nd day then also you have good chance of conception but that egg to mature will take at least 8-10 days and that will occur only if the scan after 3-4 days shows at least 1 dominant follicle.
So the fate of this cycle depends on your next Ultrasound finding only.
PCOD is a tricky disease as patients with severe PCOD also conceive spontaneously without even knowing that they have problem and at times patients with minimal PCOD have profound conceiving problems.
But a lean patient with young age and active lifestyle usually conceive easily so don't feel sad or panicked so soon.
You have tried only the basic treatment yet so just relax and hope for the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (5 minutes later)
Thanks for the detailed answer. I got this scan done on Friday. So should I get the next scan done visit tomorrow
doctor
Answered by Dr. Manisha Jain (3 minutes later)
Brief Answer:
Tuesday preferably

Detailed Answer:
Welxome dear.
Yes either tomorrow or a day after but in case comfortable get it on Tuesday and I really wish that there is a dominant follicle and that God bless you with a healthy baby soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (37 hours later)
Hello mam. I got the scan done today. PFA the report of the same and please advise next steps.
doctor
Answered by Dr. Manisha Jain (9 hours later)
Brief Answer:
We will follow this follicle to maturity

Detailed Answer:
Hello XXXX, as you must have read in report there is a dominant follicle in right ovary which is indeed a good sign and thus no need to cancel the cycle and we will now follow this follicle by a repeat scan after 3 days.
I really hope this one grows properly and thus you will have really good chances of pregnancy.
Wish you all the best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (19 minutes later)
Good to hear this. So on what day should I get the next scan done? Also can I do anything from my end, like some dietary changes so that this follicle matures properly? I am currently taking Fertisure F and folic acid.
doctor
Answered by Dr. Manisha Jain (15 minutes later)
Brief Answer:
Ultrasound on Friday

Detailed Answer:
Get your next scan on Friday morning.
Till then nothing else is needed from your end, just take these medicines only and take a lot of water and fruits and salads.
Basically all these are full of antioxidants and thus no oxidant damage around the follicle which then grows well.
Fertisure is also a very good tablet and causes a definite increase in conception rates
All the best dear.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (2 days later)
I got the scan done today. Pfa the report and analyse the same.
doctor
Answered by Dr. Manisha Jain (8 minutes later)
Brief Answer:
Stop monitoring this cycle

Detailed Answer:
Hello dear, i have seen the attached report and it is not a good one as the previous follicle has collapsed and a new follicle has emerged in other ovary.
Though there are chances that this new follicle may grow and rupture but chances of pregnancy are negligible.
So in my opinion stop this follicular monitoring for this cycle and wait for your periods.
In fresh cycle take ovulation induction drugs along with sonography to enhance chances of fertility.
In case you have any question please feel free to ask.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (4 minutes later)
Actually the radiologist was saying that the previous follicle has not grown further and also she mentioned that if a follicle is smaller than 10 mm then we consider it as msf only. Do u think I should go for 1 more scan and see if this follicle grows and then take further steps?
doctor
Answered by Dr. Manisha Jain (11 minutes later)
Brief Answer:
It will not grow to maturity

Detailed Answer:
No dear i dont think so, this will be waste of effort, time and emotions of course.
Yes your radiologist is right as a follicle of 10 mm at 16th of cycle is a really small follicle and will not grow to a fruitful stage.
So best option will be to start anew in next cycle along with ovulation induction.
Take care.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Manisha Jain

OBGYN

Practicing since :2007

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What Does This Follicular Study Report Indicate?

Brief Answer: Repeat Ultrasound after 3-4 days Detailed Answer: Hello dear, hope you are doing well. I have seen the attached report which is giving only multiple small follicles (MSF) in both the ovaries and no dominant follicle on either side. This is not a good finding as far as chances of pregnancy in this cycle are concerned as by day 9 of the cycle usually there is a dominant follicle which will eventually grow and release egg to form a baby after meeting sperms So get a repeat scan after 3-4 days on day 12 or 13 to see if there is a dominant follicle, and in case still there are no follicles then drop this cycle and start with new cycle after periods. I know this is disheartening but most likely you will have to drop this cycle and in next cycle take proper ovulation induction drugs viz clomiphene and FSH injections along with follicular monitoring. Multiple small follicles are common in PCOD patients and need outside support for forming a good sized mature follicle. In case you have any questions about it, please feel free to ask. All the best.