FOLLICULAR STUDY AND PATIENT MONITORING.pptx

study of follicles and monitoring of patients

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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

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