Study of follicular dynamics after spontaneous and induced ovulation by ultrasonography in infertile women

Introduction: Infertility affects 10-15 % of couple in reproduction age group (novak, 13th edition, 2002). Ovulation dysfunction is a common cause of infertility. Approximately, 40% of female infertility is due to anovulation (Speroff et al., 1999). However, with the advent of USG, a simple and non invasive, more accurate method to study ovulation has been established. AIMS and objective: 1. To study the follicular dynamics after spontaneous and induced ovulation by non invasive method in infertile women. 2. To study the effect of various ovulation inducing agent on pregnancy rate. The above study by predicting the timing of ovulation can help in 3. Women undergoing intrauterine insemination 4. Timing of intercourse in infertile women 5. It wil also help to minimize the risk of ovarian hyper stimulation syndrome. Material and Methods: The present work was undertaken in dept of obstetrics and Gynecology and Department of Radiology of VIMS, Pawapuri from Nov 2015 to 2016. Patients of infertility both primary and secondary were selected and tests were carried out to know the causes of infertility. Group I – constituted 25 infertile women with ovulatory cycle; Group II – constituted 25 infertile women with anovulatory cycle. Method of Induction: In all cases treatment was started from D2 of cycle for ovulation. For ovulation induction oral clomiphene citrate (50mg) D2 to D6 of menstrual cycle. (Regimen I) Those pts who failed to respond to Regimen I were put on a combination of (CC+FSH). Single dose of HCG (10000 IU) given IM when dominant follicle attained a diameter of 18 – 20 cm USG monitoring done from D10 on was of cycle to see the no of follicle, diameter of follicle, rate of growth and endometrial thickness. Couples were advised to live together from D10 -15 on alternate day. Result: The leading follicular diameter was significantly larger (22- 26) in CC stimulated cycle as compared to spontaneous cycle (16- 21). The ovulate rate and pregnant rate was higher with regimen II. Conclusion: It helps in prediction of timing of ovulation and correct prediction of timing of ovulation is critical for infertility therapies such as intrauterine insemination and timing of intercourse, and helps to increase the pregnancy rate.