Structure

Tertiary follicle

Oocyte

The follicle contains the 1st order oocyte. The nucleus of the oocyte is called the "germinal vesicle" germinal vesicle (see illustration)

Granular cells

The oocyte is surrounded by a layer of glycoproteins, zona pellucida (zona striata)... It, in turn, is surrounded by a layer of granulosa cells.

Theca cells

Granular cells are surrounded by a thin layer of the extracellular matrix - the basement membrane (in the figure it is indicated as fibro-vascular coat). Theca cells are located around the basement membrane.

Development stages

In accordance with the stage of development, primordial, preantral (primary), antral (secondary) and preovulatory (tertiary) follicles are distinguished.

Primordial follicles with a size of 50 microns are indistinguishable with the naked eye and laid down even before birth. They are formed in the process of mitotic proliferation of primary germ cells (oogonia) that entered the embryonic ovary at the 6th week of pregnancy. Oogonia undergo prophase I of meiotic division and become primary oocytes. These oocytes are surrounded by 1–2 layers of cubic epithelial cells and form embryonic follicles. Oocytes not included in the follicle undergo reverse development. Mitotic proliferation ceases during the prenatal period of pregnancy. Thus, at the time of birth, the number of primordial follicles in the ovary is approximately 1-2 million. (for more details see folliculogenesis)

The development of primordial follicles is suspended until puberty. By this time, about 300,000 follicles remain in the ovary. The pituitary gland begins to produce follicle-stimulating hormone (FSH), which stimulates the maturation of 5-15 primordial follicles. Now these follicles are preantral (primary) follicles (size - 150-200 microns). The oocyte begins to grow, the outer surface of the oocyte is covered with glycoproteins and glycosaminoglycans, which form zona pellucida... Now the oocyte is already covered with 2-4 layers of granulosa cells, the theca around the follicle is formed from the connective tissue.

In the next stage, a cavity is formed ( antrum folliculare) containing follicular fluid ( liquor folliculare). Follicular cells responsible for the production of estrogen are divided into cells of the external ( theca externa) and internal ( theca interna) shell. At the same time, the epithelial cells of the follicle turn into granulosa cells, which are responsible for the production of progestins. Diameter antral (secondary) follicle is 500 microns.

During the maturation of the follicle, the cells of the theca's inner layer produce androgens, which penetrate through the basement membrane into the granulosa cells of the follicular membrane and there are transformed into estrogens, mainly estradiol. Thus, estrogens are released into the follicular cavity, and the secondary follicle becomes a temporary organ of the endocrine system.

The formation of the follicular cavity provokes rapid growth, during this period, the diameter of the follicle increases from less than 1 mm to 16-20 mm just before ovulation. Now the egg is located on the egg-bearing tubercle, or egg-bearing mound ( cumulus oophorus). The cavity makes up the most preovulatory (tertiary) follicle (vesicle graaf), the amount of follicular fluid is about 100 times greater than in the antral follicle.

About 24 hours before ovulation, theca cells begin to produce large amounts of estrogen. The increased estrogen content stimulates the release of luteinizing hormone (LH), which initiates ovulation. A bulge (stigma) is formed in the follicle wall, which ruptures, and the egg leaves the follicle - ovulation occurs. If a mature follicle does not ovulate, a cystic follicle will form.

After ovulation, a corpus luteum is formed from the follicle (from granulosa and theca cells), which produces progesterone. Progesterone prevents premature rejection of the functional layer of the endometrium (menstruation). If the egg has not been fertilized, the corpus luteum stops functioning, the level of progesterone drops, and menstruation begins. If fertilization has occurred, the egg begins to produce chorionic gonadotropin, which now instead of LH stimulates the growth of the corpus luteum.

Additional illustrations

see also

• Folliculogenesis (Ovogenesis)

Links

Literature

S. L. Kuznetsov, N. N. Mushkambarov - Histology, cytology and embryology. Textbook for stud. honey. Universities, 600s.

The functionality of a woman's follicular apparatus depends on her ability to conceive and give birth to a child. If their number changes, then this affects the patient's health. In the presence of single follicles in the ovary, the possibility of getting pregnant drops sharply. Moreover, such a pathology can develop not only in middle-aged women, but also in young girls.

In this article, we will look at what single follicles in the ovary are, their causes and treatment features.

A follicle is a special element within which an egg develops and grows. It provides nutrition and protection to the cell. In the future, it is the follicle that produces estrogen. Several follicles (6-10) can form in the ovary, one of which will be dominant. It is he who will "grow" the cell, ready for conception.

The number of follicles in the female body is strictly defined. It is laid even during intrauterine development. Throughout a woman's life, about 400 follicles become completely ready for the formation of an egg.

On the way of their development, these elements go through several stages: primordial, preantral, antral, preovular. Every day after its formation, the follicle grows and develops. This process is repeated every month.

The follicles are formed on the 7th day. At this time, they increase in size. In the formation, there are more cells that produce follicular fluid. Already on the 8th day, the follicle begins to produce estrogen. In this case, the epithelium becomes two-layer.

B, follicles should be from 6 to 12 pieces. However, more or less of them can form. In the presence of single follicles, a woman is not able to conceive a baby, since her ovaries do not function, the egg does not develop, which means that ovulation does not occur. The patient has an increased risk of early menopause.

Reasons for the appearance

You can name the following reasons for the formation of single follicles:

• excessive and hard sports training that depletes the body;
• early menopause, which is triggered by the removal of the uterus along with the appendages;
• hereditary predisposition;
• unfavorable ecological situation;
• strict diets, in which an insufficient amount of nutrients enters the body;
• hormonal disorders;
• a sharp increase in body weight;
• pathology of the thyroid gland and pituitary gland;
• too low level of estrogen in the blood;
• frequent stressful situations and depression;
• galactosemia;
• damage that occurred during intrauterine development;
• undergoing radiation therapy during the treatment of cancer.

The combination of these reasons negatively affects not only a woman's reproductive ability, but also her health in general.

Signs of single follicles

The most important symptom is secondary amenorrhea, which means the impossibility of pregnancy. The fact is that ovulation does not occur, the menstrual cycle is disrupted. In addition, the woman has other signs:

1. Constant hot flashes, increased sweating.
2. Sleep disorders.
3. Aching pains in the heart.
4. Secondary infertility, which can still be reversed if effective treatment is started on time.
5. An unpleasant sensation of dryness in the external genital area, which often leads to painful intercourse.
6. Decreased libido (sex drive).
7. Frequent mood swings, tearfulness, increased irritability.
8. Decreased performance.

Without normal treatment, this condition can lead to irreversible consequences. For example, without normal hormonal support, atrophic processes develop in the genitals. If signs of the formation of single follicles appear, it is necessary to urgently consult a doctor for a thorough examination.

Diagnosis of the disease

Even the dominant follicle can be irregular. This can also interfere with conception, as the egg cannot form normally. In order to make an accurate diagnosis, you should undergo certain studies:

1. External examination, during which the patient's complaints are recorded. In addition, the doctor should know when the first signs appeared, what factors provoked them, in the woman's opinion, whether the symptoms have changed over time. Also, the specialist needs data on the transferred pathologies, surgical interventions, injuries, and everyday life of a person.
2. Study of menstrual function. Here you need data on the first menstruation, the duration of the cycle and its regularity.
3. Examination of the patient on the chair. The doctor determines the change in the mammary glands or external genital organs, specific symptoms.
4. Ultrasound. In this case, a decrease in the thickness of the endometrium, the size of the ovaries, and the absence of follicles in them are determined.
5. A blood test for the concentration of sex hormones.
6. Laparoscopy.
7. Karyotyping.
8. Echo salpingography.

For further treatment of pathology, the intervention of a gynecologist-endocrinologist is necessary. The presented pathology is almost always associated with a change in the level of hormones, therefore, violations of the functionality of the endocrine system must be eliminated first.

Treatment features

If the ovaries cannot fully perform their function, then the woman's body begins to age faster. Naturally, this negatively affects not only her physical, but also her psychological state. Therapy is selected depending on the cause of the disease. However, the following treatment methods are most often required:

1. Hormone replacement therapy. A woman has to use drugs that artificially normalize the balance of sex hormones. If the patient has amenorrhea, then estrogens are prescribed to her first.
2. Physiotherapy procedures: electrophoresis, ultrasound.

Folk remedies are a good help in the fight against pathology. But they should be used only after consultation with the doctor. The following recipes are considered useful:

1. Infusion or decoction from the boron uterus. This herb is the leader among all plants used to treat gynecological problems. It restores normal hormonal levels. However, during the use of the prepared products, the dosage must be strictly observed. And between courses of therapy, you need to take breaks. The broth is prepared very simply: 1 tbsp. l. raw materials are poured into 300 ml of liquid and cooked for 10 minutes. It takes the same amount of time to insist the remedy. Drink 1 tbsp. l. up to 5 times a day. The broth is taken for 3 weeks, after which it is necessary to take a break for 7 days. Treatment should be continued until the woman's condition improves.
2. Evening primrose oil. The presented tool is considered a natural stimulant of the female reproductive system. The medicine is recommended for those patients who are diagnosed with single follicles or ovaries. Vitamin E is additionally used. Take the remedy like this: in 1 tbsp. l. oil, the vitamin capsule is dissolved, after which the mixture is drunk. This is done three times a day, 60 minutes before meals.
3. Cabbage juice. It should be drunk half a glass a day. It is better to do this in the morning, before meals.
4. Beet juice. It has a positive effect on the production of estrogen. Fresh juice should be diluted in half with cold water. It should be taken once a day for 1 tbsp.
5. A decoction of a red brush. It is required to pour 1 tbsp with a glass of water. l. dry herbs and simmer for 20 minutes. Further, the agent is cooled and consumed before meals for 1 tbsp. l.

Naturally, folk remedies are able to restore the normal function of follicle formation, but this method of treatment must be approved by a doctor. Over-stimulation of the ovaries can only do harm.

If conservative treatment does not work, then surgery can be applied. With only 3-4 follicles in the ovary, a woman can become pregnant only through IVF.

Possible complications

If a woman has single follicles, then what this means can be fully explained by the gynecologist. However, the pathology is considered extremely serious, since it can have serious consequences:

• secondary infertility, which becomes irreversible without proper therapy;
• early aging of the body, as well as menopause;
• increased chances of getting cardiovascular disease;
• osteoporosis (decrease in bone density due to poor absorption of calcium);
• psychological problems, depression;
• decreased quality of life, problems with sexual relations.

These complications can significantly worsen a person's existence. Over time, they will only get worse. If atrophic processes occur in the genitals, then the chances of even artificial insemination will drop sharply. Therefore, treatment should be started on time. You cannot lose sight of the absence of menstruation, which is not caused by pregnancy.

Prevention

In order for a woman not to develop this pathology, it is better to follow certain recommendations of doctors:

1. It is imperative to eat right. You should not follow strict diets, as sudden changes in weight lead to hormonal imbalance.
2. All viral infections must be treated on time.
3. It is important to exclude the influence of radioactive radiation. If the job is related to chemicals, then it must be changed.
4. Any medications should be taken only with the permission and under the supervision of a doctor.
5. It is important to exclude excessive psychoemotional and physical stress that negatively affects the formation of follicles.
6. The rules for taking hormonal medications should be observed.
7. A woman needs to be examined regularly by a gynecologist.
8. It is imperative to exclude unreasonable and incorrect ovarian stimulation.

Only the correct prevention of single follicles will help avoid the development of the presented pathology, as well as ensure normal reproductive function. Further prognosis (whether the patient can become pregnant) depends on her general condition and the correctness of the selected therapy.

- structural components of one of the components of the female reproductive system. They are made up of oocytes, which are surrounded by a layer of epithelial cells. On top of them are several layers of connective tissue, which are a protective layer.

Each follicle contains a not yet fully matured egg. Its final maturation occurs only after fertilization. Before the main function of the follicle is to protect the egg from any influences and provide it with comfortable conditions for maturation.

The maturation of the egg is an important stage of fertilization - it depends on how the maturation of the baby will take place and whether complications arise during pregnancy and childbirth.

Even in the womb of girls, the laying and development of the reproductive system begins (in boys, during intrauterine development, only the laying of organs occurs, their development begins only in puberty). Each girl has a bookmark of her own certain number of follicles - from 50,000 to 200,000, and this number cannot be changed in any way.

After birth, the postnatal development of the reproductive system and follicle maturation begins. One follicle matures every month. If fertilization occurs, a fertilized egg is released into the fallopian tubes.

If fertilization does not occur, an underdeveloped, unfertilized egg comes out of the follicle and the girls begin their periods, during which it leaves the body along with the rejected epithelium of the uterus and vagina.

Throughout a woman's life, all the follicles do not have time to mature. After birth, the girl begins atresia of the follicles in the ovaries, that is, the resorption of some of these cells.

This happens under the influence of maternal sex hormones, which have a strong enough effect on the child in the womb, and a change in the habitat (from water to air).

This process stops already by the second year of life, then starts again by the age of ten (by the period of puberty - pubertal age). When the follicles begin to prepare for fertilization, puberty begins, and the girl has her period. In addition to the maturation of the eggs, the ovary also has an important function - the production of female sex hormones-estrogen ... This process is also triggered during puberty.

Several follicles mature in the ovary every month, the most developed of them is called dominant follicle.

At the beginning of the cycle (in the first days after menstruation), the doctor may see several small follicles 6-8 mm in size on an ultrasound scan.

In the middle of the cycle, 1-2 large follicles are observed, one of which is dominant, and several much smaller follicles.

At the end of the cycle, you can distinguish the corpus luteum - the place where the unfertilized egg was located, which came out of the bursting dominant follicle.

It is possible to say that a woman has pathological follicles in the ovaries only if, in any phase of the cycle, during an ultrasound examination of the pelvic organs, more than 10 (usually 10-12) small follicles are observed. They are located on the periphery, the center of the ovary is not thickened.

This state can also be called polycystic ovary, but this term is not entirely correct - cysts (cavities filled with fluid) do not form in the ovary, but simply there are many small and underdeveloped follicles that will never be able to complete the development of the owl.

This condition can be noted on ultrasound and in completely healthy women. This is due to the fact that the ovary is an organ in which new cells are constantly being formed.

Stress, overwork, climate change and hormonal changes - all this can affect the maturation of cells and then extra follicles can be observed in a healthy ovary.

Nevertheless, in a healthy patient, all these structures will completely disappear until the time of the next ovulation, therefore, normal fertilization of the egg and the development of a normal pregnancy is possible.

There are pathological reasons that cause follicle underdevelopment..

• Taking birth control pills... Most women who take contraceptive pills can experience this process. Most often, this suggests that the drug was chosen incorrectly, therefore, it is impossible to prescribe oral contraceptives on your own under any circumstances, despite the fact that modern drugs are much safer than those that were 10-20 years ago. The effect of modern contraceptives is completely reversible - already in 2-3 months after stopping their use, a woman's fertility (the ability to get pregnant) is fully restored.
• Diseases of the thyroid gland - hyper- and hypofunction of this organ. In this case, violations of the maturation of the egg will not be the only pathologies in the body.
• Excessive production of prolactin (a hormone responsible for milk production during lactation).
• Other diseases of the endocrine system... It is difficult to say for sure what exactly can provoke such violations, since each person has his own hormonal background, and, accordingly, the amount and quality of biologically active substances produced is different.

1. Among the many follicles, one stands out, which nevertheless increases in size in the middle of the cycle, becomes the dominant follicle and the normal monthly cycle continues, despite the underdeveloped follicles.
2. Not a single follicle increases in size, a dominant follicle does not appear, an egg does not mature, a monthly cycle does not begin, and fertilization does not occur. In addition, a woman accumulates a large concentration of the male sex hormone in her body - testosterone ... This situation can lead to infertility.

Excess follicles in the ovaries are not a sign of the norm, so this condition must be dealt with. The main goals of therapy are to restore the menstrual cycle and enable a woman to become pregnant. .

Before starting treatment, if a woman has taken oral contraceptives, they must be stopped. The basis of drug therapy is the intake of hormonal drugs, but a surgical method of treatment can also be recommended - ovarian cauterization (The essence of this method is that all underdeveloped follicles are completely eliminated, which helps to restore normal hormone production and egg maturation).

With timely diagnosis and treatment of the disease, the function of the ovaries is restored completely, therefore, such violations currently do not lead to persistent infertility. Every woman should simply monitor her well-being and the menstrual cycle, as this will help to identify the onset of the disease in time and prevent the development of numerous complications.

If it turns out that the cause of violations of the ovarian-menstrual cycle are systemic diseases of the body (exhausting infections, severe diseases of the internal organs), then the possibility of effective treatment is directly associated with timely therapy of the main pathological process.

At the current level of development of medicine, opportunities have been created for the effective treatment of many pathologies associated with disruption of the normal development and maturation of the follicle, it is only important not to postpone the solution of this issue to the distant future.

The sooner the true cause of the pathology is established, the diagnosis is made and treatment is started, the higher the probability of its successful completion.

Diseases in which the causes of impaired development and maturation of follicles are caused by hereditary disorders ( gene and chromosomal diseases), at the present level of development of medicine, unfortunately, it is impossible to cure, but the use of reproductive technologies and such women can give the joy of motherhood.

Dominant follicle - what is it, then we can say that it is the largest, most developed follicle. In accordance with physiology, in the body of a woman at the initial phases of the cycle, several follicles develop and mature, but it is the one that exceeds the size of 15 mm or more and is dominant.

The number of follicles.

If we talk about how many follicles there should be in the ovary, 2 then at the very beginning it is worth saying that the number of primordial follicles at the time of a girl's birth varies within 1-2 million, at the time of her puberty - there are about 250-300,000 of them.

Follicles in the ovaries, the normal number in a woman's reproductive age depends on the current day of the cycle - on days 6-7, their number varies from 6 to 10, and from day 8 to the tenth, one, the largest, so-called dominant follicle is formed. As the doctors themselves note, it is rare for a woman to develop 2 or more dominant follicles in a woman's body, which increases the chances of a multiple pregnancy.

Follicle development stages.

In its development, the follicle goes through the following stages and each of them has its own medical name:

1. The primordial follicle is an unripe egg cell. It is a follicle surrounded by a connective type of shell - so throughout the entire cycle in a woman they are produced in the body from 3 to three dozen, they gradually grow and transform into the primary type.
2. Preantral type of follicle - in this case, the oocyte is enlarged, surrounded by a membrane. At this stage, the level of production of female hormones estrogen is increased in the woman's body.
3. Antral follicle - what is it? This is the so-called secondary follicle - at this stage, the cells of the granulosa layer are enlarged, which provoke an increase in the follicular fluid. This period of follicle development falls on the 8-9 day of the cycle.
4. The cycle ends with the formation of a dominant follicle, the main one before ovulation itself. It is the dominant follicle that is the largest of all.

At each stage, as the main, dominant follicle grows and develops, the number of all others will gradually decrease.

If the follicles are more than normal?

Any deviation in the direction of decreasing or even increasing is a pathology, and if more than 10 follicles are detected in a woman using ultrasound, we are talking about such a phenomenon as multifolliculation. During the examination, on the ultrasound monitor, you can see a large number of bubbles - follicular ovaries, if their number increases significantly, then a diagnosis of polycystic disease is made.

A similar phenomenon interferes with the full formation and development of the dominant follicle, natural ovulation, and subsequent conception. The reason for this phenomenon can be very different, ranging from chronic overwork and stress and ending with incorrect and prolonged use of contraceptives, malfunction of the endocrine system, sudden weight gain or weight loss. To normalize the process of production and maturation of follicles, elimination of the root causes of pathology is required - only after that we can talk about the normal process of formation of the dominant follicle, subsequent ovulation and conception.

Few follicles in the ovaries - what to expect?

Few follicles in the ovaries can also be triggered by various factors and reasons - from a malfunction in the hormonal system and a decrease in hormone levels and ending with an early menopause. In this case, it is worth undergoing an examination using an ultrasound scan, a vaginal sensor, diagnosing the causes and undergoing a course of treatment prescribed by a doctor. If in a woman's ovaries, an ultrasound scan showed from 7 t to 16 follicles - the probability of conceiving is high, from 4 to 7 - then the chances of pregnancy are small, up to 4 - conception may not be.

One ovary contains several dominant follicles.

In the process of treating female infertility, most often, doctors use a course of hormone therapy, and as a result, 2 or more dominant follicles can develop in one ovary. Such a phenomenon is rare, but it can cause the birth of twins, and if a woman has had contact with different partners in a short period of time, each egg can be fertilized by a different man and children can have different fathers. Most often, two follicles are formed precisely in the right ovary, rather than in the left - it is impossible to understand the reason for this nature of such a phenomenon, and doctors have not yet undertaken to put forward their theories.

If there is no dominant follicle.

If a dominant follicle is not detected during an ultrasound scan, doctors note that several reasons can provoke this condition. In particular, such root causes can be:

• the doctor does not detect the follicle during ultrasound due to the fact that the latter has not yet reached its size - this will indicate that ovulation as a physiological process has not yet passed, and the tests for the level of hormones themselves remain normal;
• the follicle in the woman's body has developed to the desired size, but it does not burst - as a result, ovulation does not occur;
• the follicle itself at a certain stage of its development may stop in development and growth;
• diagnosing the patient's so-called sleeping ovaries

The absence of a dominant follicle can be due to early menopause, as well as in the case of:

• malfunction of the ovaries and malfunction in the endocrine system, when there is an increase or decrease in the female hormone in the blood;
• with damage to the pituitary gland or hypothalamus;
• in the case of an inflammatory or infectious nature of the disease that affects the organs and systems of the small pelvis;
• with frequent, chronic stress and constant fatigue, physical overload;

regression or aggresia, which develops with hormonal disruption in the body, including with an increase in the level of insulin in the blood;

What is worth doing?

First of all, it is worth undergoing a full and comprehensive examination - this will help to identify the root cause of pathological changes, if any, and further prescribe a course of treatment. Diagnostics is carried out not only on the basis of measuring the basal temperature, but also conducting an examination using ultrasound of the development of follicles on the 8-10th day of the menstrual cycle, passing laboratory tests for the level of hormones at various stages of the menstrual cycle.

How to grow a dominant follicle?

How to increase the number of follicles in eggs - to stimulate ovulation. In this case, doctors prescribe a course of hormonal therapy - most often a drug such as Klostilbegit is prescribed, or another one, selected taking into account the individual characteristics of the woman's body and the root cause that provoked the pathology. Also, many patients note the positive dynamics of treatment after a course of folic acid intake, as well as a course of vitamins. The main thing is not to practice self-medication, but to strictly follow the doctor's recommendations.

Folk remedies for stimulation.

Many women also note the high effectiveness of using drugs from the arsenal of traditional medicine to stimulate - most often, medicinal herbs are used for this, either individually or in collection, such as boar uterus, sage and a red brush. It is these herbs that, according to traditional healers, stimulate the development, growth and maturation of the follicle, the release of the egg and the growth of the necessary endometrium. It is enough to steam 1 tbsp. l. in a glass of boiling water of a medicinal plant or collection, insist half an hour and take for a month.

Contraindications to stimulation.

First of all, doctors note that stimulation is not carried out in the case of diagnosing male infertility, when both partners must undergo the examination, as well as when:

• uterine pathologies;
• diagnosing acute inflammatory processes occurring in the organs and systems of the small pelvis, affecting the reproductive system of a woman;
• with obstruction of the fallopian tubes;

As noted by medical practitioners, stimulating ovulation and developing the dominant follicle after 35-36 years for all women should become a regular procedure before a planned pregnancy. In terms of the duration of the stimulation course, its duration should not exceed 6 menstrual cycles. If pregnancy has not occurred within a given period of time, then in addition to the non-maturation of the dominant follicle and the absence of ovulation, the causes of infertility are other, more serious diseases and pathologies.

Until the moment of birth, about half a million follicles are initially laid in the developing body of a girl.

But already upon reaching puberty, their number is reduced to forty thousand. During her life, only 500 matures in a woman's ovaries.

Without their full development, the fair sex is not able to get pregnant.

The procedure for forming the components of the ovaries is called. It is quite complex and multi-stage. It all starts in the first phase of the menstrual cycle under the influence of estrogen. The functional balance of the reproductive system depends on the level of this hormone.

Thanks to hormones, new follicles are formed.

The maturation of structural components is accompanied by:

• pulling pains in the lower abdomen;
• irritability;
• excessive sensitivity;
• an increase in the volume of white mucous discharge from the genital tract.

Rectal temperature decreases before ovulation begins and gradually rises after the oocyte release process.

Follicles are the structural components of the paired sex gland, shaped like a bubble. They contain gametes (eggs) arranged in a ring of epithelial cells and two layers of connective tissue. Reliable protection of the egg depends on whether a woman can conceive and carry a child in the future.

Phases of the menstrual cycle

The functioning of all organs of the reproductive system depends on cyclical changes that periodically occur in a woman's body.

The process is usually divided into three phases:

1. follicular or menstrual;
2. ovulatory;
3. luteal or secretory.

Phases of the menstrual cycle

Smoothly flowing from one to another, the periods prepare a viable egg for fertilization, and in the future for bearing a healthy fetus.

Follicular

The onset of the phase coincides with the onset of menstruation, that is, with the first spotting. Its duration depends on physiology, age and lifestyle, and averages 11 days.

Separate parts of the brain: the hypothalamus and pituitary gland, start the ovaries. Several follicles develop simultaneously in the appendages. For seven days, the structural components reach large sizes, but by this time only one viable one is determined -.

Menstrual cycle

It continues to grow under the action, and in the process of maturation it increases by 2 mm per day. A mature follicle reaches twenty millimeters. It protects the egg cell until ovulation.

Other follicles gradually disappear. However, when the hormonal system malfunctions, these bubbles remain and interfere with the full growth of the dominant component.

Ovulatory

Shortest phase. With an approximate duration of a menstrual cycle of 28 days, only three are due to ovulation. During this period, luteal release is observed, which is aimed at completing the process of forming a dominant follicle.

At the same time, it activates other hormones, under the influence of which the wall of the vesicle containing the egg is torn. For a woman who is planning to become pregnant, this phase is a good opportunity to conceive a baby.

Luteal

The last stage occurs after the release of the sex gamete. Basically, the phase lasts up to 16 days.

Instead of a bursting follicle, a corpus luteum is formed - a temporary gland that produces progesterone.

At this stage, the hormone estrogen is actively produced, leading to the appearance of premenstrual syndrome. It is characterized by:

• swelling of the mammary glands;
• increased appetite;
• changes in mood.

When conception occurs, the fertilized egg enters the uterine cavity, attaches to the endometrium and creates the placenta. If this does not happen, then the corpus luteum dies, and the genital gamete, along with the mucous membrane and blood, is excreted from the body. At the same time, a decrease in the level of hormones is observed.

All indicators are restored after menstruation.

Ultrasound monitoring of follicle maturation

Reproductive system failures occur in women of different ages. Therefore, when conception does not occur for a long time, the gynecologist prescribes a referral for folliculometry. Ultrasound examination helps to determine:

• ovulation date;
• follicle growth and maturation;
• whether the dominant is developing among them.

Determination of ovulation by ultrasound

Reveals destructive conditions of female genital organs, including:

Doctors check the education that regulates the production of progesterone necessary for the normal course of pregnancy. In addition, during the examination, the state of the endometrium - the inner mucous membrane of the uterus - is assessed. Ultrasound will also determine a favorable day for conception and the possible gender of the child.

Indications for research

• not getting pregnant during active sex life during the year;
• a large interval between regulations;
• artificial infusion of sperm into the uterus;
• iVF planning;
• stimulation of ovulation;
• scanty or irregular periods;
• underdeveloped uterus (hypoplasia).

Training

With a constant monthly cycle of a woman, the study is carried out on the eighth to tenth days from the beginning of the regulation.

If the cycle is not constant, then it is advisable to perform the procedure from the third day after the end of menstruation.

For this, foods that cause increased gas formation are excluded from the diet: legumes, cabbage, onions, carbonated drinks. You should not eat too salty, sweet or spicy foods, as well as marinades.

On the eve of the diagnosis, you can drink a laxative prescribed by a gynecologist. Before the procedure itself, it is recommended to take a shower or wash the genitals.

How is

The survey is carried out in two ways:

1. Transabdominal - through the abdominal wall.
2. Transvaginal - the sensor is inserted directly into the vagina.

In the first method, you should drink one and a half liters of water 45-50 minutes before the start of the procedure.

The second involves the opposite action - emptying the bladder. For the accuracy of the result, it is possible to use two methods alternately.

When

Ultrasound monitoring is carried out in stages, on certain days, since a single examination will not give a specific picture of changes in the female body.

At the initial examination, several follicles 5-9 mm in size are found in the ovaries. The second time, three days later, the doctor's task is to identify the dominant one, which is larger than the others and reaches one centimeter. If in this phase it is not possible to determine it, then the examination can be stopped, since, most likely, the woman will need stimulation of ovulation.

Follicle 15 mm

During the third ultrasound, two days later, the size of the follicle is already about 23 millimeters in diameter, and the endometrium has a three-layer structure with a total thickness of about 11 mm. If this does not happen, then perhaps the fertilized egg will not stay in the uterus and pregnancy will not occur. The next study should reveal the release of the matured gamete from the ovary and changes from the inner mucous layer of the uterus.

Advantages and disadvantages

Ultrasound monitoring is much more effective than the calendar method or basal temperature measurement, as it gives the most accurate picture of the monthly cycles in the female body.

However, this method is very time consuming, because the patient has to undergo examination 4-5 times during the menstrual cycle.

In addition, to clarify the result, the procedures should be repeated during the next cycle of menstruation.

According to these procedures, violations in folliculogenesis, if any, are detected. And also the exact date of ovulation is set, which is needed to determine the period of time suitable for conception.

How many follicles should ripen?

Normally, about ten follicles develop in a woman's body every month. But only one becomes dominant. If several have formed at once, then there is a high probability of the formation of a multiple pregnancy.

Why don't follicles mature?

Disruptions in the ovulation process are a common cause of infertility, which is preceded by various physiological and pathological factors in the body. Among them:

• lesion of an inflammatory or infectious nature of the pelvic organs;
• tumors of various origins and impaired microcirculation in the hypothalamus or pituitary gland;
• destructive conditions of the ovaries caused by surgery, inflammation, trauma;
• constant stress, depression;
• overweight;
• excessive physical activity;
• early.

The maturation of the follicle in the ovary is a regular multi-stage process depending on many reasons. In order for conception to occur at the intended time, deviations that interfere with fertilization must be detected in a timely manner. For this, an ultrasound examination is carried out, which helps to track folliculogenesis at each stage in order to identify pathologies.