Clinical Applications of Ultrasound in Assessment of Follicle Development and Growth

Monitoring of individual follicles during the menstrual cycle demonstrates in a noninvasive way the changes in their number and position during the early and the late follicular phase and the luteal phase. The differences in relations between the follicles near the dominant follicle can be demonstrated with the same technique using 3D reconstruction of the ovary. An increased perifollicular blood flow can be measured in the perifollicular period using color and pulsed Doppler. Automated estimation of blood volume around the ovarian follicles brought a new concept to this area. Results confirm the observation that vascularity around the follicle is intense in the periovulatory period. The blood volume does not differ between follicles containing an oocyte and those with no oocyte in the aspirate, or a nonfertilizable oocyte. From our results we can hypothesize that those follicles containing oocytes able to produce pregnancy have a more uniform perifollicular vascular network . Recognition of the follicle growth pattern has a prognostic value for the outcome of assisted reproduction methods. Follicular diameter and changes in growth patterns are more important than follicular wall thickness as parameters having an impact on clinical success.