Menstrual cycle analysis and monitoring

A normal menstrual cycle lasts between 21 and 35 days. If your menstrual cycle repeatedly deviates from this, one possibility is to look into your menstrual cycle in detail. Through extensive hormonal examinations and, if necessary, cycle monitoring, we may be able to determine what is causing these irregularities in your menstrual cycle. Based on the results of this analysis, we can diagnose you and advise treatment to improve the regularity of your cycle. 

During a menstrual cycle monitoring, the treating nurse or physician will examine the patient’s menstrual cycle. Using several methods of examination, the treating nurse or physician can determine:

• Whether the patient’s hormonal cycle is normal

• Whether any follicles are maturing

• Whether ovulation takes place

• When ovulation takes place

• Whether the endometrium develops as expected

• The duration of the luteal phase (the period from ovulation to next menstruation)

What is the aim of cycle monitoring?

The aim of cycle monitoring is to examine whether the menstrual cycle is normal and regular. The treating nurse or physician can, in certain cases, discover underlying causes of being unable to conceive in order to recommend and discuss potential treatments with them.

During fertility treatments such as intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), the menstrual cycle will be monitored using ultrasound examinations and possibly blood testing.

This allows the treating nurse or physician to determine exactly when to do the insemination, or which day is the best day of your cycle to do an ova retrieval (during which ova are sucked from the ovaries to be artificially inseminated). The moment of ovulation can be monitored in two ways: either with ovulation tests or by initiating ovulation using a hormone injection.

When will we do a cycle monitoring?

Menstrual cycle monitoring is part of the orientation phase of fertility examinations. Especially in the case of women with irregular menstrual cycles, regular ultrasound examinations and laboratory analyses can help determine whether follicles are maturing or whether ova maturation is disordered. Follicle growth is also monitored during fertility treatments.

What happens during cycle monitoring?

The treating nurse or physician checks the patient’s menstrual cycle. Several ultrasounds and hormonal examinations are conducted to achieve this.

1. The first examination will usually take place between the tenth and twelfth days of the cycle, just before ovulation is expected to take place. Using an ultrasound, we determine whether a follicle is maturing inside one of the ovaries and whether the endometrium is developing well.

2. Depending on the results of the first ultrasound, it may be necessary to do a second ultrasound examination. The treating nurse or physician will follow the patient’s menstrual cycle closely until a follicle is maturing and/or ovulation has taken place.

3. Roughly a week after ovulation, the hormone levels are checked. Progesterone levels (progesterone is produced by the corpus luteum) are especially important, since progesterone plays an important part in, among other things, the lodging of an embryo in the endometrium (the lining of the uterus).

If the patient’s cycle is longer or highly irregular, several examinations will usually be done in just a few days. Cycle monitoring may continue for several cycles, if necessary.

A possibility: hormonal stimulation 

If the treating nurse or physician has determined through cycle monitoring that no follicle has grown and/or ovulation has failed to occur, we’ll usually advise a hormonal treatment. This stimulates ova maturation and may prompt ovulation. In many cases, when combined with copulation at the ideal moment during your cycle, this treatment should be enough to assist you in getting pregnant. You and your treating nurse or physician will create an individualized plan for the cycle monitoring of a hormonally stimulated menstrual cycle.