Cycle monitoring

Cycle monitoring is an ultrasound examination used to determine the day of ovulation and assess the functioning of a woman's reproductive system. It helps to determine the most fertile days in the menstrual cycle and to prepare for assisted reproduction procedures. The examination includes observation of the growth of ovarian follicles and assessment of the thickness of the endometrium. It is performed using an ultrasound scanner with a vaginal transducer on an appropriately calculated day of the cycle. The procedure takes about 10 minutes and requires no special preparation other than emptying the bladder. Find out how to calculate the correct day for monitoring and increase your chances of conceiving.

Highlights

• Cycle monitoring is the observation of ovarian follicle growth using vaginal ultrasound to determine the day of ovulation.

• The monitoring day is calculated using the formula: average cycle length/2-2 (for a 28-day cycle, this is day 12).

• The examination takes approximately 10 minutes and requires the bladder to be emptied before the ultrasound.

• Correct menstrual cycle lasts 26-32 days - if your cycle is outside this range, consult your doctor.

Make an appointment for a consultation with cycle monitoring

If you are not yet an Invimed patient and want to be sure of your ovulation date, make an appointment for a consultation with cycle monitoring at the chosen Invimed clinic. Our gynaecologist will help you to pinpoint the exact day when your chances of conceiving a baby are highest.

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What is ovulation monitoring?

Ovulation monitoring involves observing and assessing the process of growth and maturation of the ovarian follicles. During monitoring, the doctor also examines the structure and thickness of the endometrium, i.e. the endometrium. The examination is performed by means of vaginal ultrasound.

In women preparing for in vitro Cycle monitoring is carried out until the ovarian follicles have reached the appropriate size and maturity. The attending doctor then orders the patient to be given a drug which causes the ova to mature. He or she then sets a date for the egg retrieval for IVF).

^{Cycle monitoring. Ovulation versus phases of the menstrual cycle: follicular phase and luteal phase.}

Ovulation monitoring - visits to the clinic

In order to determine the day of ovulation, it is usually necessary to have at least two to three monitoring visits (in the case of IVF their number depends on the method of stimulation and its course).

• The first appointment with the doctor can take place at any time during the cycle. The doctor examines the patient to assess the structure of the ovaries and detect any pathological changes within the reproductive system.

• If the couple has decided to use the IVF technique, the first monitoring visit takes place approximately five to seven days after the start of the hormone stimulation. Appointments are set by the attending physician.

• During subsequent monitoring visits, the doctor performs an ultrasound examination and also orders a blood sample to determine the progesterone and oestradiol levels in the woman's body. The ultrasound examination in the natural cycle is carried out before ovulation and a few days after ovulation.

What time of day is the cycle monitoring? Monitoring visits for hormonal stimulation usually take place in the morning.

Ovulation monitoring by ultrasound

W Invimed We carry out ovulation monitoring using a modern ultrasound scanner with a transvaginal transducer. This is one of the most important examinations in the diagnosis of infertility and in the case of treatment with assisted reproduction techniques. In the case of in vitro Cycle monitoring is performed before the puncture and before embryo transfer to assess the thickness of the endometrium.

Ovulation monitoring for all women trying for a baby W Invimed The ultrasound examination as part of ovulation monitoring is performed by experienced gynaecologists who guide couples undergoing infertility treatment on a daily basis. Patients of the clinic can make an appointment for ovulation monitoring. Women who are not our patients and who would like to accurately determine their fertile days are welcome to make an appointment for a consultation with cycle monitoring.

How do I prepare for cycle monitoring and how does the visit go?

You should make an appointment for ovulation monitoring just as you would an appointment. Before the ultrasound carried out for ovulation monitoring, the bladder must be emptied. The examination takes about 10 minutes. During the ultrasound, the doctor checks whether the follicle is growing, what size it is and whether it has already ruptured. At the patient's request, the doctor may print out an ultrasound picture of the follicle. If the follicle is already mature, the doctor will determine when the couple should have intercourse to have the best chance of natural conception, or in the case of assisted reproduction techniques, when to have an LP, insemination or embryo transfer. 

When to report for cycle monitoring?

Cycle monitoring at Invimed clinics (service available at the clinic in Poznan, Gdynia i Katowice) is not only part of the preparation for insemination or in vitro, is also an offer aimed at women who would like to know when their chances of conceiving naturally are best. If you are interested in cycle monitoring, please contact us as soon as possible to book a suitable date for your gynaecological consultation. 

In order for cycle monitoring to be meaningful, you need to come for it on a specific day of your monthly cycle. The menstrual cycle starts from the first day of menstruation and continues until the day before you bleed again. It should last between 26 and 32 days - the cycles of about 80% women meet this criterion. If your cycle does not fall within this range, make an appointment for an initial infertility consultation at our clinic as soon as possible. If your cycle lasts between 26 and 32 days, you may benefit from monitoring to determine ovulation (ovulation) and the most fertile days in your cycle.

How do you determine the day on which it is best to carry out monitoring? 

Divide the average number of days in your cycle by 2 and then subtract 2. The result obtained determines the day of the cycle on which it is most advantageous to carry out monitoring. For example - when the cycle lasts 28 days on average, the operation is 28/2-2=12, i.e. you should come for monitoring on the 12th day of the monthly cycle.

If the calculated day falls on a Sunday, the cycle monitoring can be arranged slightly earlier, e.g. on Friday. If the result is not a whole number, round it down (12.5 -> 12).

A few minutes for cycle monitoring

Cycle monitoring only takes a few minutes, it is not a full-blown gynaecological consultation. Cycle monitoring at Invimed is a transvaginal ultrasound performed on the patient after the first infertility consultation or after the first consultation with cycle monitoring. In this situation, it is not necessary to take a repeat history. The purpose of the examination is only to assess the growth of the follicle and to determine the date of ovulation.

Attention! Cycle monitoring takes only a few minutes. It is based on performing a vaginal ultrasound and determining whether ovulation is occurring. The monitoring is not preceded by a medical interview or analysis of any test results. This is why women who are not yet Invimed patients are welcome to come in for a cycle monitoring consultation or an initial infertility consultation.

How to provide the doctor with the test results?

In the case of consultations with a gynaecologist (as part of the initial infertility consultation) and an immunologist, the teleportation takes place on the basis of a history and medical records provided by the patient.

• diagnostic semen testing including:

  • computer-assisted semen analysis (CASA),
  • sperm DNA fragmentation testing (SCD),
  • testing the degree of sperm binding to hyaluronan (HBA),
  • morphology study of motile sperm organelles (MSOME),
• isolation of oocytes from material obtained by the doctor during the puncture of ovarian follicles,

• morphological assessment of oocyte quality and the Oosight polarised imaging system,

• preparation of ova for IVF procedures,

• evaluation and preparation of semen for insemination and in vitro fertilisation procedures,

• performing in vitro fertilisation procedures, i.e. IVM, IVF, ICSI/PICSI/IMSI/HBIMSI (read the article: In vitro fertilisation methods).

• embryo culture to the blastocyst stage (IVC),

• performing embryo biopsies for pre-implantation genetic testing of PGT-A and PGT-M (read article: Genetic diagnosis),

• standard monitoring of embryo development, assessment of their development and implantation potential,

• Time Lapse Imaging monitoring of embryo development and prediction of developmental potential,

• preparing embryos for transfer,

• freezing, storage and thawing of semen and ovarian tissue,

• Vitrification and heating of oocytes and embryos (read article: Vitrification),

• running a germ cell and embryo bank.

Free embryology consultations at Invimed

Invimed patients can benefit from an embryology consultation from the moment they have started preparing for assisted reproductive procedures at their chosen Invimed clinic. A consultation with an embryologist does not have to be ordered by the attending physician, but may be recommended by him or her. 

Embryology consultations are directed to Invimed patients who are interested in:

1. Embryological procedures and their effectiveness at Invimed.
2. The course of the embryological procedure in their case and its outcome concerning, for example, the number of embryos obtained and vitrified, the quality of oocytes, sperm and embryos.
3. Interpretation of own test results of comprehensive semen testing, SCD, MSOME, HBA and about methods to determine oocyte and embryo quality.
4. Assisted reproduction procedures used at Invimed and their effectiveness (insemination, standard IVF, ICSI, IMSI, PICSI, hb- IMSI, ED, sperm freezing, oocyte and embryo vitrification, preimplantation genetic testing).
5. Topics related to embryology that patients think may apply to their treatment process at Invimed.
6. Possible reasons for failure, lying in the field of embryology (for patients who did not achieve pregnancy through the procedure or who had a miscarriage after confirmation).

Frequently asked questions - FAQ

1. Pisarski, T. (ed.). (2002). Obstetrics and gynaecology. Podręcznik dla studentów (wyd. IV). PZWL, Warsaw.
2. Bręborowicz, G. H. (ed.). (2020). Położnictwo i ginekologia Volume 1-2 (3rd ed.). PZWL Wydawnictwo Lekarskie, Warsaw. ISBN: 978-83-200-6229-8.