In the female reproductive system, there are cells that allow embryos to be conceived, called follicles, and they are located in the ovaries. If a deviation from the established norm is found, this indicates that pathology is developing, as a result, infertility may occur.

The concept of follicles and their functions

The luteal and follicular phases make up the entire ovarian cycle. For us, only the follicular cycle is of interest. The finished egg is enveloped by a pair of balls of connective tissue, as well as a ball of epithelial cells, and it is part of the follicle. Full protection of the egg will guarantee the ability to conceive and bear a healthy baby. That is why the main task of the follicular cycle is the reliable preservation of the egg and its protection from external negative factors. The maturation period of one such egg is 28 - 30 days.

Important! Each ovary contains a follicle containing an incompletely matured egg. Only after fertilization does it mature to the end.

The hormone estrogen is also produced only during the follicular cycle. These cells form in women throughout their lives. Only 0.01% survive the ovulation period, the rest die. According to statistics, only a few cells are prone to ovulation.

Role of dominant follicles

A mature and large enough follicle that provides full protection of the egg ready for fertilization is called dominant. Its size can reach a couple of centimeters just before ovulation. Most often it is located in the right ovary.

The process of ovulation occurs at a time when, under the influence of hormones, the dominant cell reaches its maximum size and ruptures. The finished egg is sent to the tubes of the uterus. Ovulation does not occur if the dominant cell remains immature.

Attention! It also happens that the dominant follicles mature in both ovaries at once. Such cases are very rare. This should not be a cause for concern. The simultaneous maturation of dominant formations suggests that during the period of ovulation, a woman has every chance of conceiving two embryos.

Common deviations from the norm

Deviated cells in the ovary, this is when there are more than 10. In medicine, several terms are used when diagnosing abnormalities, these are "multifollicular" and "follicular ovaries". Before making this diagnosis, a woman must undergo an examination and do an ultrasound.

Having heard such a diagnosis, you should not be upset and think that this is an indicator of infertility. Multifollicular ovaries may be after nervous breakdowns, constant stress or overwork. In such a situation, you do not need to panic and you should not take any medications. Having eliminated the reason that caused such a diagnosis, by the next period of ovulation, normalization of cells in the ovaries can be expected.

Factors that provoke deviations from the norm:

• improperly selected contraceptives;
• problems with work thyroid gland;
• after a period of feeding the baby (excess prolactin in the body);
• the endocrine system is not working properly.

Attention! How to deal with this situation? After examination by a specialist and confirmation of the diagnosis, a method of treatment is prescribed, which is followed relentlessly. With the wrong treatment, infertility develops, so you cannot start it.

There are two types of menstrual cycle and they pass depending on the number of dominant follicles.

Types of the menstrual cycle:

• normal;
• cycle with deviations, in the absence of a mature dominant follicle.

With a large accumulation of hormones and multifolliculosis, infertility develops.

No bursting dominants

There are times when fully developed and matured dominant follicle does not burst during ovulation. In such a situation, fertilization does not happen, since the egg does not come out. The medical name for this condition is persistent follicle. The menstrual cycle begins a week after the dominant follicle does not burst in the left ovary. If this situation is repeated in the left ovary, then over time a cyst may form there.

At what stage of folliculosis the specialist can tell only by the results ultrasound examination.

Complete absence of follicles

The complete absence of follicles in the ovaries can occur after early menopause or dysfunction. For doctors, it is very difficult, if even impossible, to restore the follicles in the body. Most often, in such a situation, the gynecologist prescribes hormone treatment.

Failure of the menstrual cycle will be the first signal that follicles are missing. A gynecologist is consulted if within 30-35 days menstrual cycle does not bounce back.

Folliculosis is not always a problem, but the complete absence of follicles suggests that you should immediately undergo treatment.

What are antral glands

Oocytes have been extensively researched since artificial insemination became widespread. Thanks to research, leading gynecologists have been able to figure out why some women can easily give birth to a child, while others suffer from infertility. That is why scientists have taken control of the antral follicles. What is it?

Follicles up to 8 mm in size are called antral follicles. On ultrasound, you can see how many reserve eggs have collected for further fertilization. With small antral follicles, the likelihood of positive fertilization is very low. If the size of the antrum reaches 5 mm, then stimulation by the gynecologist is required for conception. If the size is more than 5 mm, the woman does not need stimulation. During pregnancy, follicular development stops.

What is polycystic ovary disease?

Various factors affect the number of cells in the ovaries. Their increase can be influenced, and this is far from uncommon in our time. With a detailed study, the gynecologist can tell why exactly there was an excess of cells in the body. In medicine, this phenomenon is called polycystic disease.

Depending on the cause of polycystic disease, methods of its treatment are chosen.

The goals of polycystic disease treatment:

• reduced male hormone in a woman's body. There is no increase in cells to dominant, in the presence of excess testosterone;
• violation and restoration of menstruation;
• voluntary fertilization. In order to conceive a child on your own, it is necessary to normalize the growth of follicles in female body;
• normalization of food metabolism.

During treatment, specialists may prescribe hormone therapy, diet or surgery.

The excess or shortage of cells does not play a role, it is always necessary to bring them back to normal. You should not self-medicate and if you find a problem, you should immediately consult a doctor.

The female reproductive system is a very complex and harmonious "structure". There can be nothing accidental in it. In order for a woman to be ready to conceive a child at any time of the year, nature created ovulation. This is the name of the process when the egg is released from the ovary. The role of the follicle in this process should not be underestimated. After all, it is the follicle that is the place where the egg appears and matures.

The outer layer of the ovaries contains many follicular cells. During each ovulation, some of them grow and develop. Soon, the dominant follicle of the right ovary becomes distinguishable (it is larger than its "brothers"). The lot of the rest of the cells becomes atresia - the reverse development.

The dominant follicle grows rapidly and eventually bursts, releasing a mature egg. If the sperm fertilizes this egg, conception will occur.

How it develops

It is known that folliculogenesis (the process when a follicle develops from an “embryonic” stage to a preovulatory stage) can only be in a sexually mature girl. At the beginning of the menstrual cycle, it is impossible to predict which follicle will become dominant (recall that the first day of the cycle is the day a woman starts her period, and the last day is the one that precedes menstruation). Consider what happens to a woman's ovaries before ovulation:

• On the fifth - seventh day of the cycle, without exception, all follicular cells are small (their diameter is about five millimeters). They are surrounded by a connective shell.
• On the eighth - tenth day of the cycle, the dominant follicle is already clearly distinguishable. Its size is about thirteen to fifteen millimeters. An egg cell will develop inside this formation. Such a "leading" follicle often appears in the right sex gland in women. But it can also form in the left ovary.
• The eleventh - thirteenth days are the period of active growth of the dominant follicle. This "house" for the egg can grow by several millimeters per day. And other follicular cells shrink and soon disappear.
• On the fourteenth - sixteenth day of the cycle, ovulation occurs. By this time, the size of the "champion" is about twenty millimeters in diameter (and sometimes more). Then the follicle bursts, the egg comes out of it.
• A follicle that has “released” its contents begins to change. Soon, a corpus luteum appears in its place. And in the space behind the uterus, a small amount of fluid appears.

Nature's Wise Strategy

It would be wrong to think that follicular cells appear in adult daughters of Eve "out of thin air." The girl's reproductive system begins to develop even before the baby itself is born. A constant number of follicular cells in the ovaries is established. It ranges from fifty to two hundred thousand. For an adult lady, it is impossible to increase this supply.

It is easy to guess that during a woman's life, not all the follicles that nature gave her will have time to mature. Therefore, some of these cells are absorbed even in infancy. This process stops at two years, and will resume again in five to seven years.

When a girl begins to form into a girl, the follicular cells begin to mature. As a result, the young lady starts to have her period.

The most responsible task that nature has assigned to the follicles is to protect the eggs inside them from all unwanted influences... In addition, these cells produce the female hormone estrogen. In a month, a woman matures one follicle. Very rarely, two follicles can become dominant.

The absence of follicles can be caused by a hormonal "disruption" in the lady's body. The beginning of early menopause is not excluded - more and more often women under the age of forty become its "victims". This situation will affect menstruation (they can be delayed for a long time). For a woman who has noticed unwanted changes in well-being, it is important not to delay the visit to the gynecologist. Otherwise, her chances of becoming a mother will significantly decrease (or disappear altogether).

Ultrasound is indispensable

When a gynecologist is faced with the task of determining whether a woman can conceive a child, the possibilities of ultrasound are used. On ultrasound, the doctor observes where the dominant follicle appears, what size it reaches. This procedure is called folliculometry.

The ultrasound examination will need to be done several times. For the first time, a woman comes to the ultrasound office on the eighth to tenth day of the cycle. The main object of the specialist's observations is the dominant follicle formed in the left or in the right ovary of the lady. The next tests will take place every two days - until the moment when the onset of ovulation is confirmed.

The doctor will find out the exact time of ovulation, assess the characteristics of the corpus luteum. Special preparation for the ultrasound procedure is not required. If the transducer is looking through the abdominal tissue, you will need to fill your bladder before the procedure. And with transvaginal examination of fluid in bladder shouldn't be.

Most of the questions arise when the egg did not leave its shelter (that is, ovulation did not take place). To understand what led to such a violation, you need to continue research until the girl starts her period. It is important to determine what reasons prevented ovulation from occurring, as well as to figure out what happened to the follicle next. If it has decreased and disappeared, the situation is not too alarming. More problems a woman can deliver a persistent follicle - one that has not ovulated, but continues to develop. It is he who can become a follicular cyst.

What could have influenced the development of the "leader"

Several follicles mature in the gonads of a lady every month. One of them becomes dominant. Experts' observations confirm that such a "leading" follicle appears more often in the lady's right ovary. There is nothing strange here - in sexually mature women, the right sex gland is more active.

However, the left ovary also successfully produces "houses" with eggs. The main thing is that every month, against the background of smaller follicular cells, a large one is formed. If this follicle has released a mature egg, ovulation was successful.

Irregular periods and prolonged unsuccessful attempts to conceive are key signs that a woman is having problems with ovulation. There are several factors that block the development of the largest follicular cell:

• Oral contraceptives. Birth control medications can negatively affect follicular development. Fortunately, this effect is reversible. It is enough for a lady to give up contraceptives, and in a couple of months ovulation will be restored.
• Latent infections.
• Diseases of the thyroid gland. Situations when the functionality of the thyroid gland is reduced or increased negatively affect not only the genital area, but also the entire body of the lady.
• Excessive production of the hormone prolactin.

The listed factors can significantly reduce the reproductive capabilities of a woman. But, fortunately, many disorders in the female body can be eliminated by medicine. The main thing is to find out in a timely manner what exactly prevents ovulation.

Return to normal

When a woman has very few follicles in her gonads, this is not normal. An excessive amount of them can also cause the doctor to doubt the health of the female ovaries. If a lady does not form a dominant follicle, an egg does not mature, and her period does not go, it is obvious that violations in her genital area are serious. But in most cases, they are eliminated with correctly selected drugs.

If the examination confirms the presence of a persistent follicle in a woman, the doctor will prescribe her a course of hormones. The situation when the dominant follicle in a lady does not develop also requires competent treatment. A patient with this disorder is prescribed medications that stimulate ovulation. The effectiveness of treatment can be judged by ultrasound examinations (they will show whether a dominant follicle has appeared in one of the sex glands).

A woman's ability to become pregnant is determined by the follicles in the ovaries, their number and degree of maturity. Knowledge about the norms of physiological processes taking place during internal organs the female reproductive system, allows you to fix possible deviations in time and receive timely medical care.

Folliculus are multi-layered hollow formations around which the epithelium and connective tissues are located. They protect the site where the oocyte matures before ovulation and also affect estrogen synthesis.

Follicles in the ovaries, the norm of which is about 500 thousand, are laid at birth. They begin their growth during the girl's puberty and go through certain developmental cycles. It is an ongoing process that ends during menopause. Most of the specimens die in a certain cycle as a result of atresia. The rest goes through all stages of evolution.

There are 3 stages of growth:

• small;
• big;
• active maturation.

Each element has one female reproductive cell and follicular cells.

Follicle types

In accordance with the stage of development, elements are divided into certain types:

Development stages by day of the cycle

Maturation of elements occurs continuously. At the stages of growth, their active formation takes place.

Follicles in the ovaries, the norm of which in girls reaches about 6 million, directly depend on the maturity and health of the parents' body. Reproduction of elements occurs during intrauterine development. In the process of life, they are spent in the same amount as they were formed earlier.

There are 3 stages of development. In the first preantral stage, follicles are composed of a nucleus and epithelial cells. Before that, they are at rest. During puberty in girls, the elements move to the stage of small stature.

The elements are gradually covered with new layers and microscopic fluff. They become multi-layered and begin to secrete the female hormone estrogen. At this stage, capillaries are formed, connective tissue... The amount of fluid in the cavities begins to increase.

During this period, various diseases in childhood, stress, excitement can adversely affect the amount of folliculus.

Some of the elements die, and some pass to another stage of great growth. At this time, the egg accumulates nutrients, and a cavity with follicular fluid is also formed. The cells begin to produce large amounts of estrogen.

The third stage is the shortest. The follicle begins to mature 12 hours before ovulation and disappears 2 days after fertilization. With a successful process, cell division continues, and the maturation stage ends with the formation of a haploid set of chromosomes.

The role of the dominant follicle

The selection of the dominant follicle occurs in the third cycle of development. The element size is approximately 20 mm. It develops normally if the body is healthy, there are no pathologies.

In the fluid that fills the follicular antrum, the estrogen content increases sharply. The rise in its level causes the release of luteinizing hormone and ovulation. When there is a rupture of the wall of the dominant follicle and the release of the egg, the process of reduction division is restored.

The norm of the number of follicles in the epididymis by age

Follicles in the ovaries, the norm of the number of which serves to determine the morphological criteria of age, depend on the hormonal activity of the body. Age is an important argument for evaluating the reproductive system. The main patterns of follicular development depend on hormonal regulation of body functions.

Starting from adolescence, under the influence of hormones of the anterior lobe of the pituitary gland, cyclical changes occur in girls in the ovaries. The endocrine system controls each folliculus.

The genetically established stock of folliculus by age is:

• at the time of birth, there are 2 million immature elements;
• 11 thousand pieces are lost monthly;
• by the time of puberty, 300 - 400 thousand pieces remain;
• before the onset of age-related menopause, 1000 pieces are lost. monthly;
• by the age of 47-50, the ovarian reserve is depleted.

As a result, by the age of 45, a woman has a low probability of conceiving, despite the fact that menstrual cycles and hormonal activity of the ovaries remain.

The norm of the number of follicles during pregnancy

The follicles in the ovaries have their own rate, which is an estimate of the upcoming superovulation during fertilization.

Their number is interpreted as follows:

• less than 5 - infertility;
• 5-7 - low probability of fertility;
• 8-15 - pregnancy is possible;
• 16-30 is the norm;
• more than 30 - polyendocrine syndrome, accompanied by impaired ovarian function.

During pregnancy, the female body is not completely free of folliculus. Only those that have awakened with a dominant follicle are destroyed. The rest are dormant and awaken after the birth of the child.

The norm of the number of follicles with menopause, menopause

With the onset of menopause, there are changes in the functioning of the genitals, hormonal disruption. Follicles in the ovaries, the norm of the number of which is limited, during menopause change and decrease sharply. It is their absence that determines the decrease in estrogen levels. As the number of periods decreases, the folliculus also decreases.

With menopause, the elements significantly complicate the course of the last independent menstruation. During this period, the ovaries decrease in size and are subject to various diseases. If they began to increase, then perhaps this is caused by the development of a cyst, polycystic disease, or a malignant tumor.

It is important during this period to visit a gynecologist once every six months in order to diagnose the disease in time.

How does the size of the follicles normally change during the cycle?

At the beginning of each menstrual cycle, under the influence of follicle-stimulating hormone, new folliculus begins to develop in the ovaries.

The process of folliculogenesis with a standard cycle of 28 days is as follows:

• at the age of 5 days, the size of the antral follicles is up to 5 mm;
• on day 7, they increase at a rate of 1 mm per day;
• on the 8th day, the dominant is selected. It continues to grow at a rate of 2 mm per day and reaches sizes up to 15 mm. The rest of the folliculus regress and disappear;
• on the 14th day there is an ovulatory phase. The dominant follicle reaches a size of 24 mm, then it bursts and an egg is released from it.

The average life span of an oocyte is 12 to 24 hours.

What is folliculometry, what is it for

The technique monitors the growth and development of folliculus in the ovaries and helps determine the possibility of conception. Ultrasound examination is recommended from the eighth to the tenth day of the menstrual cycle. On the eighth day, a dominant follicle will be visible.

Ultrasound examination is performed to obtain the following information:

Repeated folliculometry is performed subject to the presence of an ultrasound of the pelvic organs, completed no later than 6 months ago.

A repeated series of ultrasound examinations is carried out in order to:

• establish the fact of ovulation;
• determine the phases of the menstrual cycle;
• find out the day of the release of the egg;
• to carry out extracorporeal fertilization;
• diagnose infertility;
• control the effects of hormonal drugs on the ovaries.

When carrying out folliculometry, attention is paid to the maturation of the follicles and the endometrium.

Disorders with abnormal development of the dominant follicle

If the development of the dominant folliculus is disturbed, ovulation does not occur, since the oocyte cannot come out. In such cases, observation and ultrasound are performed. Starting from day 10 of the cycle, the growth of the dominant folliculus is monitored. If it matures slowly, the egg cannot leave the ovary. In this case, treatment is prescribed. During the next cycle, observe the result.

Disturbances in the development of a dominant element can occur for various reasons:

Pathology in the maturation of the dominant is caused by depression, stress, nervous overstrain.

Possible deviations

Follicles in the ovaries, which may be exceeded or underestimated, may stop growing or develop to the desired size. In this case, the woman does not ovulate. The cause of the deviations is detected using ultrasound and determining the level of sex hormones in a woman.

Persistence

The pathology is caused by an imbalance of hormones, which is necessary for the regulation of the menstrual cycle.

Persistence can be recognized by the following symptoms:

• underestimated level of progesterone in the blood;
• increased estrogen levels;
• the dominant follicle has existed for a long time;
• there is no luteal phase of the menstrual cycle;
• there is no corpus luteum and fluid in the posterior space.

The therapy is aimed at normalizing hormonal levels. Doctors prescribe drugs that lower estrogen levels in the follicular phase and increase progesterone levels in the luteal phase of the menstrual cycle.

Exceeding the size norm

Excessively oversized follicles may indicate a cyst. A mass is a cavity filled with fluid, sometimes with blood or pus. In this case, the folliculus diameter exceeds the norm and becomes more than 30 mm. In this case, it is necessary to perform a puncture and suction of the follicles.

Pathology causes disruptions in the menstrual cycle and painful symptoms in the lower abdomen.

Absence

The temporary absence of folliculus is mainly associated with psychological state women. As soon as the body recovers, the elements are formed again.

Failures can be caused by the following factors:

• improperly selected contraceptives;
• endocrine diseases;
• a sharp change in weight up or down.

The disappearance of folliculus over the age of 45 is a natural process, since menopause occurs.

Regulation of the follicle maturation process

The main goal of therapy is to restore a normal menstrual cycle and relieve a woman of infertility. The result can be achieved by stimulating ovulation, reducing or increasing the number of antral follicles.

Stimulating ovulation

Stimulation of ovulation is carried out after passing comprehensive diagnostics, aimed at detecting the causes of pathologies in the menstrual cycle. Anti-estrogen drugs are prescribed to stimulate the production of estradiol and the growth of follicles.

Prevention of cysts is carried out with injections of hormonal drugs Praegninum or Gonacor. Stimulation is not carried out when the ovarian reserve is depleted during menopause and with obstruction of the fallopian tubes.

Decreased number of antral follicles

With an increased content of folliculus, therapy is aimed at normalizing the hormonal fund. Combined oral contraceptives can help regulate the production of follicle-stimulating and luteinizing hormone, estrogen, prolactin and progesterone.

Depending on the pathology, drugs are prescribed:

Combined hormonal drugs used to treat menstrual irregularities, reduce or eliminate ovulatory syndrome.

Is it possible and how to increase the number of antral follicles

The production of anti-Müllerian hormone affects the amount of folliculus. With the help of a complex of vitamins, as well as preparations containing biologically active substances, it is possible to increase the stimulation of ovarian functions, to increase the chances of successful maturation of eggs.

But it is impossible to increase the production of the hormone with medications, since the amount of folliculus depends on the genetic characteristics of the body and the woman's age.

The oocyte develops inside follicles in the ovaries. Changes in hormonal levels, the possibility of conception depend on the norm of their number. In case of deviations from the norm, the risk of various pathologies is possible. There may be several reasons for violations, therefore it is important to undergo a qualified examination in order to avoid infertility.

Article design: Mila Friedan

Folliculometry video

What is ultrasound folliculometry:

The formation of a dominant follicle occurs in the female body on a monthly basis and is a reflection of the normal function of the reproductive system. Follicle visualization and determination of its size make it possible to assess not only the state of the woman's body, but also to make a forecast about a more appropriate time for conceiving a child.

The dominant is the most developed component of the ovarian structure, containing a large number of granulosa cells.

It can be localized both in the right and in, it grows rapidly within, is filled with liquid and by the time the egg is released it reaches a size of 20-25 mm.

The process of development of the dominant follicle takes on average 2 weeks, while the rest undergo a reverse development for another initial stages ripening.

The dominant, under the influence of estrogen and luteinizing hormone, ovulates on the 14th day of the cycle. The sign is its disappearance and the definition of a small amount of fluid behind the uterus. At this place, the formation takes place in the future.

Most often, the dominant is localized in the right, but its detection in the left or in both ovaries is a variant of the norm. When diagnosing two dominant follicles, most often ovulation occurs in only one of them.

Structure

• embryonic vesicle (first-order oocyte);
• a layer of glycoproteins and granulosa cells,
• basement membrane and surrounding theca cells;

Functions and meaning

Folliculogenesis stages

Regardless of the location and number of dominants, the follicle goes through 4 stages of formation in its development:

1. Primordial phase. At this point in development, the follicle is an immature egg surrounded by a connective tissue membrane. It has a small size and a flat shape; during the menstrual period, one organ can contain from 5 to 20 primordial formations.
2. Preantral stage. At this stage, which occurs in the middle of the menstrual period, the oocytes begin to mature and increase in volume, acquiring a round or cubic shape, the connective membrane becomes denser and begins to produce estrogen.
3. The antral period is characterized by the formation of secondary elements, observed on the 8-9th day of the menstrual cycle. The granular layer of cells thickens and begins to produce follicular fluid containing a large amount of estrogen, which gradually fills the resulting cavity. Its average diameter in this period is 10-13 mm. Formations can be both single-chamber and contain several liquid cavities. Usually their number does not exceed 10.
4. Dominant formation is the final stage of folliculogenesis. Usually only one oocyte enters the dominant phase, the rest undergo reverse development (atresia). It has a rounded shape and reaches a size of up to 25 mm, one wall protrudes into abdominal cavity, the other attaches to the stroma. The center contains an ovum that is ripe and ready for ovulation.

Ultrasound signs of a dominant

• visualization of a follicle 18 mm and larger;
• determination of the ovarian tubercle in it;
• thickening of the layer of granulosa cells (theca);

After the release of the egg into the abdominal cavity:

• a decrease in the dominant follicle in size or its complete disappearance upon previous detection;
• free fluid in the posterior space;

Features in the left ovary

Since the formation of a dominant oocyte followed by the appearance of a corpus luteum in its place is a physiological process, there are no significant differences from ovulation in the right ovary.

Localization of the dominant follicle in the left ovary is a variant of the norm.

• ovulation in the left ovary occurs less frequently due to its smaller size and the number of eggs;
• in the presence of a dominant in the left and right organs, the chance of conceiving twins increases at the same time;

Common deviations

1. Lack of dominant oocyte formation. It is observed with a decrease in follicle-stimulating hormone in the blood or with an increase in the concentration of luteinizing hormone.
2. Follicular atresia occurs in various endocrine disorders ( diabetes, impaired glucose tolerance, hyperthyroidism) due to the occurrence of hormonal imbalance.
3. Persistent follicle. It is diagnosed using ultrasound and is observed when ovulation does not occur. The oocyte maintains a normal volume or is slightly enlarged, but does not undergo regression. A persistent oocyte can be visualized at the same time as the dominant one.
4. Multifollicular ovaries are characterized by the simultaneous maturation of many oocytes, often a consequence of exposure to stress factors on the woman's body, chronic fatigue, emotional overstrain. Multiple follicles are not always a symptom of the disease and require dynamic monitoring, since after several cycles their number can return to normal without medical intervention.
5. Luteinization is the formation of a corpus luteum at the site of an egg that has not undergone ovulation. It can develop due to hormonal disorders, long-term inflammatory diseases of the pelvic organs, endometriosis.
6. Formation follicular cyst occurs when the oocyte membrane does not break, and it continues to increase in volume. Diagnosed by ultrasound: detection of a formation more than 25 mm in diameter, filled with liquid. A condition in which several of these cysts form is called polycystic.

Risk factors for the development of pathologies

• inflammatory pathology of the pelvic organs;
• endometriosis;
• long-term use of oral contraceptives;
• incorrect selection of medical contraception;
• concomitant endocrine pathology (diabetes mellitus, thyroid disease);
• period breastfeeding(increased production of prolactin);

The dominant follicle, which is defined in the ovary in the first phase of the menstrual cycle, precedes the development of pregnancy. If you have complaints of a gynecological nature or when planning a pregnancy, you should seek the advice of a specialist.

When a girl reaches puberty, her body already has an ovarian reserve. This phrase defines a specific supply of eggs in the ovaries. They are immature, each housed in a special sac of functional cells. This "construction" is called follicles.

Several follicular sacs develop every month due to exposure to the hormone follitopin. One of them is dominant, it is progressing noticeably, it is growing. Its development indicates that there will be ovulation, conception is likely.

A mature female reproductive cell leaves the right or left ovary, but it happens that only one of them is active. What does the dominant follicle in the left ovary mean, what consequences can such a feature of its formation lead to?

Why does a dominant follicle appear in the left ovary

According to the medical standard, the ideal phenomenon is considered when in the female body the eggs, ready for fertilization, develop and come out alternately from two ovaries. But there are several factors when only the female genital gland, located on the left, is active.

Often the dominant follicle in the left ovary is due to familial, genetic characteristics. If close blood relatives-women have confirmed activity of this particular gonad, there is a high probability that their heiresses, after medical research, will confirm a similar phenomenon.

Dysfunction of the right organ leads to the fact that the left one begins to work actively.

Experts name several situations when such a situation is observed:

1. the presence of inflammation;
2. development ;
3. deviations during the maturation of the egg, its exit from the follicle.

Incorrect structure, underdevelopment of the female reproductive gland on the right, her injuries, surgical operations, medical removal after pathologies have been identified or as a consequence of an ectopic pregnancy are reasons that complement the list.

Another reason for the formation of a dominant follicle in the left ovary is organ dysfunctions endocrine system... Prolonged stay in a state of emotional excitability, stressful situations, unhealthy diet, excess weight or lack of it become possible "provocateurs" of this phenomenon. For other reasons, doctors attribute the presence of diseases of a chronic nature.

How many dominant follicles can form

In order for the desired fertilization to occur in a woman's body, one mature reproductive cell is enough. It is the norm if several follicles “prepare” to become dominant at once - from 4 to 8. If their number is more than 9, there is a high probability of the development of a pathological process, it is defined as a multifollicular ovary.

Statistics confirm that two dominant follicles can form simultaneously in the left ovary. This phenomenon is not common, it is observed in women with genetic background.

A similar result is observed after a course of hormonal treatment, which was aimed at stimulating the ovulation process. In the organ on the left, two (or more) eggs may mature, ready for fertilization. With a favorable course of pregnancy in the mother, the development of fetuses without pathologies, fraternal twins are born.

An ultrasound is required to determine or confirm that an egg is forming, developing and exiting the ovary on the left side. An intravaginal examination is necessary, which is prescribed over several cycles.

The doctor will determine the echoes of the dominant follicle in the left ovary. The main one is the visual identification of a follicle with an egg cell actively developing inside.

Its size will be 18 mm or more, and the granulosa cell layer is markedly thickened. Inside such a "bag", the specialist will examine the egg-bearing tubercle. If the study was carried out immediately after the release of the egg, the doctor will note signs - a decrease or disappearance of the follicle, the appearance of fluid behind the uterus.

Is pregnancy possible with a dominant follicle on the left

Is it possible to count on the development of pregnancy if it is established that the "main" follicle develops only in the sex gland on the left? Gynecologists confirm that such a process is one of the possible options normal functioning of the female reproductive system.

But it becomes more rare due to the special structure, development of the sex gland in this side - its smaller size, the small number of "laid" eggs in comparison with the right one. If your menstrual cycle is regular, there is a high chance of conception.

For it to happen, you need to reliably know on which days ovulation occurs. To determine it, gynecologists advise using special tests that can be purchased at the pharmacy, track.

If there is a delay in the cycle, pregnancy has not occurred, the risk of developing several pathologies that are dangerous to reproductive health and a woman's life increases:

• failure of hormonal balance;
• hyperplasia of the tissues of the uterine epithelium;
• prolonged absence of menstruation;
• occurrence uterine bleeding breakthrough character;
• the growth of benign or malignant tumors.

Lack of menstruation is always a reason for an extraordinary appointment with a gynecologist.

Conclusion

If the processes of formation of a dominant follicle, subsequent ovulation occur stably in the left ovary, pregnancy may occur less likely than when the right sex gland is functioning or both at the same time.

To increase the chance of conception, it is necessary to determine exactly why the right organ has lost its capacity. After confirming the diagnosis, the doctor prescribes treatment - surgical, medication, conducts.

Video: Follicle maturation