The follicles in a woman's ovaries allow her to become pregnant, but only if they are mature and normal. good quality. Deviations from the norm can lead to the development of cysts and sometimes infertility. There are several reasons why this happens, so you need to contact medical care immediately if the slightest discomfort appears, since women's health may suffer greatly. Important role The size of the follicles, as well as their number, play a role.

Follicle and its function

The main job of the follicles of the left and right ovaries is to protect the eggs from the harmful effects of various factors.

The eggs that are inside the follicles have not yet matured, so their protection, the normal course of maturation and fertilization, and the course of pregnancy largely depend on the abilities of the follicles.

In females, the development of the reproductive system occurs already in the perinatal period - the number of egg follicles is formed and changes in this number never occur.

One follicle matures in a month. Besides protective function they produce female hormones called estrogens.

The normal number of follicles maturing in the ovaries

Their number is calculated taking into account the day menstrual cycle.

For example, multiple, 2-3 days after menstruation, are not a pathology. Then they develop differently.

In the middle of the cycle, one or two of them are larger than the rest. By the end of the cycle, there is one big one left. It is from this that the egg comes out, mature and ready for fertilization. This follicle is called dominant, prevailing.

Start menstrual flow indicates that a rupture has occurred.

When a norm is violated: causes and consequences

A violation is said to occur when there are more than 10 follicles in one ovary. Pathology can only be detected through ultrasound of the pelvic organs. Moreover, their number does not change during the cycle. When there are a lot of them, this does not at all indicate any disease. This phenomenon can be explained by overwork, frequent stress, and emotional stress. Their number usually returns to normal after the first ovulation.

Underdevelopment can be caused by other reasons:

• Incorrectly selected oral contraceptives;
• Functional disorders thyroid gland;
• Excessive production of prolactin;
• Problems at work endocrine system.

Such a violation and its cause can be identified using a number of diagnostic procedures and gynecological examination.

In any case, there are two options for the development of the disorder: the first is a normal menstrual cycle with one dominant follicle; the second – there is no dominant, the egg does not mature, the cycle is disrupted, there is no possibility of fertilization.

In the latter case, an accumulation of male sex hormone occurs in the woman’s body, which entails the absence of pregnancy.

The role of dominant follicles

As a rule, they develop differently in the two ovaries. When both are diagnosed as dominant, there is a chance of conceiving twins. But this will only happen if they both ovulated, which is quite rare.

Two dominant follicles matured in one ovary increase the chances of a multiple pregnancy.

Persistence of the follicle of the left or right ovary

Confirmation of such a diagnosis is very bad news. This means that dominant follicle develops as it wants until the moment of rupture. As a result, it does not allow the egg to be released and over time it can transform into a cyst.

Persistence prevents ovulation. Pathology can be caused by hormonal imbalance, excessive amounts of male sex hormone. Delayed treatment leads to infertility.

Treatment consists of taking hormonal drugs. In addition, it is necessary to have a comprehensive effect on the body. First you need to suppress male hormones. Therapy lasts from 5 to 9 days of the cycle. Then the hormones are administered intramuscularly from day 9 of the cycle. Therapy lasts 5-7 days. In addition, stimulation of the pelvic organs is carried out. For this purpose, laser therapy, massage, and ultrasound are used.

Absence of follicles in both ovaries

This condition is caused by dysfunction of these organs or early menopause. The disorder is corrected through hormonal therapy.

What is it if antral follicles are found in the ovaries?

With the development of artificial insemination technologies, scientists began to pay attention to the qualitative and quantitative composition of eggs. These parameters allow you to assess how high a particular woman’s chance of becoming pregnant is. Antral follicle counting was developed for this purpose.

What are antral follicles?

These are follicles whose size does not exceed 8 mm. They are counted using transvaginal ultrasound. The results of their calculation make it possible to establish the ovarian reserve - the number of eggs ready for immediate fertilization.

If there are less than 4 antrals, then ovarian stimulation will be low, the probability of pregnancy is the same, so IVF is recommended. If there are about 7 of them, you can try to conceive a baby on your own.

When their number ranges from 18 to 26, then the possibility of successful conception is the highest.

If there are more than 26 of them, then there is a possibility of developing polycystic ovary syndrome.

What does it mean if many follicles are detected in the ovary?

This pathology can be triggered by taking hormonal contraceptives, increased prolactin, stress, sudden weight loss, obesity, endocrine disorders. This means that pregnancy due to the disease is unlikely, as it is accompanied by many sexual dysfunctions.

This pathology is called polycystic disease, but it has nothing to do with the growth of cysts. IN mandatory a woman must undergo a comprehensive diagnosis. Once the diagnosis is confirmed, treatment begins.

Therapy is aimed at achieving the following results:

• decreased levels of male hormones;
• normalization of the cycle if it is disrupted;
• pregnancy (if necessary);
• prevention of metabolism.

Therapy may include low calorie diet, hormonal drugs, metaphormin, antiandrogens, ovulation-stimulating agents.

The size and number of follicles play an important role in conception, as they are a reflection of a woman’s ability to give birth, become pregnant and carry a child. The article talks about what causes premature ovarian failure and what it means, what treatment is necessary and how to give birth to children if there are no follicles on ultrasound.

By the time of the first menstruation, more than 300 thousand follicles are found in the ovaries of girls. During life before the onset of menopause, every monthly cycle accompanied by their death after ovulation. If a woman detects, usually in the middle of the cycle, discharge from the genital tract like egg white or clear mucus, this means that the dominant follicle has burst and ovulation has occurred.

From total number only 0.1% of follicles ovulate, the remaining 99.9% shrink. If the dominant follicle, which has stopped developing, begins to decrease without reaching mature size, then the cycle is called anovulatory, i.e. ovulation has not occurred and conception is impossible this month.

Estrogen, progesterone and male sex hormones in minimal quantities are responsible for the functioning of the ovaries. Hormonal disorders impair reproductive function: follicular apparatus becomes exhausted, menstruation ends, and conception becomes impossible.

Typically, the dominant follicle develops in one ovary. If two follicles develop simultaneously in two ovaries, then the chances of conceiving twins increase by 2 times, but this requires that they reach their peak development and burst at the same time.

The number of follicles is normal

The menstrual cycle is accompanied by hormonal changes, therefore the number of follicles in the ovary depends on a specific day:

• on the 5th day of the cycle – up to 10 follicles ranging in size from 2 to 6 mm;
• from 7 to 9 days of the cycle - from 10 to 20 follicles, one of which (dominant) is up to 15 mm in size, the rest are half as large;
• from 11 to 14 days of the cycle - the dominant follicle can reach 25 mm.

Giving a child life becomes possible if there are more than 7-16 follicles. If there are 4-6 of them, then there is little chance. If there are less than 4 or none at all, then natural conception is almost impossible. In the latter case, it is recommended to do IVF, look for a surrogate mother or donor eggs, if the treatment hormonal drugs did not produce results. If a woman has undergone IVF, pregnancy usually occurs successfully and is closely monitored by a doctor.

Not all females ovulate on days 14-16. Depending on the characteristics of the body and the number of days in the cycle, the growth of the dominant follicle can vary greatly from day to day. For example, if the cycle is 40 days, then ovulation with high probability will happen on the 20th. Accordingly, on the 14th day of the cycle, the follicles in the ovaries will be smaller.

To track ovulation, the doctor prescribes folliculometry - counting the number and size of follicles.

Reasons for the absence of follicles in the ovaries

After age 45, the disappearance of follicles is a natural process called menopause. Reproductive abilities for pregnancy gradually decrease until they disappear completely, hormonal function subsides, then menstruation stops against the background of progressive depletion of follicular function.

The term “premature menopause (menopause)” is being replaced by “premature ovarian failure,” although the essence of the disease remains common.

Causes of premature ovarian failure (this is complete absence follicles or eggs that do not respond to hormonal stimuli) in reproductive age the following:

• genetics;
• autoimmune disorders;
• viral infections;
• toxins;
• starvation, unhealthy diet;
• excessive smoking;
• alcohol consumption;
• chemotherapy;
• radiotherapy;
• on the pelvic organs;
• incorrectly administered hormonal therapy.

Because of close connection female sex hormones with the nervous system, the absence of follicles on ultrasound may be a temporary phenomenon caused by stressful situations, depression, excessive loads. Usually the next cycle is restored and continues to operate as usual. In other cases, treatment with hormonal drugs - prerequisite to maintain health and the ability to conceive a child.

Treatment is necessary for those women whose failure is caused by endocrine diseases, severe fluctuations in weight, unsuccessful use of contraceptives.

What to do if there are no follicles

First, you need to make sure that the doctor who made the diagnosis is competent. It is advisable to contact another specialist and do a repeat ultrasound on a different device in the next cycle.

Before you panic, you should start treating the disease from specialists and at the same time take advantage of the opportunities to solve the problem:

1. Normalize your lifestyle: quit smoking, give up alcohol, exercise physical activity in reasonable quantities, maintain the regime.
2. Adjust your diet: give up salty, fatty, spicy foods. Reduce consumption of citrus fruits, pineapples, pears, cabbage, rice. Legumes, vegetables, pomegranates and apples have positive influence for ovulation.
3. Use traditional methods: sage, plantain, aloe stimulate ovulation.
4. Inhale vapors essential oils: sage, basil, cypress, anise.
5. Consult a specialist about vitamin therapy. Folic acid and vitamin E effectively combat insufficient ovarian activity.
6. Treat viral infections, including STIs.
7. Eliminate psycho-emotional stress, stress, and, if necessary, use sedatives nervous system(valerian, glycine, etc.)

It happens that the above methods are sufficient to normalize the functioning of the ovaries and improve well-being, but the main way to solve the problem is to see a doctor and undergo hormonal therapy under strict control.

Depending on the reason that caused the dysfunction, normalize the work female organs eliminating it will help. For example, if the disappearance of follicles occurred due to a sudden weight gain, then its normalization is sufficient for recovery.

Before use additional ways Solving the problem requires consultation with a specialist.

Diagnostics

To make a diagnosis, it is necessary to conduct a number of studies:

1. Examination by a gynecologist. It is important to describe in detail how you feel, symptoms, first signs, previous diseases, operations, etc.
2. Data about the menstrual cycle. It is necessary to indicate the duration of the cycle, regularity, features of discharge, etc.
3. Blood test for the hormones FSH, TSH, LH, AMH, estradiol, prolactin.
4. Smear for flora and STDs.
5. Ultrasound of the pelvis with detailed characteristics conditions .
6. Mammography.
7. Analysis for oncocytology, tumor markers.

Treatment

Therapy is selected based on the cause of the dysfunction. Most often used following methods treatment:

1. HRT (artificial normalization of sex hormones using drugs).
2. Physiotherapy (ultrasound, electrophoresis, etc.)

Before prescribing HRT, the specialist must inform the patient about side effects, contraindications, positive changes. It is appropriate to prescribe HRT only after hormonal studies, otherwise the doctor’s competence should cause mistrust.

If there are contraindications, the patient is prescribed homeopathic remedies and phytoestrogens.

Traditional treatment methods

Means traditional medicine It is allowed to use only after consultation with a doctor, otherwise the body’s condition may deteriorate irreversibly due to serious complications.

After receiving permission from your attending physician, you can use the following: healthy recipes traditional medicine:

1. Cabbage juice. Drink 0.5 cups per day on an empty stomach.
2. Beet juice. Dilute cold water, take 1 tbsp. l. 1 ruble/day.
3. Decoction of boron uterus. Add 1 tbsp to 300 ml of water. l. herbs, cook for 10 minutes. Infuse and take 1 tbsp. l. up to 5 rubles/day for 3 weeks, then take a break for a week.
4. A decoction of lungwort, licorice root, calamus, horsetail or aralia (any mixture of your choice). Add 2 tbsp to 2.5 cups of boiling water. l. plants, drink 100 ml. 3 rubles/day before meals.

Correctly selected hormonal therapy together with other methods gives positive results: hormonal background normalizes, the patient develops follicles. There is a chance to get pregnant naturally, without resorting to artificial insemination, donors and surrogates.

Normalization of lifestyle, stable psycho-emotional state and good mood have a powerful effect in the fight against disease. Having achieved the appearance of at least 4 follicles in the ovary with the help of treatment, a woman has a chance to become a happy mother of a child born naturally.

Conception occurs due to ovulation. It is provided by one leading follicle, in the depths of which the egg matures. If there is no dominant follicle for several cycles, this indicates infertility.

How the “dominant” develops, why in some cases it does not exist, read our article.

A certain number of eggs are laid in the ovaries of each girl during the period of intrauterine development. Before puberty, they are in a “dormant” state, and with the onset of the menstrual cycle they begin to function.

The growth and death of the follicles in which the egg develops occurs monthly. In this case, follicular development goes through several stages.

At the beginning of the cycle, the growth of several follicles begins, which are of the same size. However, around the 9th day of the cycle, a leader begins to clearly stand out among them: a follicle that is significantly larger than the others in size (it is also called the Graafian vesicle). Its diameter can reach 15 mm. From the moment the dominant is isolated, the remaining follicles begin to regress, that is, decrease in size and gradually die.

Approximately on the 14th day of the cycle, the dominant reaches its maximum sizes(from 18 to 24 mm) and ruptures, “releasing” a mature egg. Ovulation occurs.

At the site of the bursting dominant follicle, a corpus luteum. Its task is, in case of successful conception, to supply the woman’s body with the hormone progesterone necessary for pregnancy.

A dominant can develop on any ovary. Although most often it is observed on the right. There are frequent cases of the development of a dominant follicle on both ovaries. This mainly occurs after stimulation of ovulation or when artificial insemination. In this case, the chances of conceiving twins or triplets are high. If an ultrasound reveals that there is no dominant follicle in a woman’s ovaries, ovulation, and therefore conception, cannot occur.

Additional examinations

Anovulatory cycles, when the dominant does not develop, occur several times a year in each healthy woman. Similar phenomenon is not pathological. During these periods, the ovaries “rest”.

In addition, after 30 years there is a slow but steady increase in anovulatory cycles. Early menopause, occurring before the age of 45, also guarantees frequent anovulatory cycles. Despite the fact that women at this age rarely plan pregnancy, gynecologists believe that these deviations cannot be ignored and prescribe appropriate hormone therapy.

If such disorders are recorded in young women childbearing age monthly, this indicates pathological changes that require mandatory treatment.

Why the follicle does not grow or is not able to “release” a mature egg at the time of ovulation, only the attending physician can answer after a series of studies:

• Examination on a gynecological chair;
• Blood test to determine levels important hormones on different stages menstrual cycle;
• Folliculometry is an ultrasound diagnostic procedure during which the entire process of ovarian function during the menstrual cycle is monitored monthly.

The gynecologist also pays attention to the length of the menstrual cycle. Too big or short cycle often indicates an ovulation disorder.

Most often, the absence of a dominant is associated with hormonal imbalance. Per process proper development follicles are influenced by several hormones: luteotropic, follicle-stimulating, estrogen and progesterone. Each of these hormones is important at a certain stage of egg maturation. Their insufficient quantity or incorrect distribution leads to problems with the maturation of the dominant.

How does the follicle behave?

There are several reasons why there is no dominant follicle or its development is pathologically altered. But in any case, with these disorders, ovulation does not occur. Let's consider exactly how the “wrong” follicle can behave.

Persistence

If a woman has a lack of LH or progesterone, it develops instead of the dominant one.

The development of the follicle reaches the size required for ovulation, but it cannot rupture, releasing the egg. Therefore, she remains in his body.

A characteristic feature of persistence is the ability of the dominant to remain on the ovary throughout the entire period of the menstrual cycle. Moreover, it is often recorded even after the end of menstruation.

Signs of the development of a persistent follicle:

• The corpus luteum is absent;
• The amount of estrogen is increased;
• The amount of progesterone is reduced;
• Lack of fluid behind the uterine cavity.

"Sleeping" ovaries

The follicles do not mature, they do not grow at all, so ovulation cannot occur.

Follicular growth disorder

In this case, they mature poorly, and stopping at a certain phase of development, they begin to regress. Or the dominant develops successfully, but does not reach required sizes to the ovulation phase. A blood test for hormones will be normal.

Ovarian cyst

If the dominant follicle continues to grow without releasing an egg, it will give rise to a follicular cyst. This benign education appears if there is no ovulation. The reason for this pathological change is hormonal imbalance, which most often occurs due to dysfunction of the cerebral cortex. On appearance follicular cyst The following factors also influence:

• Poor nutrition;
• Chronic diseases;
• Irregular intimate relationships;
• Mental disorders;
• Frequent abortions;
• Surgical intervention for diseases of the genitourinary area.

A follicular cyst can affect the regularity and duration of the menstrual cycle.

A cyst-like change may also appear at the site of formation of the corpus luteum. After a follicle bursts, liquid always remains. If its amount exceeds the norm or contains blood, a cyst appears on the corpus luteum.

In most cases, such cystic changes do not require special treatment. They disappear on their own after 2-3 cycles, and if conception occurs, by the beginning of the second trimester.

What treatment is prescribed if there is no dominant

Problems of missing dominant follicles most often affect women who are diagnosed with inflammatory diseases genitourinary area. Prolonged stress And depressive states, abortions also lead to impaired maturation of the dominant follicle.

What to do to restore correct work ovaries, the gynecologist will tell you after complex diagnostics, which we talked about above. Hormone therapy is most often prescribed.

Gynecologists often prescribe. This drug is popular in Russia, but it should be used with great caution and only under the supervision of the attending physician: medicine has many contraindications. In addition, some patients are strictly prohibited from using it.

It should be remembered that any potent hormonal drugs with uncontrolled use may harm your health rather than help. Therefore, self-medication in this case is unacceptable.

To maintain reproductive system also make an appointment folic acid and multivitamins. In this case, the selection of drugs and dosage is selected individually, depending on age and general condition woman's health.

At a consultation with a gynecologist

Obstetrician-gynecologist Elena Artemyeva answers patients’ questions.

—I am 24 years old. I have never been pregnant. Menstruation is scanty, cycle is 20 days. I took Cyclodinone for four months (prescribed by a doctor), my cycle became longer. But now at the end of the cycle I feel very unwell. An ultrasound scan of the ovaries did not show dominant follicles. How to cure it? Is it necessary to take hormones? I'm afraid of gaining weight due to hormonal treatment.

- You need to undergo an in-depth examination. You will have to donate blood for hormones twice: on the fifth-seventh and twentieth-twenty-third days of the cycle. Your gynecologist will tell you which specific hormones to test for. Be sure to visit an endocrinologist and undergo an examination to rule out pathologies of the thyroid gland and pituitary gland. You may need to do an MRI of the brain.

Depending on the results, treatment will be prescribed. You may need stimulation with hormonal drugs for the growth of dominant follicles and ovulation. In most cases they do not cause sharp increase weight, don't worry.

— I took Regulon for four years, I stopped it six months ago. Pregnancy does not occur. The cycle is 34-36 days. The ultrasound did not show a dominant follicle or corpus luteum. Can I get pregnant?

- Normal after oral contraceptives Ovulation is restored within 2-4 months. Your case is not the norm. You need to contact an endocrinologist or, better yet, a gynecologist-endocrinologist and examine your hormonal profile, in particular, you need tests for insulin, prolactin, TSH, as well as “female” hormones. After the examination, you will be prescribed treatment. Will you be able to get pregnant? Why not, if ovulation is restored and normal cycle? In most cases, hormonal imbalances can be corrected.

“I haven’t been able to get pregnant for two years.” Could it be that the follicle first grew to 8 mm (on the 7th day of the cycle), and then, on the 11th day of the cycle, became smaller - 6 mm. This is the result of my folliculometry...

- This is a sign of ovarian dysfunction. Get tested for hormones (sex, thyroid, insulin, prolactin). Depending on the results, you will be prescribed treatment. It is also important for the husband to be examined (in general, examination of a couple always begins with confirmation of the man’s fertility). Let him do a spermogram.

A follicle is a structural component of the female reproductive gland, consisting of an egg and its surrounding tissues.

Its persistence appears when the rupture of the capsule is not detected and the egg is not able to enter the uterine cavity. The dominant follicle is the one that will very soon ensure the release of the egg into the uterine cavity.

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Knowing information about what a follicle is helps to plan a pregnancy and detect problems associated with conception.

In the female body, unique processes of follicle maturation occur. They are laid during the period embryonic development. Their approximate number in the womb is approximately 500 thousand.

By the beginning of puberty, their number decreases to 40 thousand, but not all of them fully mature. Throughout reproductive period 500 unique sacs with eggs mature. The rest gradually become atretic, that is, they fade away.

The process of their ripening is extremely complex from a biological point of view. It is influenced by a huge number of factors. It starts in the first phase female cycle. In order for this process to occur normally, the presence of follicle-stimulating hormone is required.

At one time, about 10 sacs with oocytes mature, but only one of them will be dominant. An egg will be released on the 14th day.

Approximately on the 7th day of the cycle, using ultrasound, it is possible to visualize the process of growth of the oocyte capsule. The size of each is several millimeters.

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Daily ultrasound determines further growth. Reaching 2 cm in diameter, the follicle bursts, sex cell is released and enters fallopian tube. In a normal monthly cycle, this occurs on days 13-15. This may be accompanied by the following symptoms:

• some tenderness in the lower abdomen;
• the amount of mucus from the female genital organs increases;
• basal temperature drops;
• an increase in the amount of luteinizing hormone in the blood.

In one monthly cycle, one follicle matures in the female body. Rarely there are 2 of them, which is not considered a pathology. Moreover, the release of several eggs significantly increases the chances of getting pregnant.

Species

The following types of follicles are distinguished:

• primordial;
• primary;
• secondary;
• tertiary

Primordial are otherwise called resting. They are localized in the subcapsular zone. They are the smallest. Cells have a flat structure.

The primary ones are otherwise awakened. They are slightly larger than the primordial ones. Around the egg there is a membrane formed by protein substances.

Secondary follicles have several large size. They have stratified epithelium and several small chambers filled with fluid. Around it grows a membrane inside the ovary - the theca. It appears in the ovary earlier than the theca and it is by it that the secondary capsule is identified.

Finally, the tertiary follicle (or Graafian vesicle) is mature. He has reached his greatest development. It begins to put pressure on the surface of the ovary. Its predominant volume is occupied by a cavity (capsule) filled with fluid and containing an oocyte. Surrounded by theca.

What is a persistent follicle?

A persistent follicle develops when the capsule does not rupture. The egg then remains in her because it does not enter the uterine cavity.

This process is pathological because in the presence of persistence, fertilization cannot occur. A woman experiences difficulties with the onset of gestation.

The capsule can exist in the ovary for about 10 days. After this period ends, a new menstruation begins. In some cases, a woman experiences a delay, and it can even last up to one and a half months.

Ovarian capsules dissolve on their own without taking additional medications. Sometimes an ovarian cyst develops and requires treatment.

In the blood of women with persistent ovarian capsules, the amount of estrogen increases and the level of progesterone decreases. Signs of ovulation disappear because the corpus luteum moves into the so-called posterior uterine space.

If ovarian capsules exist long time, then there are delays in the monthly cycle. When menstruation appears, it is released large number blood.

Pay attention! Reproductive activity is related to the balance of hormones. Due to the fact that hormonal levels are disrupted, persistence develops.

If a persistent follicle is detected, pregnancy can be planned only under the supervision of a doctor. To do this, the gynecologist determines the dominant capsule. This is possible with the help of ultrasound examination.

It is done on the eighth day of the cycle. On day 12, the most suitable conditions for conception are created. For this, another ultrasound is prescribed.

The third examination is scheduled for the 18th day. The specialist checks for ovulation. A woman should carefully monitor the condition of her body. After 10 days, a pregnancy test is allowed.

What is a dominant follicle?

Every month, several capsules containing eggs increase in the ovary. Then their growth stops, only one or very rarely two continue to increase. He is dominant. The rest are gradually regressing.

Every day the size of the dominant follicle grows by several millimeters. On the eve of ovulation, it reaches a size of up to 18 - 20 mm. Under these conditions, an oocyte emerges from it, completely ready to receive a sperm and form a zygote.

On ultrasound, the dominant follicle can be seen from the fifth day. It is less often seen on the eighth day. At this time, it is significantly superior to other bags.

This growth is due active influence follyl-stimulating hormone. If there is not enough of it in the blood, then it does not reach the required values ​​and even decreases. In this case, an ovarian cyst develops. After ovulation, the corpus luteum grows in the ovary.

Interesting! The dominant follicle is most often found in the right ovary. Today it is not known exactly what causes this phenomenon. Often the corpus luteum can be found just in the right ovary. It is assumed that the phenomenon in question occurs due to the activation of the nervous system.

Norms

How many follicles should there be in an ovary?

The number of all sleeping oocytes is laid down by nature at the stage of embryonic development. It is characteristic that before the onset of puberty it decreases significantly. One egg is released every month.

The number of capsules with oocytes is determined by the day of the cycle. There may be several of them just a few days after your period. On the fifth day there can be up to 10 of them, and this is also the norm. After all, only one follicle will be dominant.

Deviations

In the absence of a dominant follicle, the egg is not released. This happens as a result of hormonal imbalance and certain pathologies:

• decreased production of follicle-stimulating hormone and increased excretion of luteinizing hormone;
• regression due to hormonal disorders(including due to an increase in insulin levels);
• the presence of a persistent process;
• the presence of an overripe pouch;
• formation of a follicular cyst that grows in place of the dominant follicle (size exceeds 2.5 cm during ultrasound examination);
• polycystic ovary syndrome;
• pathological luteinization, when without ovulation the corpus luteum grows at the site of dominance.

Pay attention! If persistence occurs, the follicular membrane ruptures. The egg can be released into abdominal cavity. Pregnancy does not occur in these cases.

All ovarian development disorders require careful instrumental examination. Doctors prescribe tests of a woman’s hormonal levels, since the cause of deviations may be pituitary gland dysfunction and endocrine diseases.

Increased quantity

If the ovaries have more than 10 follicles, they are called multifollicular. There is also polyfollicularity, that is, when an ultrasound reveals a significant number of vesicles. When their number increases several times, the diagnosis of “polycystic disease” is determined.

If the follicular elements are scattered throughout the periphery of the ovary, they become crowded. This interferes with dominance and all processes that promote conception.

This pathology develops due to stress and goes away after a short time. Treatment of the problem is carried out if:

• multifollicularity is caused by problems with the functioning of the endocrine glands;
• there is a sharp weight loss or weight gain;
• there were failures in the choice of oral contraceptives.

Insufficient quantity

Follicular insufficiency is caused by hormonal problems. You can find out the problem with an ultrasound on the seventh day. If there are less than 6, then the probability of conception is negligible. Finally, if there are less than 4 of them, then pregnancy practically does not occur.

In some cases, women have no follicles at all. About problems with female body signals the complete absence of menstruation. If they are absent for more than 3 weeks, you need to urgently visit a gynecologist.

Why does the follicle not mature?

It may not ripen due to the following reasons:

• dysfunction of the female reproductive glands;
• disorders of the functionality of the endocrine system;
• tumors of the pituitary gland, hypothalamus;
• inflammatory pathologies of the pelvis;
• stress, nervous instability or depression;
• early onset of menopause.

In these situations, there may be no follicles in the ovaries at all. It often happens that it does not reach sufficient size for an egg to be released.

Follicle growth chart - size by day

The pattern of its growth can be clearly presented in the form of a table.

Stages of development

During its development, the follicle goes through several stages (phases).

Early phase

Several follicles are growing. After one of them (dominant) reaches 24 mm in diameter, ovulation occurs.

Luteal phase

The period between ovulation and the start of a new cycle is called the luteal phase (or corpus luteum phase). After the graafian bubble bursts, it begins to accumulate fats and pigments. This is how the corpus luteum develops. It produces progesterone, androgens, esradiol.

These substances activate the maturation of the endometrium. The uterus is preparing for the implantation of a fertilized oocyte. If pregnancy occurs, the corpus luteum continues to secrete progesterone until the placenta reaches a certain size and begins to produce it itself.

If pregnancy does not occur, the corpus luteum is destroyed. The levels of estrogen and progesterone gradually decrease, which contributes to the start of a new monthly cycle.

More about the antral glands

These are glands that are highly likely to develop into a primordial follicle. In the future, it has the potential to evolve into a dominant one, from which an egg will then be released.

Potentially, all antral glands have a chance to mature into a full-fledged oocyte. But there can be no more than 500 of these in a woman’s entire life. By the age of 50, a woman’s monthly cycle gradually fades away and reproductive function ceases.

What does an ultrasound show?

Capsules with eggs can be easily detected on the screen during ultrasound diagnostics from the fifth day of the cycle. In the future, their dimensions increase. On the 7th day of the cycle, you can see which of them is dominant.

Upon examination, empty follicle syndrome can be detected. This means that the ovary is not able to provide the release of the sex gland. Such a woman needs to get rid of infertility.

Ultrasound is completely safe for the body.

Frequently asked questions

How many days does a follicle mature?

This process lasts only 9 days (plus or minus one). Provided that the woman’s hormonal background is stable, ovulation occurs on the 14th day of the cycle.

What could go wrong

With a hormonal disorder, there may be too many follicles in the ovary or, conversely, too few. Sometimes there is no sex gland at all.

All these phenomena have a negative impact on reproductive function women.

If the size does not correspond to the standards

The shrinkage of the follicle on the day of ovulation leads to the fact that the egg cannot be released from it. The woman will not be able to get pregnant. An increase in the graphite bubble indicates high probability cystic process. It also has a negative effect on conception.

If the follicle does not burst

In this case, they talk about its persistence. This phenomenon is considered pathological and requires correction.

Where do twins come from?

Fraternal twins occur when not one, but two eggs are released from the ovary.

Interesting! There are known facts when twins were born from two men. This occurs if a woman has had sexual intercourse with different men, and the fusion of the egg and sperm occurred on different days.

The follicle is the most important structural element of the ovary. The likelihood of an egg being released and a woman’s chances of becoming pregnant depend on their number and development. The discrepancy between its size and quantity and the norm is a pathology. Such women should be treated for infertility.

Monastic collection helps with such diseases and conditions

1. Diseases of the uterus (fibroids, erosion, endometritis, bends and prolapses of the uterus);
2. ovarian cysts, inflammation of the appendages;
3. thrush and unpleasant odor;
4. pain during sex;
5. infertility;
6. discomfort when urinating.

Folliculogenesis is a cyclic process that occurs in the ovaries under the control of the nervous and endocrine systems. Its main mechanism is the transformation and transformation of the follicle into a mature egg.

The main stage of folliculogenesis is the formation of a dominant (main) follicle.

The dominant follicle is formed through sequential stages:

The beginning of the formation of many small ones,

Growth and development of small follicles,

Maturation of the dominant follicle,

Ovulation.

We can say that a mature dominant follicle is an egg that must ovulate. Thus, it becomes clear that in the presence of all the above stages of follicle formation, ovulation ultimately occurs, i.e. pregnancy is possible.

The formation of small follicles begins from the first days of the menstrual cycle. However, their growth begins only in the hormone-dependent stage, which occurs immediately after the end of the luteal phase. At the same time, the amount of estradiol and progesterone decreases, but the amount of follicle-stimulating hormone (FSH) increases.

It should be noted that on dominant follicle There are many factors that can lead to his death. However, it is designed in such a way that all its processes are aimed at preserving the egg and its fertilization. Therefore, the dominant follicle is “protected” by epidermal growth factor and transforming growth factor (TGF).

5-7 days after the onset of menarchy, small follicles begin to form. They are also called tertiary or antral. There are quite a large number of them - about 10 pieces. This phase of folliculogenesis is called early proliferation or the beginning of the formation of small follicles. The diameter of these small formations does not exceed 5 mm. They are located in the form of “beads” along the periphery of the ovary. Over time, some of the follicles increase in size and gain strength.

Consequently, the dominant follicle is formed after approximately 10 days of the menstrual cycle, and at this time its size reaches 15 millimeters. Other follicles that fail to gain the required mass regress and die. As a result, we can conclude that there may be more than one dominant follicle. When two or more eggs mature and are subsequently fertilized, a multiple pregnancy develops. This process does not occur often, but such cases have been recorded. Most often this is an iatrogenic cause: medicines hormone-based, or IVF. But it is not excluded physiological reason birth of twins and triplets.

By the immediate moment of ovulation, the dominant follicle should reach a diameter of about 20 millimeters (maybe more). In place of the follicle, a slightly smaller corpus luteum should form than its predecessor.

If fertilization does not occur, then within a week after the egg leaves the ovary, the corpus luteum begins to decrease in size - it regresses. By the time of rejection, the endothelium of the uterus, as a rule, dies, and in its place only an area of ​​impaired echogenicity may remain.

Speaking about folliculogenesis, one cannot help but dwell on the concept of “persistent follicle”.

It is customary to call persistent a follicle that goes through all stages of folliculogenesis, except for immediate ovulation. What reasons may lead to this phenomenon are not fully understood. However, doctors often accept persistence as a variant of the norm, unless, of course, it is constantly recurring.

Sometimes it happens that a persistent follicle turns into a small ovarian cyst. Patients who develop a cyst need to be monitored. If this process does not cause complaints, then treatment is not required.

As a rule, persistent follicles rupture, but it is almost impossible to get pregnant in this situation, because the endometrium of the uterus is too thin for implantation.