The purpose of cycle monitoring is to determine if there are any abnormalities in your ovulation and/or to help you time your intercourse. It consists of blood work and transvaginal ultrasounds every few days to daily until ovulation. The general outline is below.

  • On day 1 of your cycle, you call your physician’s nurse. (Day 1 is the first day of full menstrual flow.) If you get the voice mail, please leave your name and the date of your day 1. The nurse will advise you of when to come in.
  • Blood work and ultrasound are done between 6:30a.m.-8:00a.m. Monday-Sunday. No appointment is required; it is done on a first come first serve basis.
  • Each morning of monitoring, please check in with the receptionist. She will direct you to the appropriate waiting room. You will be called when it is your turn for blood work.
  • Blood work: At the blood lab, the technician will draw your blood for estrogen (E2), luteinizing hormone (LH) and progesterone levels. It takes approximately 4 hours to obtain these results, and for this reason it is necessary that your blood be drawn early in the morning. The average level of estrogen for a mature follicle is 700-1000 pmol/L, LH rises above 15 IU/L usually around ovulation. Progesterone levels over 15-20 nmol/L. However, healthy pregnancies can and do occur outside these ranges.
  • Ultrasound: Once your blood is drawn, you will have your ultrasound. You will change into a gown and will have a transvaginal ultrasound with an empty bladder. Ultrasounds are done to measure the size and number of follicles you are developing. A follicle is a fluid filled sac that surrounds the egg, which is microscopic. A mature follicle is generally at least 1.7cm and can grow up to 3cm with some types of fertility medications. Again, healthy pregnancies can and do occur outside these ranges.
  • Results: Once you have completed your blood work and ultrasound, the nurse will speak with you about your results and provide you with the next set of instructions.

The daily routine of blood work and ultrasound continues until ovulation. You will then be instructed as to when to have intercourse, or, if it was not a conception cycle, the information will be discussed with you at your review appointment.