What is Your Hoogland Score

Photography W. Scifres
There is an official way to measure ovarian suppressionduring OCP use: it is cored on 6 features: 1. no evidence of any ovarianactivity on ultrasound, 2. potential activity on ultrasound, 3. non-activefollicle like structures, 5) luteinized unruptured follicle and 6 ) ovulation .Also measuring estrogen levels, and thickness of the lining of the uteruscalled the endometrium, and measuring progesterone for evidence of ovulationcan all contribute towards making a diagnosis of ovulation. We use the cut offof about 8 mmfor the sixe of a small follicle (fluid filled area of the ovary that maycontain an egg) but it’s more likely that those that are over 10 mm will progress toovulate whether you are on the birth control pill or not. Of course ovulationis a complex matter. Anyone undergoing fertility treatment cycles will tellyou, eggs don’t always release from the ovary on schedule. So Hoogland scoresaside, the ultrasound picture is not necessarily the whole story. One must havean LH surge from the pituitary gland in order to ovulate., That surge followsrapidly on the heals of a ripe follicle in a natural cycle, but the hormones inbirth control pills will prevent that surge fairly reliably, causing thefollicle to collapse and shrink without releasing it’s egg. That’s what that 5thpoint in the score is talking about, a follicle that has become lutenizedwithout rupturing. The more days a month you take your pills, the lower yourHoogland score is likely to be. The more hormone you have in your pills thelower the score is likely to be.


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