When you first start working with a fertility clinic, cycle monitoring is done as it determines when you’re ovulating so your fertility doctor can figure out the best time for insemination or have sex – to ultimately increase your chance of a pregnancy.
Cycle monitoring is done for:
- Natural cycles
- IUI, where ovulation timing is determined
- IVF, to measure the number and size of the follicles
- Donor cycles, where uterine lining is determined in the recipient
Monitoring is typically done in the mornings to get the best glimpse of your hormones, and to determine how you are responding to any drugs you may be taking.
When does cycle monitoring start?
Cycle monitoring takes place in the first half of your menstrual cycle. It begins when you start your period, and are experiencing substantial flow, not spotting. You will usually need to visit your fertility clinic around days 2-4 of your period where blood testing and ultrasounds will be done.
What does cycle monitoring monitor?
Blood work measures estrogen levels, a hormone that’s necessary for follicular growth as well as development of the uterine lining. Your ovarian reserve is also measured because your doctor will be looking for 6 to 10 follicles that will continue to grow in the next few days.
Ultrasounds are also done to visualize the progressive growth of the follicles and lining. Right before ovulation happens, a dominant follicle should be about 20 to 24mm in diameter. This, along with hormones (estrogen and LH), will indicate that ovulation will happen.
What happens after ovulation?
At ovulation, the dominant follicle is released, and is basically waiting for sperm to fertilize it. Your doctor may give you a trigger shot of hCG to facilitate ovulation.
At this point, you will be told to have sex or an insemination is done once (or twice) to fertilize your egg.
Depending on the type of cycle you have, you might go back to the clinic in the luteal phase to measure your progesterone levels, or and ultimately determine if you are pregnant.
Cycle monitoring can be particularly stressful because of the frequency of visits, as well as feeling anxious about how your hormones and follicles are doing.
Because you have a lot on the line – time, money, hope, there’s a desire to get everything right. Do the best you possibly can to get the outcomes you want. Expanding your health team, potentially including a naturopathic doctor, may support and enhance these treatments.