[Monitoring of follicular growth. Significance of echography].

Follicular growth and ovulation may be estimated by various techniques: basal body temperature charts, cervical score and vaginal smears examination, gonadal steroids or gonadotropin measurement and more recently, pelvic echography. Echographic monitoring permits the determination of the number and the size of ovarian follicles and the prediction of the time of ovulation. 1065 cycles of patients consulting in an artificial insemination with donor semen program have been analyzed. Follicular growth is superimposable in spontaneous and hMG-induced cycles, but clomiphene treatment leads to the formation of larger follicles. Only one dominant follicle (greater than or equal to 15 mm) is generally observed in spontaneous cycles; multiple dominant follicles are visualized in respectively 11,8 and 24,3% cycles treated with either hMG or clomiphene. These follicles are localized in only one ovary in half of the cases. Consecutive monitoring in several cycles shows that the ovaries do not alternate systematically. While this type of monitoring does permit a reduction in the number of straws used, it does not improve the success rate of artificial insemination.