Why does the dominant follicle not mature? What are the developmental features of the dominant follicle in the left ovary In gynecology, what is a dominant follicle

The female reproductive system is a complex biological structure that works by constantly producing different types of hormones. Changes occur monthly in a woman's body, which differ in stages and consistency.

Size chart according to the days of the menstrual cycle

IMPORTANT! These data are presented as average values for a menstrual cycle of 28 days. If it is longer or shorter, then the size of the “Graafian bubble” will be slightly different. However, before ovulation, they should be 18-24 mm.

If there is a Graafian bubble, when will you ovulate?

The presence of a "graafian vesicle" implies that ovulation will occur soon, but in clinical practice this does not always happen.

If there are endocrine disorders, insufficient or excessive production of the FSH hormone, then ovulation may not occur, and the Graafian bubble will not burst.

In this case, the following ultrasound picture is possible:

Follicular cyst.
Follicle regression.
Persistence.
luteinization.

The detection of a “graafian bubble” does not mean that ovulation will occur with a 100% probability. In most cases, this happens, and especially when it has reached its maximum size, but no one has canceled the endocrine mechanisms of a pathological nature.

IMPORTANT! If the dominant follicle has reached a size of more than 24 mm, then it is permissible to talk about the presence of a cyst. Ovulation in this case will not occur.

Features on ultrasound

Most often, the dominant follicle develops on the right ovary, but folliculogenesis is not excluded in the left pair of the organ. In any case, the ultrasound picture should not reveal any pathological changes.

Left ovary

If a “Graaffian vesicle” forms in the left ovary, then it is fixed on its stroma. The diameter of the bubble should correspond to the menstrual cycle.

No additional formations (cysts, malignant or benign tumors) are normally detected. The echogenicity of the ovary in the normal state is always average, and its dimensions fit into the allowable values.

In this case, deviations of 1-2 mm are not significant. The surface of the ovary is usually represented by tubercles or small mounds, as follicular capsules ripen on it.

During ovulation, some fluid may accumulate in the retrouterine space, which can be seen on ultrasound. The uterus itself and the fallopian tubes are also detected without features.

REFERENCE! At least 5 follicles should mature in each ovary. In total, there are about 12-13 of them with a diameter of about 3-7 mm. If there are fewer such capsules, then we can talk about pathology and infertility.

Right

Most often, the dominant follicle matures in the right ovary. With what it is connected, scientists could not find out. It is on the right ovary that the largest formation is usually found, which then bursts, forming a corpus luteum.

At the same time, no specific features are diagnosed on ultrasound. The right ovary fits into standard sizes, but slightly enlarges before ovulation.

In phase 1, at least 5 follicles are detected. They are located peripherally along the ovarian tissue. At 7-8 days a day, you can easily see the largest of them. It is this formation that gynecologists call the “dominant follicle”.

In the left non-ovulating ovary, no features are observed, with the exception of the maturation of small follicles no larger than 8-10 mm in size. In the future, they simply regress and die.

Generally speaking, ideally, the right and left ovaries should have the following ultrasound signs:

The location is typical.
Compliance with normal sizes (length: 20-38 mm, width: 17-30 mm, volume: 4-10 cm 3 , thickness: 15-23 mm).
Have moderate echogenicity with the exception of the Graafian vesicle, which has elevated echoes prior to ovulation.
Absence of cysts and neoplasms.

Cardinal changes in the ovaries occur only during pregnancy. They increase in size, which is a physiological norm. During menopause, there is a clinical picture of their reduction, as well as the absence of folliculogenesis.

In conclusion, it must be said that the dominant follicle is a rounded formation that forms in the ovary from the very first day of menstruation. Inside it is a mature egg, which is released into the fallopian tubes during ovulation.

The role of the “Graaffian vesicle” in the reproductive system is quite huge, because the further onset of the luteal phase of the cycle depends on its proper maturation.

If it does not form or does not ovulate, then it is impossible to conceive a child. The egg is simply not developed for fertilization. With such a clinical picture, treatment and careful diagnosis are necessary.

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 by successive steps:

The beginning of the formation of many small ,

Growth and development of small follicles,

maturation of the dominant follicle

Ovulation.

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

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 completion 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 the dominant follicle is affected by many factors that can lead to its death. However, it is designed in such a way that all its processes are aimed at preserving the egg and fertilizing it. Therefore, the dominant follicle is “protected” by epidermal growth factor and transforming growth factor (TGF).

5-7 days after the onset of menarche, 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 ones. The diameter of these small formations does not exceed 5 mm. They are located in the form of "beads" on the periphery of the ovary. For some time, part of the follicles increases in size and gains strength.

Therefore, the dominant follicle is formed after about 10 days of the menstrual cycle, and at this time its size reaches 15 millimeters. Other follicles that could not gain the desired 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 is not common, but such cases have been recorded. Most often this is an iatrogenic cause: hormone-based drugs, or IVF. But the physiological reason for the birth of twins and triplets is not excluded.

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 yellow body should form, slightly smaller than its predecessor.

If fertilization does not occur, then within a week after the release of the egg from 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 off, and in its place there can only be a site of disturbed echogenicity.

Speaking of folliculogenesis, one cannot help but dwell on the concept of "persistent follicle".

A persistent follicle is one that goes through all stages of folliculogenesis, except for immediate ovulation. What reasons may lead to this phenomenon is 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 should 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 such a situation, because the endometrium of the uterus is too thin for implantation.

INTERESTING! The dominant most often occurs, but with artificially stimulated ovulation, it grows on both. And in this case, the chance of conceiving twins increases.

Why is it missing?

When the dominant does not appear, in a woman, and pregnancy is impossible. The causes of this pathology are as follows:

ovarian cyst;
"sleeping" ovaries;
violations in the development of the dominant.

persistence

When there is not enough progesterone and luteotropin in the body, the follicle, having taken the right size, cannot burst and release the egg. In this case, it is called persistent, and the pathology is called persistence. Her symptoms are:

there is no fluid behind the uterine cavity;
the amount of estrogen is very high;
and the amount of progesterone is too low;
the corpus luteum does not develop.

ATTENTION! With persistence, the dominant remains on the ovary throughout the entire menstrual cycle, and sometimes it can be fixed even after the end of the cycle. Thus, the body seems to be ready for ovulation, but it does not occur.

Cyst

When a follicle fails to rupture and release an egg, but instead continues to grow, it turns into a cyst on the ovary. This cyst is a benign formation that occurs due to hormonal failure.

The risk of its occurrence is also increased by factors such as:

chronic diseases of the pelvic organs;
frequent abortions;
operations of the genitourinary sphere;
wrong diet.

Such a violation affects the woman's menstrual cycle, affecting its duration and regularity. Thus, the cyst interferes with the creation of a new dominant follicle. However, it rarely needs treatment, and usually goes away on its own within two, sometimes three, cycles.

Sleeping ovaries

In this case, we are talking about ovarian dysfunction, in which there are simply no follicles, no. They don't grow at all. And ovulation never occurs.

Does not mature for other reasons

Developmental disorders are a pathology in which the follicles stop at one of the stages of development and suddenly begin to regress. At the same time, a dominant can form, but it will not reach the desired size by the time of the ovulation phase.

IMPORTANT! With developmental disorders, hormonal analysis does not show any pathologies, fully complying with the norm.

What to do?

If there is a suspicion that the dominant is absent, you need to consult a doctor and undergo a series of examinations. After that, the cause of the pathology will be established and the necessary treatment will be prescribed. Self-medication should not be done, so as not to aggravate the condition.

At the hospital, the doctor will perform an examination on a gynecological chair. And since the most common reason for the absence of a dominant is a hormonal failure, he will prescribe a blood test for hormones.

Moreover, at different stages of the cycle, because for the formation of a dominant in each phase, a different amount of hormones is needed. And the doctor needs to know at what stage and which hormones are not enough.

Folliculometry is also prescribed - a procedure that includes ultrasound diagnostics throughout the entire cycle. This allows you to track the work of the ovaries in each phase.

In addition, the doctor will pay attention to the duration of the cycle, because if it is longer or shorter than normal, this is a sign of ovulation disorder.

ATTENTION! A cycle when the dominant is not formed occurs several times a year in absolutely healthy women. This is normal and means that the body seems to be resting.

Prevention methods

Preventive measures are aimed at supporting the creation of follicles and preventing ovarian dysfunction.

These include:

quitting smoking, alcohol, drugs;
a full sexual life with regular sexual intercourse;
active lifestyle, nutritious diet;
if possible, avoiding stress and excessive physical exertion;
taking measures to protect against STDs;
exclusion of abortion;
control of the level of hormones in the blood.

And without fail, it is necessary to regularly undergo preventive examinations in the antenatal clinic.

What treatment is prescribed?

Since most often the reason for the absence of a dominant follicle is hormonal failure, treatment is prescribed with the help of hormonal drugs. The schedule for their intake is made by a doctor, depending on how saturated the woman's body is with estrogens.

A week before menstruation, progesterone may be prescribed in the form of a 1% solution, by injection. To stimulate the ovaries to grow and develop follicles, doctors recommend estrogen medications such as Estradiol or Hexestrol. However, you cannot start hormonal treatment on your own - this will further increase hormonal failure.

In addition, if necessary, the doctor may prescribe treatment for inflammatory diseases of the urinary-genital area.

In conclusion, we can add that a healthy lifestyle is the best prevention of ovulation problems. And if the absence of a dominant follicle has already been diagnosed, do not despair: modern medicine can help in recovery.

The coordinated work of all organs of the reproductive system of a woman is the key to a successful pregnancy. Once a month there comes a period of time when conception can occur. These days, one of the eggs leaves the follicle after its rupture and goes to the uterine cavity.

During sexual intercourse during the period of ovulation, there is a high probability of the fusion of female and male germ cells, the formation of a zygote, and then the gradual formation of a new person. If a couple in love trying to conceive a child for a long time fails, perhaps the reason lies in the violation of the maturation of the dominant follicle.

What it is?

This is the reservoir of the egg, after the release of which ovulation occurs.

Even in embryogenesis, the laying of structures occurs, in which the eggs will be located later.

On average, a girl has about 200,000 follicles in her ovaries.

In girls who have reached puberty, a regular menstrual cycle is established, in one of the phases of which the formation and release of germ cells occurs.

Several follicles can mature at the same time, but in the future, one of them will experience increased growth. It is from it that the egg will subsequently come out. This structure, which prevails over its counterparts in the process of maturation, is called the dominant follicle.

Sometimes there are cases when two dominant follicles are formed, but normally only one is needed. When it bursts, ovulation occurs and conception is possible.

Graaffian bubbles, which are lagging behind in development from the dominant one, undergo a process of reverse development and disappear. After the implementation of its function, the dominant follicle is also transformed. It turns into a corpus luteum, which has its own hormonal influence on the course of the menstrual cycle and pregnancy. There may also be disturbances in the development of follicles.

These include:

- these structures of the reproductive system, having reached a certain size, stop further growth, but their involution does not occur. They continue to be in the ovaries. The most justified reason that can explain this phenomenon is considered to be too thick or strong wall of the follicles;
Premature Regression- when the vesicles either do not reach the desired size, or reach, but reverse development occurs even before the eggs are released from them;
Cyst formation- occurs if the opening of the capsule has not happened, and the follicle continues to grow. A cyst or several such neoplasms are formed, which can not only lead to infertility, but also to a breakdown in the functions of other body systems.

Important! In violation of the normal maturation of the dominant follicle, ovulation does not occur, which leads to infertility. Therefore, when its signs appear, a woman herself or with her partner can come to a specialist to determine what is the reason for the impossibility of conception. The doctor will conduct an examination, which will include a blood test to assess the hormonal levels and an ultrasound of the ovaries, and offer options for solving the problem.

Why is it formed in the right or left appendage?

Two dominant bubbles can form at once.

But in the vast majority of cases, indeed, only one grows, which is responsible for further ovulation.

No difference was found between the dominant follicles that developed in the right and left ovaries.

It is only noticed that more often this process is carried out in the right uterine appendage. There is no reliable explanation for this, although there is a theory that maturation on the right occurs mainly in right-handed people due to the prevailing action of the nervous system on this side. It is also worth noting that the right ovary is larger than the left, the blood supply in it is more intense.

Sometimes dominant follicles are formed simultaneously in two uterine appendages.

The reason for this may be:

genetic predisposition- if in the family of a woman there were cases of the birth of twins, then it is likely that she will suffer the same fate;
Hormonal imbalance- can be caused by taking medications, abruptly canceling them, nervous or physical overexertion;
Irregular sex life when intimate relationships are very rare.

Also, the presence of a dominant Graaffian vesicle can often be found in one and the other ovary in girls who have not yet given birth, but have already crossed the threshold of their thirties. Apparently, in this way, nature increases their chances of getting pregnant.

If two dominant follicles develop in one appendage, this is not considered a pathology. All of the above etiological factors play a role in such a situation. In each of them, an egg matures, and if there is no disturbance in these processes, two ovulations will occur in one cycle. After intercourse, a double conception is possible, leading in the future to the birth of twins.

Note! If a girl, in whose body there are two dominant follicles, had sexual contacts with different partners in one period of time, the probability is quite high that she will simultaneously give birth to children from different fathers.

An ultrasound examination visualizes the presence of one or more dominant follicles. They differ from other vesicles in size - at the last stage of formation, the follicles reach an average of 22 mm.

Does maturation occur in every cycle?

Yes, ovulation is normal - the rupture of the follicle and the release of the egg from it should be observed in each menstrual cycle.

If this does not happen, then there are some pathological changes in the female body that require a more detailed study.

It is also considered normal if there are two non-ovulatory cycles per year that do not follow each other (for example, in January, and then in February).

A one-time failure of a function may occur after exposure to some strong internal or external factor, but the occurrence on a permanent basis is a cause for concern. If a girl noticed that there were disorders in the activity of her reproductive system, and they do not go away for a long time, she needs to seek the advice of a specialist. The sooner this happens, the better.

Stages of development

The reproductive system begins to emerge in embryogenesis. In the fetus, it is represented, among other things, by immature oocytes (immature eggs), surrounded by connective tissue. These cells with a completely unformed membrane are called premordial follicles. At puberty, they begin to produce estrogens, participate in the regulation of the menstrual cycle, and become preantral. One of them becomes dominant, and also undergoes some changes necessary for reproductive function.

Stages of formation of a dominant follicle:

Elementary- occurs along with the appearance of menstruation, the intensity of growth increases as it approaches the hormone-dependent stage, when the level of progesterone and estrogens decreases, and the follicle-stimulating hormone is actively synthesized. There are biological mechanisms in the female body that negatively affect this process, but thanks to the epidermal and transforming growth factor, the bubble receives protection. It gradually fills with liquid, increases in size, reaching about 5 mm. This is now a tertiary or antral follicle;
middle of development- closer to the 10th day of the cycle, the dominant bubble increases to 15 mm, gaining strength. At the same time, the rest stop growing and regress. By the time of ovulation, it becomes larger by another 5 mm. Next, the opening and release of the egg occurs;
Finite- gradual regression and transformation of the follicle into a corpus luteum. After transformation, it begins to secrete other hormones and perform slightly different functions.

Important! Development can be disturbed, and this is manifested either by the appearance of persistent forms that do not mature further, but do not disappear either, or by pathological growth without rupture, resulting in a cyst. Such deviations may not have a significant impact, but if a negative impact occurs, they must be eliminated.

Why might he be missing?

The absence of a dominant follicle may be based on a hereditary predisposition or hormonal imbalance, but it can be said for sure that it does not bode well.

This physiological formation, containing the egg, plays one of the main roles in the process of conception.

If it is not present, the woman is unable to conceive.

In such a situation, you should seek the help of a specialist. He will conduct an examination, the purpose of which is to search for the etiological factors of pathology. Having learned the reason, the doctor will prescribe the appropriate treatment. Basically, it consists in the use of hormonal drugs. It is thanks to them that you can influence the maturation of the follicles and significantly increase the likelihood of conception. With the correct use of hormones that are active in certain phases of the cycle, it can be adjusted and fertility can be restored.

Expert opinion

Olga Matveeva

Gynecologist-obstetrician
Experience 6 years

In the human body, everything is calculated and provided for to the smallest detail. Long before the birth of a child, mechanisms and structures appear that in the future will be responsible for the continuation of his kind. These amazing processes can be disturbed, but modern medicine helps in solving such problems. For any woman, especially for one who wants to become a mother, it is important that there are no failures in the work of the reproductive system. Violation of the maturation of follicles, often leading to infertility, is a reason to consult a doctor. In our time, there is every opportunity to eliminate the problems that caused many families to break up decades ago.

Content

The female body is arranged in such a way that the birth of a new life depends on the quantity and quality of these small follicular elements in which the egg matures. Expectant mothers should know what processes are going on in their reproductive organs in order to contact a gynecologist in time for violations.

What are follicles

The process of the emergence of human life begins with the fertilization of the egg. What are follicles? These are the elements that protect her, the place where she matures until the moment of ovulation. The egg is securely surrounded by a layer of epithelium, a double layer of connective tissue. The possibility of pregnancy and bearing a child depends on high-quality protection. On ultrasound, it looks like a round formation. The second function of the elements is the production of the hormone estrogen.

Follicles on the ovaries go through their monthly cycle of evolution:

start developing a few small pieces;
one - antral - begins to increase in size;
the rest decrease and die off - atresia occurs;
the largest - dominant - continues to grow;
under the influence of hormones, it breaks through, ovulation occurs;
the egg enters the fallopian tubes;
during sexual intercourse at the time of the meeting with the sperm, fertilization occurs;
if this does not happen, during menstruation, the egg leaves the uterus along with the epithelium.

What is a dominant follicle

By the middle of the menstrual cycle, the follicular apparatus approaches the main stage of its activity. What is a dominant follicle? This is the largest and most mature element that protects the egg, which is already ready for fertilization. Before ovulation, it can grow up to two centimeters, more often located in the right ovary.

In a mature state, under the influence of hormones, it breaks - ovulation. The egg rushes to the fallopian tubes. If the maturation of the dominant element does not occur, ovulation does not occur. The causes of this condition are developmental disorders.

Persistent ovarian follicle - what is it

Due to hormonal changes that begin in adolescence, during menopause, there may be a violation of the activity of the follicular apparatus - persistence. This can cause delayed menstruation, bleeding. Persistent ovarian follicle - what is it? The situation means that the protective element:

matured;
reached a dominant state;
there was no rupture;
the egg did not come out;
fertilization did not follow;
pregnancy did not take place.

In this position, persistence occurs - the reverse development of the follicular formation, with further development of events from it, the formation of a cyst is possible. In order for the formation to burst, treatment with progesterone is prescribed in gynecology. What happens during persistence? The following process develops:

hormones continue to be produced;
thickening of the endometrial mucosa occurs;
the uterus is compressed;
the endometrium begins to shed;
bleeding occurs.

Primordial follicle

The reserve of eggs for the whole life of a woman is laid in the womb, it is called the ovarian reserve. The primordial follicle is the primary stage in the development of the protective element. The rudiments of germ cells - oogonia - are located on the periphery of the inner surface of the ovary, have dimensions that are not visible to the eye. They are protected by a layer of granulosa cells and are at rest.

This continues until the girl's puberty - the beginning of the menstrual cycle. The course of this period is characterized by:

the formation of follicle-stimulating hormone;
under its influence, the growth of the nucleus of the egg - the oocyte;
maturation of two layers of the outer protective shell;
monthly development of several follicular elements that protect the egg.

Antral follicles

At the next, secondary stage, the follicles in the ovaries continue their development. Around the seventh day of the cycle, there is an increase in the number of cells that produce follicular fluid. Structural processes of the structure take place:

antral follicles start producing estrogen on day 8;
theca cells of the outer layer synthesize androgens - testosterone, androstenedione;
the cavity containing the follicular fluid increases;
The epithelium differentiates and becomes two-layered.

Preovulatory follicle - what is it

At the last, tertiary stage of maturation, the egg takes its place on a special hill, it is ready for fertilization. Preovulatory follicle - what is it? At this point, it is called the Graaffian bubble and is almost completely filled with liquid. Its number has increased tenfold compared to the previous period. The day before ovulation, major changes begin to occur.

At this time, the production of estrogen increases, then:

it stimulates the release of luteinizing hormone, which triggers ovulation;
the Graafian bubble forms a stigma on the wall - a protrusion;
a breakthrough appears at this place - ovulation;
after that, a corpus luteum is formed, which prevents the rejection of the endometrium due to the production of progesterone;
after ovulation, it forms a pronounced network of blood vessels, helping the further formation of the placenta.

Solitary follicles in the ovary

How many tragedies happen because of the impossibility of conceiving a child. In some cases, ovarian impoverishment syndrome is observed. A woman is not able to become pregnant because their functioning stops. Single follicles in the ovary cannot develop to a normal size, there is a lack of ovulation, an early menopause occurs. The reasons for this situation may be:

active sports;
starvation diets;
menopause;
hormonal disorders;
obesity.

The norm of follicles in the ovary

If there is an abnormal development of the follicular apparatus, the woman undergoes a regular examination for ultrasound. Compare the real picture and the number of follicles in the norm. With deviations - increases or decreases - a pathology arises - the impossibility of conception, the woman begins to be treated. How many follicles should an ovary have? At reproductive age, it depends on the days of the cycle:

on the sixth, seventh - from 6 to 10 pieces;
from the eighth to the tenth - one dominant appears - the rest die off.

How many follicles should be for conception

In order for a woman to become pregnant, the full maturation of the egg is necessary. How many follicles should be for conception? At the stage before fertilization, it is necessary to have one - high-quality dominant development. He must be ready to ovulate. If two such formations are found during an ultrasound examination, and they both undergo fertilization, twins will be born.

Follicle maturation

Folliculogenesis - the process of growth and maturation of the follicle under favorable conditions ends with ovulation and fertilization. Things don't always go well. In case of developmental disorders, observation and analysis is carried out using ultrasound. Starting from the 10th day of the cycle, the growth of the dominant element is monitored. If slow maturation is observed, ovulation does not occur, treatment is prescribed. During the next cycle, monitor the results. So you can increase the rate of maturation, achieve the onset of a long-awaited pregnancy.

Follicle size by day of cycle

Every month during menstruation, there is a gradual growth of follicles by day. The following process is observed:

until the seventh day, the size of the bubble is in the range from 2 to 6 millimeters;
starting from the eighth, there is an activation of the growth of the dominant formation up to 15 mm;
the rest shrink and die;
from 11 to 14 days of the cycle there is a daily increase;
the mature element can be up to 25 mm in size.

Many follicles in the ovary - what does it mean

Deviation from the norm in the direction of increase is considered a pathology. A large number of follicles in the ovaries - more than 10 pieces are called multifollicular. With ultrasound, a huge number of small vesicles are observed, which is called follicular ovaries or polyfollicularity. When their number increases several times, a diagnosis of polycystic disease is made.

This situation does not mean the formation of a cyst, it is characterized by the presence of multiple follicular elements along the periphery. This can interfere with the development of dominant education, ovulation and conception. Such problems can be caused by stress or nervous disorders, and can quickly return to normal. Requires treatment for a situation caused by:

improper selection of oral contraceptives;
endocrine problems;
weight gain;
drastic weight loss.

Few follicles in the ovaries

A woman cannot become pregnant, to find out the reason, she is prescribed an ultrasound scan. Such a study takes place during the antral phase of the activity of the follicular apparatus - on the seventh day of the menstruation cycle. When at the same time they find that there are very few follicles in the ovaries, it is possible that the situation was provoked by a decrease in hormone levels. The analysis is carried out using a vaginal probe. If, during the examination, the follicles in the ovaries are in the amount of:

from 7 to 16 - there is a chance of conception;
from 4 to 6 - the possibility of getting pregnant is small;
less than 4 - there is no chance of conception.

Two dominant follicles in one ovary

During the treatment of infertility with hormones, their concentration increases, instead of one, two dominant follicles mature in one ovary. It rarely happens on the left side. Those elements that should have stopped their development under the action of hormones begin to grow. Fertilization of two eggs can occur simultaneously or with a short time interval. This will lead to the birth of twins. If a woman has had sexual intercourse with different men in a short period, it is possible that the children will have different fathers.

Why the follicle does not mature - reasons

Developmental disorders have very serious problems - it leads to infertility. Why is the follicle not growing? There can be many reasons for this:

early menopause - natural or surgical;
disruption of the ovaries;
having problems with ovulation;
low estrogen production;
endocrine disorders;
inflammation in the pelvic organs;
pituitary pathology.

Interruptions in maturation cause: stressful situations, the presence of depression, nervous strain. An important role is played by the state of the follicular component itself, it can:

absent;
have a stop in development;
not reach the required dimensions;
be late with maturation;
not develop at all;
linger with the moment of formation.

Learn more, .

Follicles in the ovaries - the number is normal. Dominant follicle and how maturation occurs in the ovaries