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What does this follicular study report indicate?

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Posted on Fri, 7 Jul 2017
Question: Hello Doc,

I am XXXX, 30 years old...Married for 5 years....Started planning for a baby just a year back....Facing irregular periods since last 3 years....
My last period was on 5th May after taking meprate tablet. From 6th may to 10th may (5 days) i was on Fertyl 50mg tablet (2 tablets in the night) ,,

Today is the 18th day and i did the follicular scan which shows:
Left ovary: 8.6 X 6.5mm
Right ovary:9.0 X 7.1mm
Endometrial Thickness : 7.5mm

I had taken HCG (5000) injection two days back but still the follicular growth is not good. Yesterday i had some light white spotting which generally happens during ovulation.
Does it mean i already ovulated ? Did the dominant follicle already ovulated and now i am left with other follicles?

My concern is if i should take another shot of HCG...Is it safe?

Or should i terminate this cycle

Best Regards,
XXXX
doctor
Answered by Dr. Khushboo Priya (1 hour later)
Brief Answer:
No need to take another injection hcg.

Detailed Answer:
Hi, welcome to healthcaremagic.

I think you might have ovulated before 18th day. Follicle size is very small on day 18. It means either follicle has already ruptured or follicle has not formed.

You can take progesterone like susten or duphaston for next 2 weeks. Do a urine pregnancy test after that.

If negative, wait for the periods.

From next cycle, after taking clomiphene,track your follicles growth by repeated ultrasound and when follicle is more than 17 to 18 mm, take injection for rupture of follicles. Be in contact with your husband for 2 to 3 days after the injection. Take progesterone for next 2 weeks after rupture is confirmed on ultrasound. Do a urine pregnancy test after that.

Try atleast 3 to 6 cycles.

Hope I have answered your question. If you have any other query, I will be happy to help.

Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Khushboo Priya (17 minutes later)
Thank you Doctor XXXXXXX for your detailed answer.

This is not my first cycle where i am trying HCG.

In Feb 2017 i had taken two shots of HCG and the follicle size had increased to 22mm on the 23rd day .

From last few cycles and scans i do see that my follicle growth starts only after 16th day....During 12th or 13th day there will be hardly any follicle seen.

If i have already ovulated , then what are the follicles seen in the scan today?

Best Regards,
XXXX
doctor
Answered by Dr. Khushboo Priya (16 minutes later)
Brief Answer:
Follicles which are seen can be other small follicles.

Detailed Answer:
Hi, I think the follicles which are seen now can be the other small follicles apart from the dominant follicle. Generally ovary contains many Follicles, only one or two of which become dominant. Rest are small and can be seen at any day of period.

I think you should get yourself evaluated for thyroid profile and prolactin level . Also get a day 2 FSH, LH and AMH level done.

Also get a HSG done to see if tubes are normal or not.

If ovulation induction with timed intercourse doesn't work, you can go for IUI.

Talk to your doctor regarding this.

Hope it helps.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
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Dr. Khushboo Priya

Infertility Specialist

Practicing since :2010

Answered : 4255 Questions

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What does this follicular study report indicate?

Brief Answer: No need to take another injection hcg. Detailed Answer: Hi, welcome to healthcaremagic. I think you might have ovulated before 18th day. Follicle size is very small on day 18. It means either follicle has already ruptured or follicle has not formed. You can take progesterone like susten or duphaston for next 2 weeks. Do a urine pregnancy test after that. If negative, wait for the periods. From next cycle, after taking clomiphene,track your follicles growth by repeated ultrasound and when follicle is more than 17 to 18 mm, take injection for rupture of follicles. Be in contact with your husband for 2 to 3 days after the injection. Take progesterone for next 2 weeks after rupture is confirmed on ultrasound. Do a urine pregnancy test after that. Try atleast 3 to 6 cycles. Hope I have answered your question. If you have any other query, I will be happy to help. Regards