Determining ovulation, on the one hand, is a fairly simple matter, but on the other hand, it’s not very simple, since when predicting this day, you need to take into account many small nuances. What methods exist for diagnosing a favorable time for conception?
There are actually many methods; they can be figuratively divided into subjective ones, as well as those that can only be used in medical or home conditions. Remember that determining ovulation at home or medically for any purpose is meaningless if a woman is taking oral contraceptives (they block the ability of the ovaries to ovulate), as well as if the Mirena hormonal device is installed. But let's get back to the methods.
Home diagnostics
1. Measuring basal temperature. All women probably know about this method of determining ovulation. Doctors have also been using it for decades, although less than before, since more reliable diagnostic methods have now appeared, such as ultrasound and special tests. Basal temperature can be measured in the mouth, vagina, or anus. It goes without saying that you need to measure every day only in one selected place. Most often it is measured rectally, since this method is considered the most accurate. Determining ovulation by basal temperature is based on monitoring its values and jumps up or down. So, just before ovulation, temperature values may drop slightly. This is the most favorable time for sexual intercourse, since the egg will be released in the coming hours. After ovulation, the temperature rises to 37 degrees or higher. Be sure to keep in mind that the egg remains viable after ovulation for 1, maximum 2 days. Since determining ovulation by temperature involves monitoring minimal changes on the thermometer, it is necessary to carefully follow all recommendations. Thus, BT may be increased not during ovulation if a woman takes various medicines, if a few hours before the measurement there was sexual intercourse, and no one canceled the errors of the thermometer either. By the way, over the course of one exchange. cycle, changing the thermometer for measurement is not recommended.
There comes a time in the life of almost every woman when she begins to plan her pregnancy. An important element in pregnancy is the ovulatory cycle. If, then it is quite difficult for a woman to correctly calculate the time of ovulation. To solve this problem, medicine provides ultrasound monitoring of ovulation.
Ultrasound methods involve identifying and diagnosing diseases and their causes using ultrasound. It works on the principle of echolocation: ultrasonic waves are emitted by the device, then reflected and recorded by the same sensor. As a result of this, the doctor receives a complete picture of everything that is happening inside the body.
During the cycle, the ovaries mature, then the mature follicle ruptures and the egg contained inside is released into the ovary, this is ovulation. Ultrasound monitoring of ovulation allows you to determine the moment of release of the egg from the follicle, and also, in the presence of pathologies interfering with this process, to identify the cause. A synonym for the term egg is the word oocyte.
The number of eggs in a woman’s body is strictly limited and is laid in utero. A newborn girl has about two million eggs. But over time, by 8-10 years, their number is approximately 15% of the original amount. This is due to the fact that these cells are “incubators” and are not ready to fully perform the functionality of the follicles.
The entire menstrual cycle is a sequence of ruptures of follicular cells and the release of an oocyte into the fallopian tubes. In the first phase, which is called folliculogenesis, the initial development occurs, which in turn consists of three others. The next phase is ovulation. Over time, the influence of hormones increases and the follicle becomes thinner, which leads to rupture and the oocyte comes out, moving through the fallopian tubes, where it must be fertilized by a sperm. In the last, third phase, the egg transforms into the corpus luteum, which actively produces pregnancy hormones. But if there is no pregnancy, then it dies and the cycle begins again.
It is worth remembering that ultrasound does not determine hormones.
Why perform an ultrasound for ovulation?
The duration of a normal menstrual cycle ranges from 21 to 35 days. Best time— 28 days. Women experience irregularities in their cycle - a deviation from the timing of regular menstruation by more than 10 days. When you have a regular cycle, you can quite easily determine the timing of ovulation, even without resorting to other research methods. To do this, you need to use basal temperature measurement, the calendar method and a number of other subjective signs, individual for each woman. If the cycle is irregular or periodically disrupted, the level of reliability of such improvised methods decreases. In this case, it is already necessary to resort to ultrasound monitoring of ovulation. The purpose of this study is to trace the cycle in all its stages and, if pathology is present, to detect it early.
Ultrasound for ovulation is synonymous with ultrasound screening of the follicle and folliculometry. If the first two names are similar, then the third may mislead the patient. Therefore, the doctor must clearly explain the upcoming study.
Today, ultrasound is one of the safest methods. Unlike X-rays, ultrasound does not cause any harm to the patient being examined. In addition, in some cases, ultrasound is preferred because it is more informative. Often, in the diagnosis of some acute conditions, a prime example is ultrasound, due to its speed. Another important fact is accessibility. Nowadays, this method is available to almost all segments of the population, because the vast majority of clinics have an ultrasound machine, but it is better to carry out the examination in specialized centers or departments.
What does an ultrasound show for ovulation?
When using folliculometry during the cycle, a number of indicators can be determined. and on different days of the cycle will exclude the presence of tumors or other hormone-dependent diseases. Sometimes there is simply no oocyte and, accordingly, ovulation will not occur, that is, whether ovulation occurred, an ultrasound will definitely show. If a woman, for some reason, has no signs of ovulation, she can even determine its signs and give a prognosis accordingly. Some pathologies may be hidden under a thin or, conversely, thick layer. Its thickness changes during the cycle, which makes it possible to detect the disease. Another important function is the possibility of monitoring over time, in the postoperative period or to determine the effectiveness of treatment.
Like all ultrasound methods, ovulation monitoring also has its drawbacks. Not all inflammatory processes can be detected and, accordingly, some pathologies can be missed. Also, the fallopian tubes are not visualized on ultrasound. The duration of observation is quite long - 1 or 2 cycles, during which the ultrasound diagnostic room must be visited at least 4 times.
When to do an ultrasound for ovulation?
No examination can be carried out without a preliminary gynecological examination and questioning of the patient. Even today, no matter what diagnostic methods are used, they cannot replace the human eye and hands. An ultrasound is performed for ovulation for the following indications:
- Absent or painful periods;
- Irregular menstrual cycle;
- Infertility;
- Preparing the patient for in vitro (artificial) fertilization;
- The appearance of failures in tests, especially hormonal disorders;
- Preparing for pregnancy after earlier.
An important point is to determine the day of the study. On what day of the cycle to do an ultrasound for ovulation is determined by the doctor who prescribes it. The first folliculometry is carried out at the beginning of the cycle. Then a second examination is carried out, during which the doctor detects one dominant follicle among others. It is worth noting that it is the dominant that plays the most important role in oogenesis. The following study confirms the presence of a follicle. By the time of the third, pronounced symptoms of the onset of the ovulation cycle appear. An ovulation ultrasound is performed to confirm the release of an egg.
It is important to understand that for women with different cycle lengths, the examination schedule is selected individually. In case of violation of the regularity of the cycle, the examination begins 4-5 days after menstruation, and if the cycle occurs regularly, then the middle is calculated using the calendar method and 4-5 days are subtracted from it.
How is an ultrasound performed for ovulation?
There are many types of ultrasound examinations that are used in gynecology, but for ultrasound examinations for ovulation, only the transvaginal method is used, as it is the most accurate.
During the procedure, a special vaginal sensor is used; if there are no pathologies, then the examination is absolutely painless and only in rare cases can it experience discomfort. It should be carried out only after a complete gynecological examination, although the examination is quite accessible and harmless; multiple repetitions are required, which is the main disadvantage of such an ultrasound.
No preparation is required, unlike . All that is needed is hygienic measures similar to those during a gynecological examination.
Ovulation on ultrasound
The main criterion for diagnosing ovulation is the dominant follicle. On an ultrasound of the follicle, it will appear as a round heteroechoic structure. The main feature is a rather large formation, up to 17 mm, has a clear outline and double outline. If the follicle has not grown (size up to 15mm), then the chance of an oocyte being released is very small, even if the corpus luteum is present. At the end of ovulation, when it has already come to an end, the oocyte disappears, the corpus luteum appears, and a small amount of fluid forms in the (uterorectal cavity).
Sometimes, even in the case of an ideal cycle, the egg may simply not be mature and not ready for fertilization. On ultrasound, this situation is characterized by a decrease in the egg, prolonged maturation without its release, and complete underdevelopment of the follicles. Sometimes a follicular cyst can develop when the follicle grows but the oocyte does not come out. The reasons why this can happen are tumors, inflammatory diseases, hormonal imbalances, etc.
Ultrasound for ovulation is also called folliculometry. This process is a procedure for monitoring the growth of the follicle. Why do you need to track ovulation in this way? Because not every woman today who wants to have children can conceive the first time. Therefore, it is necessary to monitor the maturation processes of the egg in order to conceive a child at the appropriate period. This method is accurate for determining the ovulation process. Who should have an ovarian ultrasound and when and is it effective for everyone? These issues are discussed in the article.
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When is the most effective time to monitor the ovaries using ultrasound?
Having decided to undergo folliculometry, a woman will first undergo a consultation with a gynecologist to find out what problems there are that may interfere with the development of the follicle. The doctor will clarify what cycle the woman has, the nature of menstruation and whether there are problems with other female organs. Depending on her answers, the doctor will set a date for ultrasound monitoring. There are three periods that depend on the cycle:
- If the cycle is 28 days without interruption, then the folliculometry procedure is prescribed exactly in the middle of the cycle. This is 9-10 days after the start of menstruation.
- If the cycle is regular, but its duration is more or less than 28 days, then the examination will take place 4-5 days before the middle of the cycle.
- If the cycle has no sequence at all and the pattern in menstruation is difficult to catch, then an ultrasound scan for ovulation is performed 3-4 days after the end of menstruation.
In what other cases will the doctor send a woman for an ultrasound of the ovaries and determine the exact date of ovulation? For concomitant diseases that do not allow you to conceive a child on your own:
- Dysmenorrhea – acyclicity of menstruation;
- amenorrhea – absolute absence of menstruation;
- if ovulation is not observed during menstruation;
- infertility within 2 years of joint efforts with a partner;
- failure of hormones in the body;
- ovarian diseases.
All these associated problems make adjustments to the date of ovarian monitoring.
How does ultrasound work to monitor ovulation?
After the doctor has determined the day for the procedure, the woman comes for an ultrasound on her day. The procedure itself is quite simple and painless. Ultrasound monitoring of the ovaries is carried out using three methods:
Of course, if a woman does an ultrasound with the aim of becoming pregnant and monitoring ovulation, then the first monitoring method is suitable for her. This procedure should be repeated more than once. Usually there are 4 visits several days apart.
- The first ultrasound is prescribed by the doctor depending on the cycle. Let's take an average cycle of 28 days, that is, folliculometry will occur on the 10th day of the cycle.
- After 2-3 days, that is, on days 12-13, a second procedure is performed to confirm the presence of corpus luteum growth;
- After another 2 days, that is, on the 14th day of the cycle, another procedure occurs. At this time, ovulation should occur soon.
- After another 3 days, namely on the 17th day, a control procedure is performed. It shows whether the egg has been released. If at this stage it still does not come out, then the doctor may recommend continuing ultrasound monitoring until the next menstruation. If ovulation was not observed during the cycle, then folliculometry continues in the next cycle.
Signs of ovulation on ultrasound
How will the doctor understand that ovulation has occurred? On the screen he will see signs that will confirm the release of the egg.
- Before the ovulation process itself (somewhere on the third visit to the uzist), maturing follicles were discovered;
- follicle rupture was noticed;
- examination behind the uterus showed accumulation of fluid;
- after the follicle ruptured, ultrasound detected the growth of the corpus luteum;
- the absence of a dominant follicle is the main sign of ovulation.
Additional confirmation that ovulation has occurred will be the presence of a large amount of progesterone in the blood. A woman can also indirectly determine that she is ovulating. Signs:
- nagging pain in the abdomen;
- viscous vaginal discharge;
- swelling of the mammary glands;
- change in taste preferences;
- increased appetite;
- frequent mood changes.
Possible violations
It happens that during folliculometry, the doctor discovers pathologies that are associated with ovulation. For example:
- Regression. This is the process of growth of a dominant follicle to a specific size. However, at a certain point the growth stopped and went in the opposite direction. Ovulation never occurred.
- Peristency is the normal development of the follicle, but at a certain point the egg was unable to rupture the follicle and come out. In this case, there will also be no ovulation.
- Follicular cyst. This is a consequence of peristency. That is, the follicle has matured, the egg has not ruptured it, and fluid has accumulated due to the intact follicle.
- Luteinization of the follicle. This is the formation of the corpus luteum, but without rupture of the follicle. This phenomenon occurs due to hormonal imbalance or poor ovarian function.
- There are no follicles. On an ultrasound, the doctor may find that the follicles are not developing at all. Of course, in this case the process of ovulation is impossible.
If such deviations are detected, folliculometry to control conception is postponed until the deviations are eliminated. Then you can start monitoring conception again.
Decoding the results
All results will be deciphered by a specialist. He knows the norm of indicators for each cycle and analyzes deviations from this norm. Below are the normal indicators. You can compare them with your results and understand whether there are problems with the ovulation process.
- Follicle growth phase.
- 1-8 days there is no dominant follicle;
- 8-12 days it is visible on ultrasound in the size of 10mm;
- 12-14 day size 15mm;
- Day 14-15 is the period just before ovulation, when the follicle reaches 21 mm.
- Ovulation:
- An egg-bearing tubercle is visible in the follicle;
- The follicle wall is thickened;
- Once ovulation has occurred, the follicle is no longer visible;
- There is some fluid behind the uterus.
- The luteal phase is the formation of the corpus luteum. If conception is favorable, it will be 18mm. If it is more than 23 mm, then this indicates either pregnancy or the presence of follicular cysts.
- Menstruation. Ultrasound shows small follicles that barely reach 8mm in size.
As you can see, depending on the phase of the cycle, the norm of indicators in the ovaries changes. There are standards for each phase. They may fluctuate slightly due to individual characteristics such as weight and age. However, normally such deviations are quite insignificant and are as close as possible to the standards.
So, according to the above information, ultrasound for ovulation is the most informative method for determining ovulation and the favorable time of conception. In addition, this procedure will also allow us to find pathologies in the reproductive system. Among the disadvantages, some believe that undergoing 4 ultrasounds per cycle is expensive and inconvenient. Moreover, if pregnancy did not occur from the first cycle. But aren't these inconveniences worth the joy that motherhood brings?
Any couple who is planning to have a child believes that best time for this is the period of ovulation. It is important to note that this condition is the only time when fertilization can occur. All remaining days are not suitable for conceiving a child.
As a rule, every woman should have an idea of what this period is, when it occurs and how those very suitable days are determined. In gynecological practice, there are many ways to find out the period of ovulation. One such method is ultrasound.
Indications for use
The decision about how much ultrasound is necessary is made by a specialist. In addition, it is possible if the patient herself has expressed a desire.
- gynecological examination for preventive purposes;
- painful periods;
- menstrual irregularities;
- abnormalities in the development of the genital organs;
- an increase in the volume of the abdomen, which may indicate the presence of a cystic formation;
- pain during sexual intercourse;
- conception planning;
- pathologies of the cervix;
- diseases of the adrenal glands and thyroid gland;
- determining the date of ovulation;
- premature voluntary termination of pregnancy;
- hormonal imbalances;
- control of artificial insemination;
- sexually transmitted diseases;
- apoplexy;
- other pathological processes.
For those women who are planning to conceive a baby, it is extremely important not to miss the moment of ovulation. Considering that ovulation occurs only once during the entire menstrual cycle, it is extremely important to track its occurrence.
Ultrasound monitoring will help you see the signs of ovulation. At the same time, ultrasound allows not only to determine the already existing fact of ovulation, but also to predict its occurrence in advance. The accuracy of ultrasound in this case is as high as possible.
In this article we will talk about how an ultrasound is performed for ovulation, what are the signs of ovulation and what it looks like on an ultrasound. We will also tell you about all the nuances of this procedure and how to prepare for it.
On average, a woman's menstrual cycle is 30 days. Around day 10, the corpus luteum forms. But if we talk in more detail, then on the 10th day of the menstrual cycle, one dominant one is formed from the secondary follicles.
This, in fact, is the corpus luteum. It can be easily determined using ultrasound. However, its size usually does not exceed one and a half centimeters.
If a woman goes for ultrasound monitoring for the first time, then it should be done from the first day of the cycle, without waiting for ovulation. Ultrasound monitoring should be done at the beginning of the cycle because it is necessary to determine the ability of the ovaries to produce follicles.
Essentially, this is a kind of monitoring of the possibility of conception. But monitoring the release of the corpus luteum (ovulation) should be done either on the 9th or 10th day of the cycle.
If the patient has a history of cases where the corpus luteum came out 2-3 days earlier, then monitoring should be done on days 7-8 of the cycle. A formed corpus luteum after the 10th day of the cycle is observed extremely rarely, but if this occurs, then monitoring should be done on the 11-12th day of the cycle.
Repeated examinations
After the first ultrasound monitoring of ovulation, two more repeats are performed. So the second ultrasound control is done after three days (that is, on average, on the 13th day of the cycle).
At this time, it is necessary to confirm that the corpus luteum has formed (it should already be two centimeters in size). If the corpus luteum has regressed, ultrasound monitoring will not be able to show it.
The third ultrasound control of ovulation is carried out two days after the first. At this stage, the corpus luteum reaches its maximum size of 2.5 centimeters, after which growth stops.
If, after maturation, the ovulation process proceeds normally, the corpus luteum (its follicular membrane) will eventually rupture. In this case, the egg will rush into the fallopian tubes and through them into the uterus.
The next day after this process, the egg can be fertilized. But if fertilization does not occur, then she will die. You need to understand that the lifespan of an egg is several times less than the lifespan of a sperm.
Signs of ovulation
Ovulation can be determined not only by ultrasound data, but also by physiological signs. Such signs, however, do not mean anything without confirmation. That is why, when planning a pregnancy, if you find the following signs of ovulation, you should do an ultrasound:
- The most noticeable and characteristic signs of ovulation are heavy discharge and a change in the usual consistency of mucus released from the uterus. During ovulation, not only the appearance of mucus changes, but also the smell and color.
- Indirect signs indicating ovulation are incessant aching pain of moderate intensity in the lower abdomen.
- Hormonal signs: these include increased sex drive. When the corpus luteum forms, hormone production begins. They greatly enhance a woman's libido.
- Indirect visual signs: these include swelling and moderate tenderness of the mammary glands. Such signs are nonspecific and do not always indicate ovulation, but it is worth paying attention to them.
- Physiological signs: basal temperature. When the corpus luteum forms, for a short period of time (1 – 2 days) the woman’s temperature is around 37 degrees.
- Mild and dubious signs include mood swings and sudden changes in taste preferences.
Preparation for the procedure
Preparation for the study depends on which ultrasound diagnostic method was chosen. The easiest way to prepare is for the transvaginal (through the vagina) examination method.
To prepare for it, you do not need to follow a special diet or take medications. It is enough to empty your bladder half an hour before the procedure.
At the same time, drink half an hour before the procedure too. highly not recommended. This may distort the ultrasound results, so it is better to drink after the diagnosis.
For abdominal (superficial) ultrasound examination the situation is the opposite. In this case, on the contrary, you should drink about one liter of plain water an hour before the procedure.
This is necessary for the reason that the presence of fluid in the bladder stretches it. At the same time, the bladder puts pressure on the uterus and, accordingly, improves its visibility for the ultrasound machine.
Determination of ovulation by ultrasound (video)
Control study
To determine with extreme accuracy whether ovulation occurred and when, you can use an ultrasound diagnostic method. Overall, this is the only non-invasive (non-penetrating) and non-injecting (like a biochemistry test) way to detect ovulation.
However, the presence of a dominant follicle in the ovaries does not mean that it will eventually release an egg. Quite often, the membrane of the corpus luteum does not rupture and ovulation does not occur.
A follow-up examination is not only possible, but should be carried out no later than three days after expected ovulation. In this case, the process can be considered successful when:
- the dominant body according to ultrasound data is absent in the ovary;
- the corpus luteum is fixed;
- there is a small amount of fluid in the area behind the uterus.
Carrying out monitoring
The examination can be done either using the abdominal method (non-penetrating, superficial) or transvaginal (through the vagina). Preference is always given to the second method due to the fact that it is the most informative.
You can take a small pillow with you to the examination procedure. It must be placed under the buttocks to improve the viewing angle for the ultrasound sensor. In some clinics, doctors give it out.
Ultrasound detection of the onset of ovulation takes place not in one, but in three stages. They are carried out between the first and second phases of the menstrual cycle.
After the predicted onset of ovulation, a control examination is performed on the second or, less often, on the third day. It is carried out to confirm the existing egg. In general using an ultrasonic sensor it is possible to determine:
- Has ovulation occurred (if not, was there a pathological reason for this).
- Ovarian sizes.
- Are follicles present in the ovaries and in what quantity.
- Size of the dominant follicle.
- Are there any developmental abnormalities and was there an infectious/autoimmune reason for this ( common reasons impossibility of conception).
- The presence of a corpus luteum in the uterus.
After the ultrasound examination, the patient is provided with the results obtained on digital media (CD or flash drive). They should be saved and provided to your doctor, regardless of whether ovulation was recorded or not.