Follicle ultrasounds. I’ve had good ones and I’ve had bad ones.
I decided to share with you guys what is supposed to happen when you get a follicle ultrasound. You’re paying a lot of money for someone to do this to you, the least they can do is be thorough and respectful of your time. If they don’t, say something. Don’t be afraid. I have been in that situation where I felt absolutely robbed and unfortunately I was too in shock at the time to say something like I should have. This is for those of you who have never had a follicle ultrasound and don’t know what to expect.
If you are a TTC veteran like me and think I left something out, please post it in the comments so we can have a good line of information sharing! 🙂
First of all, a follicle ultrasound is done transvaginally, meaning they have a wand (shown above) and it is inserted into your – ahem – hooha. When I had my very first follie check nearly five years ago, I was totally surprised (and a bit mortified). Now, it’s a piece of cake. It’s not fun by any means, it’s very personal and a bit embarrassing, I won’t lie. So if you’ve never had this done before, this is your warning. Also, if you’re on fertility meds like me, your ovaries might be a bit sore, so this can make the ultrasound painful at times.
One tip I have for you: wear a skirt or a dress. Otherwise, you’re having to completely undress from the waist down and that adds to the already uncomfortable situation. If you have on a dress or skirt, you feel a lot better, trust me.
So, you’re probably asking why they have to do this transvaginally. The truth is, because they can see a lot better. That wand gets face-to-face with your uterus and ovaries in ways that an external scan cannot. It’s very effective when you need to see as many details as possible.
Step One: Big Picture Measurements. They will start with measuring the total size of your uterus, the level of fluid and the overall size of your ovaries. They will also measure the length of your cervix.
Step Two: The Uterus. They will measure the thickness of your endometrium. They will measure in millimeters. 7mm is considered okay, but ideally it needs to be between 8-13mm in thickness. Anything less than 7 isn’t that great for implantation. It’s not impossible, but it’s not ideal. In addition, they will check to see if your uterus is trilaminar, meaning three layers. This is what you want!
Step Three: The Ovaries. They might remeasure your ovaries, so don’t worry if it seems like they are repeating. The thing is, different angles can yield different results, so they want an average. They will now start measuring follicles. On me, they always start with my right ovary, then move on to my left. They measure each follicle from left to right and top to bottom to take an average for the size of each. They might also turn on a doppler so they can see your blood vessels, at which point you will see red splotches on the screen. Ideal follicles are at least 16mm in size and perfectly round, although different doctors prefer different sizes. If the follies are oval-shaped, they generally aren’t the best. They need to be round. A good tech will measure as many follicles as possible. A bad tech will take a look and say, “well, they all look too small,” without measuring very many. If this happens to you, push them. Not literally, but you need to ask them to keep looking. Sometimes a good follicle can be hiding in the back of your ovary, trust me. They need to give you a chance. You paid them for this, so just make sure you are getting a thorough check. Even if nothing really is there that is a good size, make them be sure.
That’s pretty much it, folks! The ultrasound only takes about 10 minutes from start to finish, depending on how many follicles you have and how good of a tech you have. I’ve been in and out in under 3 minutes (bad tech) with a half-page report and there for up to 15 minutes (good tech) with a two-page report. Just make sure you wear a skirt/dress, empty your bladder and don’t eat any taco bell before going in. 😉 Otherwise, your already embarrassing situation just might get a little more embarrassing!
Here’s to a successful follicle ultrasound at your next appointment! Cheers!