How to manage large follicles not rupturing since years? – Dr. Suhasini Inamdar

If a lady is developing good follicles in the cycles and reaching the optimum size and not rupturing, then it is called as luteinized and ruptured follicle and if it is happening for couple of months, then it is always better that she takes a trigger for ovulation so that the follicle breaks and she releases trigger. The trigger can be as simple as the HCG or the GnRH. Even after taking the injection if the follicle is not rupturing, then there is a lot of hormonal imbalance going on in the ovary. So in that case it is always better for the lady, she takes an oral contraceptive pill, which is a combination if progesterone and estrogen for 3 to 6 months and post that again the follicular studies, whether she is rupturing follicles without the injection or with the injection. If she ruptures the follicle, well and good otherwise the next stage would be laparoscopic drilling or the next stage again would be to do the follicular studies to see if she is rupturing the follicles or not. Even in spite of the drilling, the follicle is not rupturing then the only option remains with her to become pregnant is to go for IVF. If she is not trying for pregnancy and the follicles are to rupturing, then just leave it alone and not do anything about it.