Tuesday, September 16, 2008

Follicular Monitoring


I went back to my OB Gyne yesterday for my follicular monitoring (it's the 11th day of my cycle). Good news, the sizes are good and the dominant follicle is on my right ovary. I'm keeping my fingers crossed that this will be the month and hoping to have the big fat positive!

Follicular monitoring is done through transvaginal ultrasound. Follicles are fluid-filled sacs on the ovaries that enlarge as eggs ripen. Each follicle contains an immature egg. Each egg in the ovaries is enclosed within a resting follicle. Every day, thirty to thirty-five of these resting follicles begin their eighty-five days of development toward eventually trying to ovulate. At any time, a view into your ovary reveals follicles (with their enclosed eggs) in every stage of resting or growing. There are early primordial, or resting, follicles; there are somewhat larger primary follicles; there are larger pre-antral follicles (which are beginning to form a fluid-filled space); and there are antral follicles, which are just becoming visible under ultrasound at a size of approximately one to two millimeters in diameter. In addition, at midcycle, on day fourteen, there is normally a dominant pre-ovulatory follicle. After ovulation, that follicle becomes a corpus luteum, which begins to secrete progesterone.t is often erroneously thought that just one follicle develops every month, during the first two weeks of the cycle, ultimately culminating in a large, twenty-millimeter follicle from which the egg is ovulated at approximately day fourteen (in a typical twenty-eight-day ovulatory menstrual cycle). Development of this single, dominant follicle every month with its increasing production of estrogen, and the entire regulation of the monthly cycle via the pituitary hormones of FSH and LH, only gives a tiny part of the picture; it only shows what is happening to one egg in an ovary that contains, in a fertile young woman, as many as 200,000 eggs. That one egg that was destined to ovulate, developed as the single dominant follicle out of the thirty or so much smaller pre-antral and antral follicles, which had been developing in the ovary for as long as seventy days prior to the beginning of the current twenty-eight day menstrual cycle.

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