Follicular monitoring

Abstract

Assessment of the follicular maturity and endometrial receptivity and the time of hCG is one of the key factors for success of all ART procedures. Maturation of the follicle and the endometrium, ovulation and leutinization is a process of multiple biochemical, morphological and vascular changes. The vascular changes are reflection of the biochemical changes and can be studied by color Doppler. 3D ultrasound gives a better assessment of the follicular and endometrial size, that is the anatomical maturity, than 2D ultrasound and 3D power Doppler gives not only qualitative but also quantitative idea of global vascularity, that is the reflection of functional/physiological maturity. Follicular vascularity distribution and flow indices can be better parameters of follicular quality and can be more reliable parameters to decide the time of hCG and IUI. Endometrial assessment can be more meaningful if its morphology is studied more in detail along with abundance of its vascularity as well as flow indices. Thus, deciding correct time of hCG can improve conception rates in ART cycles.