Monday, February 28, 2011

Why follicular studies ( ovulation tracking ) can be a waste of time

Many gynecologists advise ovulation tracking as the first line of "treatment" for infertile couples.
This seems to be sensible advise. You just have to go for vaginal ultrasound scans which help you time precisely when you ovulate. You have sex at this time, and since eggs plus sperm = baby, you get pregnant in the first cycle itself ! How can this fail - especially if you are young and all your test results are normal ?

Actually, the tragedy is that patients have very unrealistic expectations from follicle tracking ! The success rate , even in a perfect cycle , is only about 10 % ! Remember that human reproduction is not very efficient, and just timing sex does not help ( unless you've never had sex at the right time earlier !)

Doctors often forget the downside of ordering follicular studies. It can be very stressful because you need to take time out of your office work duties to get ultrasound scans done . Even worse, it can play havoc with your sexual life. We all know that Men are from Mars and Women are from Venus - and this difference gets hugely exaggreated when you are battling with infertility, because you and your partner seem to be on completely different planets as regards having a baby . Most men would rather let nature take its own course - and having sex frequently in order to have a baby sounds like fun ! They just cannot understand why baby lust seems to have taken over their wife's life - and why you are obsessed with stuff like eggs and ovulation and fertile times !

Doctors can be very casual about advising scans and they underestimate the additional stress this puts on the marriage ! Husbands hate having to have sex on demand - they feel they have become reduced to becoming sperm donors who have to perform when ordered to do so. This takes all the fun out of sex, and adds to the marital disharmony when the wife refuses to have sex on any day other than the day of ovulation because she wants her husband to "store up" the good sperm ! This can often be the last straw which breaks the camel's back , because infertility already stresses the couple. Also, having to lie with your legs up in the air for the scans can be quite embarrassing and humiliating - and having a doctor insert an ultrasound probe into your vagina on a daily basis can be a major turnoff !

My advise is that one cycle of ovulation tracking is enough. This can be useful because it teaches you to correlate the scan findings with your body's signals , such as your cervical mucus and ovulation pain . Scanning also allows you to make better use of OPKs and the free online fertility calculator in future cycles, because you understand what's happening to your body, so you do not have to medicalise baby making sex in future cycles and track ovulation discreetly at home !

However, if your doctor advises repeated follicular studies, please get a second opinion ! Otherwise you ( and your husband) are likely to get fed up and frustrated before getting pregnant !

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  1. dear madam,

    i really like to thank you for this knowledge and its really give me so much relief b'coz i am also facing this now a days and i gone through 2 rounds and dr ask me to go for more two till ur egg become 18mm in size.

    but i think now i will not go for more two round and go with ur suggestion.

    thanks you so much......

  2. Hi,
    m also facing the same prob nt get relief after reading this..thanks .but i have one qustion in my mind that why it happen in my body ?why my egg is not rapchered after 20mm in size ? what i have to do for this?? they are giveing me injection for that can you tell me abut this prob...

  3. pallavi3:09 PM


    even i'm facing the problem of size of eggs... its just small multiple from beginning even on the 20th day.... why is this so... why my eggs are not growing?
    is that a harmonal problem?
    what should i do....

  4. Anonymous10:41 AM

    Hi Pallavi,

    yes you have a hormonal problem which is lower FSH Count(Follicular Stimulating Hormone).Which increases the size of egg, for this you have to consult an infertility specialist and probably you may be given FSH injections for egg's growth, as it is very necessary to have a size of minimum 18 to 19 mm egg to concieve.

  5. Dear Soni,

    If your follicles do not rupture, this means you have LUF syndrome. Read more at

    1. Hi,
      I had hcg injection 10k on 5th jan and done ovulation study on 6th but follicle didint rupture doc gave me one more hcg trigger 10 k still on saturday 7th no ovulation..doc did iui on same day..on 8th jan ovulation occurs from 1 follicle other was still not there any chances

  6. Dear Pallavi,

    You need to do blood tests to check your hormone levels to find out why you are not ovulating.

    This is called anovulation.

    You need the following medical tests.
    1. blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( anti-Mullerian hormone) and TSH ( thyroid stimulating hormone)
    ( to check the quality of your eggs). Do this from a reliable lab such as SRL (;
    2. a vaginal ultrasound scan which should check for the following.

    a. ovarian volume
    b. antral follicle count
    c. uterus morphology
    d. endometrial thickness and texture

    Please send me the detailed test results and medical reports . You can scan them in as a single Word file and email them to me.

    Once we know what the problem is, then we can treat it !

    We look forward to helping you to have a baby !

  7. can we have intercourse during 2 day of follicular study?

  8. mine is also the same question, can we have sex during follicular study as it takes a couple of days

    1. Yes , you can have sex as often as you like. The more the sex you have , the better the chances of your getting pregnant. You cannot run out of sperm - and freshly ejaculated sperm ( after a shorter abstinence period) have been fertilising ability !

  9. Anonymous2:18 PM

    i have done follicular ultrasound scan once . after that is it necessary to do again and again until we conceive or we can try conceiving with out scanning. plz anyone answer me....

  10. If this was a natural ( unmedicated ) cycle and the ultrasound scan results were fine, the you can try well-timed intercourse for the next 3 months ( assuming you are young and all your results are normal). You could monitor ovulation by tracking your cervical mucus; or using OPKs ( ovulation prediction kits)

  11. I have went follecular study for three months and my egg raptured every time. My usg result also normal. I didn't get pregnant. My doctor suggested me go for follecular study again. Why am not getting pregnant even I have normal results

  12. Hii I am also having ovulation scanning.. itsy 29th day... pls tell me will I grt pregnant other not its my fist follicular scanning test.. and I am very muchness tensed... If my period will come in this cycle then should I go for another ovulation scanning cycle or not...

  13. Going through this right now.dnt wanna go for a 3rd round.n yeah thats right we spent whole this tym totally in stress.n also found out that i have an endometrial polyp.dnt wanna do anything really.just want to have a positive frame of mind

  14. Today I had done first time follicular study. Is that safe to have sex.

    1. Yes. The more often you have sex, the better your chances of getting pregnant

  15. Anonymous10:12 PM

    Hi. Delayed liquefaction time of 1 hour 30 mins in semen analysis a problem in conceiving.does it need to be treated



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