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Dr. Andrew Rynne

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Follicular study showed enlarged ovary, thick endometrium and no fluid. Is it normal?

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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6011 Questions

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Posted on Tue, 8 Jan 2013 in Getting Pregnant
Question: Today is Day 10 and I have undergone the follicular monitoring today first time. Right ovary is 13.5 x 11 mm , endometrium is 6 mm, no fluid. is it normal? I am supposed to go for another ultrasound on day 12
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Answered by Dr. Aarti Abraham 3 hours later
Hello XXXXXXX
I appreciate your query.
Follicular monitoring involves, not just one single scan, but a series of ultrasound scans during important days of your menstrual cycle, in order to track the normal changes in the uterus and ovaries .
Sometimes it is done if ovulation induction agents ( drugs to stimulate the ovaries to produce eggs ) are administered as part of ongoing fertility treatment.

It is normally started on or after the 7th day of your menstrual cycle. It checks the resting ovary for cysts and the uterus for any fibroid or pathology.

The ultrasound is done at interval of few days serially to assess the size of the growing follicles ( eggs ) . Normally during a menstrual cycle, during initial days, multiple follicles get recruited, out of which one slowly grows as the dominant follicle, which finally ruptures ( egg is released from the ovary ) around the day of ovulation ( normally Day 14 in a 28 day cycle ).

Simultaneously, it evaluates the Thickness of the endometrial stripe (the lining of the uterus). Eight to 10 mm is optimal around the days of ovulation.
It also is done for a couple of days after the follicle reaches optimum size ( 20 - 20 mm ) after ovulation, in order to confirm rupture of follicle and release of mature egg from the ovary.
On day 10, the endometrium ( 6 mm ) in your case is fine, as by day of ovulation ( if it is day 14 , that is, if you have a regular cycle, it would grow to 8 - 10 mm ), which is optimum

Also, the size you mentioned 13.5 x 11 mm, is not the size of the ovary, but the size of the biggest follicle in the right ovary, which is likely to grow as the dominant follicle . As there is no comment on the left ovary, I assume that there is no lead follicle there, which is normal, as one egg only per cycle matures, unless drugs are given for multiple follicle development.

The lead follicle grows by 1 - 2 mm per day, considering which , by day 14 in your case, it should reach a size of 20 mm, which is perfectly normal.
Also, rupture will be confirmed by a further scan.

Fluid is seen only when the follicle ruptures, releasing its fluid into the pelvic cavity.

Hence, based on your report, as of today, I would say it is completely normal.
Please do post the entire series for a complete analysis.

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Take care.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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