Follicle Study - Protocol for Radiology

FOLLICLE STUDY\nFAX WET READ STAT TO 717-221-5647\n\n1. Baseline ultrasound exam (transabdominal and transvaginal) on Day 3 of cycle. Note uterine measurements, myometrial echotexture, presence of fibroids. Report endometrial thickness and pattern: Hypoechoic, trilaminar, hyperechoic, etc. Report ovarian measurements in 3 dimensions with estimated volume. Report presence/echotexture of any cysts/masses with size in 3 dimensions and mean diameter.\n\n2. Follow-up transvaginal exams beginning 5 days before estimated Peak day (determined by Divine Mercy Women's Health), noting:\n A. Endometrial thickness, echotexture, and phase (early/late proliferative, early/late secretory, or menstrual)\n B. 3 dimensions and volume of each ovary\n C. 3 dimensions and mean diameter of any follicle >1.0 cm\n D. Presence and mean diameter of cumulus oophorus, if detected\n\n3. If dominant follicle mean diameter ≤1.2 cm: next exam in 3 days\n4. If dominant follicle mean diameter >1.2 but <1.6 cm: next exam in 2 days\n5. If dominant follicle mean diameter ≥1.6 cm: next exam next day\n\n6. Continue daily exams until either:\n A. Evidence of follicular rupture: Disappearance of dominant follicle, or decrease of mean diameter by ≥0.7 cm, with some evidence of free fluid.\n B. Continued growth of lead follicle to mean diameter near 3.0 cm or greater, with development of internal echoes (striations or low-level diffuse echoes) consistent with luteinized unruptured follicle, for at least 2 days.