Follicular study involves a series of transvaginal ultrasounds to monitor follicle growth in the ovaries and determine the optimal time for fertility procedures like IVF. It begins on day 9 of the cycle and continues until day 20. A follicular study is done by inserting an ultrasound probe into the vagina to view the ovaries and measure follicle size and endometrial thickness. It benefits women who want to know their ovulation window or have fertility issues. Patient monitoring also tracks hormone levels, follicle development, uterine lining, and health before, during, and after IVF to help ensure successful treatment and pregnancy.

1. FOLLICULAR STUDY AND
PATIENT MONITORING
SHIKHA VIDHYADHAR KADAM
MSC CLINICAL EMBRYOLOGY SEMESTER II
ROLL NO- CE-21-04

2. What is Follicular Study?
The follicular study is a series of transvaginal ultrasound scans that studies the growth of
follicles in a woman’s ovaries to identify the exact ovulation window in her menstrual cycle.
The female reproductive system has small tissues called ovarian follicles that contain and
release egg for fertilization during ovulation. A follicle is a fluid area in which the eggs grow.
When the eggs are mature patients are advised for further procedures.
 These scans will start around day 9 of the cycle and continue till day 20. It is a vital process
for getting pregnant including through fertility treatments like IVF.

4. How is a Follicular study done?
Follicular study is done via TRANSVAGINAL ULTRASOUND.
A follicular scan is done by inserting a small probe into the vagina to examine the tissues
containing eggs and the endometrial lining thickness to determine when the patient is likely
to ovulate.
Once the probe is inside the vagina doctors get a clear view of the uterus and ovaries.
During menstruation patients undergo day 2 scanning for IVF procedures.

5. Who Should Get A Follicular Study Done?
Follicular study be beneficial for women who:
Do not know when they ovulate
Women with advanced age and reproductive disorders.
Symptoms such as a little bit of pain or aching near the ovaries during ovulation.
If a woman is on drugs that are used to induce ovulation
Women who have had unfortunate miscarriages in the early stages of pregnancy can use
these scans to understand why they occurred.

6. What are the Advantages of Follicular Study
Follicles that do not grow till the time of rupture can be diagnosed.
Some dominant follicles do not rupture.
The endometrial lining might not be good enough in either thickness or quality.
They help to guide treatments with ovulation-inducing drugs or injections.
To detect complications like OHSS and others.
Lastly, follicular scans help in detecting luteal phase deficiency.

7. PATIENT MONITORING
The term " monitoring " means " close continuous observation ", so when we refer to
monitoring an in vitro fertilization and embryo transfer (IVF-ET) cycle we mean close
observation not only of a patient’s initial parameters and her own ovarian response to
ovulation induction, but also events after completion of the therapy.
Monitoring is important so as to check up on the activities of the patient not only before the
treatment or therapy but also after treatment.
It is better to divide monitoring into three stages: before starting treatment , the period of
treatment, and the period that follows the completion of therapy.

8. Baseline Treatment Before Any Starting Procedure.
Blood work is essential to prepare a patient for IVF, increase the chances of successful
fertilization, and confirm pregnancy after embryo transfer has been performed.
Blood work gives a better idea of hormones regulating and functioning in our body for the
development of eggs and ovulation.
Tests such as : CBC, HB, TLC, PLATELETS, PT, TSH, BLOOD SUGAR, LFT, KFT,
HIV, VDRL( VENEREAL DISEASE RESEARCH LABORATORY), HBsAg, HCV, CREATININE.
LH, FSH, E2, AMH, PROGESTERONE, PROLACTIN.

9. PATIENT MONITORING DURING OPU.
 Clinicians monitor patients during ovarian medications are given for ovarian stimulation.
Evaluating E2 levels ( Estradiol) more the estradiol more production of eggs.
To check follicle number, and follicle size. Egg size should be 17-20mm during retrieval.
To evaluate uterine lining quality and thickness.
No food and water intake for at least 6 hours before the procedure.
Then to check body temperature, SpO2 levels, and blood pressure after the procedure and
also to check if there is any vomiting sensation.
After the procedure only a liquid diet or juices are recommended.

10. PATIENT MONITORING DURING EMBRYO
TRANSFER
All the necessary tests are done before the embryo transfer such as estradiol, which is an
estrogen given to support the uterine lining, embryo implantation, and the resulting
pregnancy.
Administration begins at the onset of the frozen embryo transfer cycle (approximately 14
days prior to your embryo transfer).
Progesterone, is given to support embryo implantation and the resulting pregnancy.
 Administration begins exactly 3 days prior to your scheduled, or exactly 5 days prior to
your scheduled frozen embryo transfer.

11. Patient Monitoring After Embryo Transfer
After embryo transfer clinician has to check patient’s body temperature, blood pressure, and
oxygen levels are at a normal level.
Then the patient is advised not to stretch the lower abdomen and lift heavy objects and
complete bed rest.
No sexual contact for 14 days.
Embryo transfer can lead to constipation therefore regularly 3 to 4 litres of water is
compulsory.
After embryo transfer beta HCG test is taken within 14 to 15 days to check the pregnancy.
Patients are advised not to take mental stress as that effect the growth and implantation of the
embryo.

12. CONCLUSION
Follicular study is important in women infertility, so as to get a clear idea and future vision.
Health professionals give us the best guide for our conditions when checked on time.
Patient monitoring helps to keep a close eye on patients and their changing conditions after
the procedure.
Assisted help is given by the clinician if any changes occur.

13. THANKYOU