The significance of monitoring folliculogenesis

Abstract

This manuscript describes various uses of ultrasound imaging in assisted reproductive technologies as the principal noninvasive technique for evaluation of ovarian function and the process of follicular growth. Serial real-time pelvic ultrasonography has been described as a rapid, reliable method for monitoring follicular growth, rupture, and regression. The evaluation of preovulatory follicles by ultrasounds relies mainly on the study of the follicle diameter, but also on the follicle growth pattern, the follicular wall thickness, the perifollicular vascularity and the perifollicular blood flow. Predicting fertility potential has become important as women seek to use costly assisted reproductive technologies. The term ovarian reserve has been used to describe the capacity of ovaries to respond to stimulation with gonadotropins and therefore predict fertility potential. Ultrasounds can evaluate the ovarian reserve by the study of the antral follicle count and the study of the ovarian volume. Ultrasounds monitoring is important in assisted reproductive techniques. During controlled ovarian stimulation (COS), ultrasonographic evaluation of follicle growth and number will influence gonadotropin dose in the next days or the cancellation of the cycle if no response is documented. Monitoring of follicle growth and its vascularization at the end of COS could certainly increase the quality of the retrieved oocytes considerably. Moreover, the better monitoring of controlled ovarian stimulation in vitro fertilization-intracytoplasmic sperm injection permits a final good outcome.