The size of the follicle is 33 mm, is ovulation possible? Follicles in the ovaries - the number is normal. Dominant follicle and how maturation occurs in the ovaries. Why does the follicle not grow

The follicle is the component of the ovary that is surrounded by connective tissues and is made up of an ovum. The follicle contains the nucleus of the oocyte - the "embryonic vesicle". The oocyte is located inside a glycoprotein layer surrounded by granulosa cells. The granulosa cells themselves are surrounded by a basement membrane, around which are theca cells.

The primordial follicle consists of an oocyte, a stroma cell, and a follicular cell. The follicle itself is almost invisible, its size averages 50 microns. This follicle is formed before birth. It is formed due to germ cells, they are also called oogonia. The development of primordial follicles is facilitated by puberty.

A single-layer ordinary follicle consists of a basal plasty, a follicular cell that forms a transparent membrane, and a multilayer primary follicle consists of a transparent membrane, an inner cell, and granulosa cells. During puberty, follicle-stimulating hormone (FSH) begins to be produced. The oocyte grows and is surrounded by several layers of granulosa cells.

The cavitary (antral) follicle consists of a cavity, the inner layer of Theca, the outer layer of Theca, granulosa cells, a cavity containing follicular fluid. Granulosa cells are already starting to produce progestins. The diameter of the antral follicle averages 500 µm. The gradual maturation of the follicle with the formation of its layers gives rise to the production of female sex hormones, including estrogen, estradiol, androgen. Thanks to these hormones, this follicle turns into a temporary organ of the endocrine system.

A mature follicle (Graaffian vesicle) consists of an outer layer of the theca, an inner layer of the theca, a cavity, granulosa cells, a radiant crown, and an oviparous tubercle. Now the egg is located above the egg tubercle. The volume of follicular fluid increases by 100 times. The diameter of a mature follicle varies from 15 to 22 mm.

How big should a follicle be?

It is impossible to answer this question unambiguously, since the size of the follicles change during the menstrual cycle. Follicles are fully formed by an average of fifteen years. Their sizes are determined only with the help of ultradiagnostics.

We will most accurately analyze the norm for the size of the follicle by the days of the menstrual cycle.

In the first phase of the menstrual cycle (1-7 days or the beginning of menstruation), the follicles should not exceed 2-7 mm in diameter.

The second phase of the menstrual cycle (8-10 days) is characterized by the growth of follicles, mainly their diameter reaches 7-11 mm, but one follicle can grow faster (it is commonly called dominant). Its diameter reaches 12 - 16 mm. On the 11-15th day of the menstrual cycle, the dominant follicle should normally increase by 2-3 mm every day, at the peak of ovulation it should reach a diameter of 20-25 mm, after which it bursts and releases the egg. Meanwhile, other follicles simply disappear.

This is what the follicle growth looks like. This is repeated monthly until the onset of pregnancy. For a more visual and understandable definition, we provide you with a table by which you can understand whether your follicles are maturing normally.

What is a dominant follicle

The dominant follicle is considered to be the follicle that is ready for successful ovulation. With natural ovulation, it stands out for its size. As we said earlier, although all follicles begin to grow, but only one of them (in rare cases, several) grows to a size of 22 - 25mm. It is he who is considered dominant.

Generative function as a priority. Let's figure out what it is.

There are two components of ovarian function.

The generative function is responsible for the growth of follicles and the maturation of an egg capable of fertilization. The hormonal function is responsible for steroidogenesis, which changes the lining of the uterus, helps not to reject the fetal egg, and regulates the hypothalamic-pituitary system. It is generally accepted that the generative function is in priority, so if it fails, the second one loses its abilities.

At what size follicle does ovulation occur?

Ovulation is the release of an egg from a burst mature follicle. In this case, the size of the follicle during ovulation becomes 15 - 22 mm (in diameter). To make sure that you have a full-fledged follicle by the time you ovulate, you need an ultrasound.

empty follicle syndrome

Currently, two types of this syndrome are described: true and false. Distinguishes their level of hCG. It can be said that thanks to IVF technology, scientists have examined under a microscope the phenomena when the follicle is “empty”.

According to statistics, in women under 40 years of age, this syndrome occurs in 5-8% of cases. The older a woman gets, the higher the number of empty follicles. And this is no longer a pathology, but the norm. Unfortunately, it is impossible to accurately and immediately diagnose this syndrome. To do this, you will need to completely exclude damage to the ovaries (structural anomaly), lack of ovarian response to stimulation, premature ovulation, hormonal failure, defects (pathologies) in the development of the follicles, and premature aging of the ovaries. That is why there is no such diagnosis as an “empty follicle”.

But scientists have found the reasons that accompany the development of the syndrome. Namely: Turner's syndrome, incorrect time of administration of the hCG hormone, incorrect dose of hCG, incorrectly selected IVF protocol, incorrect technique for sampling and washing the material. As a rule, a competent reproductologist, before making this diagnosis, carefully collects an anamnesis.

polycystic ovary syndrome

Otherwise, it is called the Stein-Leventhal syndrome. It is characterized by dysfunction of the ovaries, the absence (or altered frequency) of ovulation. As a result of this disease, follicles do not mature in the body of a woman. Women with this diagnosis suffer from infertility, lack of menstruation. A variant is possible when menstruation is rare - 1-3 times a year. Also, this disease affects the violation of the hypothalamic-pituitary functions. And this, as we wrote earlier, is one of the functions of the proper functioning of the ovaries.

Treatment here can proceed in two ways. It is operational and medical (conservative). The operative method often involves resection with the removal of the most damaged area of ovarian tissue. This method in 70% of the case leads to the restoration of a regular menstrual cycle. For a conservative method of treatment, hormonal drugs are mainly used (Klostelbegit, Diana-35, Tamoxifen, etc.), which also help regulate the menstrual process, which leads to timely ovulation and the desired pregnancy.

Folliculometry: definitions, possibilities

Under the name folliculometry, it is customary to understand the observation of the reproductive system of a woman during the menstrual cycle. This diagnostic tool allows you to recognize ovulation (whether it was or not), determine the exact day, and monitor the dynamics of follicle maturation during the menstrual cycle.

Monitoring the dynamics of the endometrium. For this diagnosis, a sensor and a scanner are used (it is more common for us to call this ultrasound). This procedure is absolutely identical to the procedure for ultrasound of the pelvic organs.

Folliculometry is prescribed for women to determine ovulation, evaluate the follicles, determine the day of the cycle, for timely preparation for fertilization, to determine whether a woman needs to stimulate ovulation, to reduce (in some cases increase) the likelihood of multiple pregnancy, to determine the reasons for the absence of a regular menstrual cycle , detection of diseases of the pelvic organs (myomas, cysts), to control treatment.

This procedure does not require strict preparation. It is recommended only during these studies (usually ultrasound is done more than once) to exclude from the diet foods that increase bloating (soda, cabbage, black bread). The study can be carried out in two ways: transabdominally and vaginally.

The values of indicators of the norm and pathology of the development of follicles

The norms of indicators both by day and during ovulation, we described above (see above). Let's talk a little about pathology. The main pathology is the lack of follicle growth.

The reason may be:

in hormonal imbalance
polycystic ovaries,
dysfunction of the pituitary gland,
inflammatory processes of the pelvic organs,
STD,
neoplasms,
severe stress (frequent stresses),
breast cancer,
anorexia,
early menopause.

Based on practice, health workers distinguish such a group as hormonal disorders in a woman's body. Hormones inhibit the growth and maturation of follicles. If a woman has a very small body weight (plus there are still STD infections), then the body itself recognizes that it cannot bear a child, and the growth of the follicle stops.

After normalization of weight and treatment of STDs, the body begins the proper growth of follicles, and then the menstrual cycle is restored. During stress, the body releases hormones that contribute to either miscarriage or follicle growth.

After a complete emotional recovery, the body itself begins to stabilize.

Stimulation of ovulation

Under stimulation, it is customary to understand a complex of hormonal therapy, which helps to achieve fertilization. It is prescribed for women with a diagnosis of infertility for IVF. Infertility is usually diagnosed if pregnancy does not occur within a year with regular sexual activity (without contraception). But there are also contraindications for stimulation: impaired patency of the fallopian tubes, their absence (except for the IVF procedure), if it is not possible to conduct a full-fledged ultrasound, low follicular index, male infertility.

The stimulation itself occurs using two schemes (they are usually called protocols).

First protocol: increase in minimum doses. The purpose of this protocol is the maturation of one follicle, which excludes multiple pregnancy. It is considered sparing, since when using it, ovarian hyperstimulation is practically excluded. When stimulated with drugs according to this scheme, the size of the follicle usually reaches 18-20 mm. When this size is reached, the hCG hormone is injected, which allows ovulation to occur within 2 days.

Second protocol: lowering high doses. This protocol is prescribed for women with a low follicular reserve. But there are also requirements for it that are considered mandatory indications: age over 35, previous ovarian surgery, secondary amenorrhea, FSH above 12 IU / l, ovarian volume up to 8 cubic meters. With the stimulation of this protocol, the result is already visible on the 6th - 7th day. With this protocol, the risk of ovarian hyperstimulation is high.

Control ultrasound examination. This study is usually carried out transvaginally. The purpose of the study is to confirm ovulation. This ultrasound should normally show that there is no dominant follicle, but there is a corpus luteum. There may be some free fluid behind the uterus. Ultrasound is performed strictly 2-3 days after the expected ovulation, since if you are late, you can not see the corpus luteum, and the same fluid.

A woman's ability to conceive and bear is determined by the number of follicles in the ovary. The expectant mother must have an idea about the processes taking place in the reproductive organs. Knowing how many ovarian follicles should be normal will allow her to receive medical attention in a timely manner in case of danger.

Follicles are the structural components of the ovary, consisting of an egg and 2 layers of connective tissue. The number of these elements depends on the age of the woman. A pubertal girl has about 300,000 follicles ready to produce eggs. In a woman aged 18-36, about 10 elements mature every 30 days. At the very beginning of the cycle, 5 structural components can mature simultaneously, then 4, then 3. By the time of ovulation, there is only one left.

No need to worry

Normally, the number of follicles in the ovaries is determined by the days of the cycle. If a couple of days after the end of menstruation, numerous follicles are present in the ovaries, this is normal.

The middle of the cycle is characterized by the appearance of 1-2 elements, the size of which is slightly different from the rest. Then a mature egg begins to emerge from the largest follicle. The size of this element allows us to call it dominant.

You can specify the number of follicles in the ovaries using ultrasound of the appendages. This procedure is carried out by means of a vaginal probe. So the specialist finds out the number of antral follicles, the size of which varies between 2-8 mm. Their number is interpreted as follows:

16-30 - the norm;
7-16 - low level;
4-6 - low probability of conceiving;
less than 4 - the likelihood of infertility.

Ultrasound scanning most often reveals 4 to 5 follicles. Less commonly, 2 to 3 elements are visualized. In preparation for in vitro fertilization, a woman is prescribed hormonal stimulation of the maturation of follicles. Therefore, in the course of the study, from 4 to 6 ripened elements can be found.

Size by day

With each critical day, there is an increase in the volume of follicles by day. Up to 7 days, their size ranges from 2-6 mm. Starting from the 8th, there is an active growth of the dominant follicle. Its size reaches 15 mm. The remaining elements gradually decrease and die. On the 11-14th day, an increase in follicles is observed. The volume of a mature element often reaches 2.5 cm.

Deviation from the norm

It is important to know what level of follicles is considered abnormal. More than 10 elements are called . Sometimes many levels of miniature bubbles are found during the examination. This phenomenon is called polyfollicularity.

If more than 30 elements are found during the study, then the woman is diagnosed. This pathology is an obstacle to the formation of a dominant follicle. Ovulation and conception at the same time become questionable. If the disease develops against the background of stress or emotional overstrain, then treatment is not carried out. Medical assistance is needed when polycystic is provoked by:

Sharp weight loss.
A rapid set of extra kilos.
endocrine pathologies.
Incorrect selection OK.

The follicular component can either be absent altogether or stop in its development. Often there is a delay in its formation or late maturation.

If the number of follicles changes down, the woman also has problems conceiving. In order to find out the exact cause, the doctor prescribes an ultrasound examination. It is carried out when the follicular apparatus is in the antral stage. This is observed on the 6-7th day of the cycle. The main provocateur of a decrease in the number of follicles is a decrease in hormonal levels.

In some women, maturation of follicles is observed during lactation. If their size varies from 6 to 14 mm, this indicates that a mature egg will soon have to come out. Then ovulation will occur and menstruation will come.

Development of a dominant and persistent follicle

Often there is uneven development of follicles in the ovaries. In some women, the presence of dominant elements in both organs is revealed. If they covulated at the same time, this suggests that a woman can conceive twins. But this is rarely seen.

You need to sound the alarm when a follicle is detected. This often indicates an incorrect development of the dominant, which does not allow the egg to come out. Over time, this background appears.

Persistence occurs on the left or on the right. The main provocateur is the increased production of the male hormone. Improper treatment leads to infertility.

To resuscitate the reproductive system, a woman is prescribed hormonal treatment. The therapy is carried out in stages. From the 5th to the 9th day of the cycle, a woman is prescribed the use of pharmacological drugs. 8 days before the arrival of critical days, the patient is given hormone injections. The duration of such treatment varies from 4 to 7 days. In the interval between the use of drugs, stimulation of the pelvic organs is carried out. A woman is assigned to undergo laser therapy and massage.

Main reasons for absence

When there are no follicles in the ovaries, we can talk about hormonal failure. Other factors provoking the lack of development of the follicle include:

natural early menopause;
improper functioning of organs;
surgical early menopause;
decreased production of estrogen;
disorders of the pituitary gland;
the presence of an inflammatory process.

Presence of single elements

Some women are diagnosed with ovarian impoverishment syndrome. Against the background of the cessation of the functioning of organs, a woman cannot conceive and bear a child. Single follicles develop poorly, ovulation is absent. This leads to an early menopause. The main reason for this condition is excessive physical activity. The risk group includes professional athletes and women doing men's work. Other reasons include menopause, a sharp jump in weight up, hormonal imbalances. Often this phenomenon is observed in women who adhere to a very strict diet.

Timely treatment helps many women. You can prevent the development of a dangerous disease by calculating your menstrual calendar. If the cycle is irregular and often goes astray, then you should immediately consult a doctor.

Throughout a woman's life, the ovaries produce a strictly defined number of follicles. Deviation from the norm does not always indicate the course of a dangerous pathological process. But if a woman ignores this signal of the body, this will lead to sad consequences.

On different days of the menstrual cycle, the follicles have a certain size, as they mature, they increase, and before menstruation they break, releasing the sex cell. Knowing about the change in the diameter of the follicular tissue is important, as it helps to calculate the period of ovulation, as well as determine the parameters of the health of the woman's reproductive system. What is the size of the follicle on the days of the cycle and why can it stop growing?

The "rudimentary" sex cells are laid in the body of every girl even before her birth, there are about 8-10 thousand of them inside the ovaries. But initially, such rudiments are not yet ready for fertilization, because they must go through several successive divisions for maturation. To protect the egg during its growth and transformation, several layers of epidermal tissue grow around it - this is the follicle, which resembles an epithelial cocoon.

Follicular tissue is under the influence of the endocrine system, its increase and development is regulated by the hormones of the ovaries themselves, as well as the pituitary gland, an indirect effect is observed from the adrenal glands. For example, FSH (follicle-stimulating hormone) stimulates the maturation of primordial (rudimentary) follicles during adolescence and on different days of the menstrual cycle, and LH (luteinizing) helps to accelerate their growth for further release of the germ cell before ovulation.

Size by day of cycle

The size of the follicle changes on different days of the menstrual cycle. After the end of menstruation, under the influence of the active substances of the ovaries and pituitary gland, the development of several epithelial cocoons (up to 6-7 pieces) begins, but by the eighth day after the onset of development, a dominant follicle appears, in which the gene activity was the highest, so it reached the mark of 8 the fastest. -10 mm. The remaining epithelial cocoons may stop growing or undergo apoptosis, that is, planned cell death.

Dominant follicle development

After that, the body "concentrates" on this dominant follicle, and the growth of the rest stops to save nutritional resources and energy. Every day before ovulation, there is an increase in this epithelial cocoon for the egg by 1.5-2 mm in diameter. During this period, the egg begins to mature, undergoes several successive divisions, during which nutrients are concentrated inside it, the necessary membranes appear (there are 3 of them in the egg).

On the 11th day of the cycle, the size of the follicle is about 15-16 mm, after which its growth slows down a bit. During this period, the egg is already at the final stage of its development, preparation for ovulation begins. On which day it happens depends on the activity of the endocrine system and the state of health of the woman, usually this happens on the 15-16th day.

On the 15th day of the cycle (sometimes there are shifts of 2-3 days), the follicle reaches 22-24 mm in diameter and a critical point occurs, since it can no longer grow, so the epithelial cocoon breaks and the sex cell comes out - into the abdominal cavity, and then into the fallopian tubes.

It is during this period, which will last only 36-50 hours, that fertilization can occur. But it is important to understand that under the influence of hormones, ovulation, that is, the release of an egg, can occur sooner or later. If you observe the follicular tissue during the ovulatory phase, you can see how the epithelial cocoon increases dramatically, the egg is released, and after that it decreases, only its remnants (yellow body) are visible.

Follicle Growth Chart

After reading a short information about, the algorithm itself becomes clear, but it is difficult to understand the exact data, so below is a simple table that shows the size of the epithelial coating of the egg on different days of the menstrual cycle.

The indicators presented in the table are the established norm for the development of follicles on the days of the cycle, but it is not in vain that the gynecologist, in order to prescribe contraceptives or determine “safe” days of the cycle, checks the size data for the girl individually, because the rate of maturation and growth of the egg in the follicular cocoon depends on her heredity , the work of the endocrine system, the level of stress and even weight.

Why does the follicle not grow

The lack of growth and development of follicles is one of the most common causes of infertility in women. Deviation from the norm of development of follicular tissue may appear due to:

disturbances in the work of the pituitary and hypothalamus;
dysfunction or underdevelopment of the ovaries;
the appearance of cysts in the ovaries or the presence of multifolliculosis;
inflammatory or infectious processes in the organs of the reproductive system;
hormonal imbalance;
the appearance of cancerous neoplasms in the mammary glands, pituitary gland or ovaries;
frequent stressful effects on the body, severe depression;
dramatic weight loss, BMI below 17.5;
early menopause.

It’s worth starting with a hormonal imbalance, which becomes the main reason for stopping the growth of follicles in the ovary. With tumors or dysfunction of the pituitary gland in the body of a girl, there is a lack of the hormone FSH, and the regulation of the release of active substances by the ovaries and thyroid gland is also disrupted. The same effect of inhibiting the development of follicles is observed with underdevelopment or poor functioning of the ovaries.

If a girl has too low weight or there are infections of the reproductive system, the body “understands” that she will not be able to bear the child, so there is no need for ovulation and follicle growth. After STD treatment or weight gain, the follicular growth cycle usually returns to normal.

During stressful periods or prolonged depression, the girl's adrenal glands secrete more than the norm of the stress hormone - cortisol, which increases the risk of miscarriage of the fetus, so follicles will not develop in such an environment. Restoring their growth in such a situation is not so easy, it can take several months until the hormonal background stabilizes.

The growth of follicles continues from the beginning of the menstrual cycle until ovulation. First, several epithelial cocoons develop, but already on the 8-9th day, one dominant one is released, and the rest stop growing. The growth of follicular tissue lasts until ovulation, during which it ruptures and releases a mature egg. But with various disorders in the body, the follicular cycle can be suspended.

05/20/2003, KAROLINA
There are no infections. fsg 4.61 (norm 1.8-11.3), lg 6.58 (1.1-8.7), prol 261.8 (67-720), estradiol 113.3 (110-440), testost 1.83 (0.5-4.3), progest. on day 22 - 7.20 (10-89). There were no abortions or childbirth. According to the HSG, the peritube of the commissure is on the left, the patency of both tubes is preserved, but they are very long and helical. BT is almost never raised. above 36.8., jump to ovulation. practical not expressed. The doctor says it might be ovulation. doesn't happen at all. The cycle is irregular, now, against the background of vitamins, it has become generally 21 days. Prior to that, I had been drinking OK for 5 years, for 10 months. I can't take. Spermogr. norms. From the above: 1) how would you advise to stimulate and maintain ovulation and what drugs are best? 2) with a cycle of 21 days on which days to drink Utrozhestan? 3) And how to reduce leukocytosis (I have chronic left-sided inflammation of appendages and Candida)?

The LH/FSH ratio is disturbed, which is normally 1\1.5. Because of this - anovulation and the absence of phase 2. I need to check prolactin again on the eve of menstruation in order to draw blood at 6.30 in the morning. Regarding the increased leukocytosis of the smear and constant thrush, it is necessary to take DNA (PCR) tests for chlamydia, gardnerella, mycoplasma and ureaplasma.

May 21, 2003 Janet
I have never had infections, abortions, childbirth either. Two years ago I had a bilateral ovarian resection. I'm afraid I might have blocked tubes. I've been trying to conceive for 7 months without success. My gynecologist does not prescribe a tube check for me, says that there is no need to worry now, you just need to make a baby. What are my chances of getting pregnant? Is it possible that the tubes are blocked? I ovulate regularly, the dominant follicle matures. My husband has a very good spermogram. He also never got sick. Both hormones are normal. During laparoscopy, when the ovaries were resected, the tubes were then passable.

Unfortunately, after laparoscopy, an adhesive process developed in the small pelvis, moreover, exactly where the surgeons' hands worked, i.e. in the area of appendages. This, apparently, violated the patency of the fallopian tubes. It is necessary to pass a gynecological smear and DNA (PCR) tests for chlamydia, gardnerella, human mycoplasmas, urogenital and ureaplasmas. If the tests are negative, then do the HSG (just ask for anesthesia before the test).

05/21/2003, Elena
After the HSG, a diagnosis was made of the tubes being passable but tortuous, bilateral valve sactosalpinx, peritubal adhesions, adhesions in the small pelvis. The doctor prescribed nystatin and vilprafen for 15 days, after lidazan, and after injections, hydrotubation. Be sure to do it, what does it give if my pipes are passable. Can I get pregnant with such tubes if I do not do hydrotubation?

Hydrotubation cannot be done with valve hydrosalpinx! After all, hydrosalpinx is the accumulation of fluid in the tube, and there is still fluid to be injected there ?! You can contact me, I propose to conduct a course of anti-inflammatory - absorbable physiotherapy with the RIKTA apparatus.

05/21/2003, Irina
I contacted you twice, thank you for not leaving my questions without attention, your answers helped me a lot. I decided to contact you again, because I was already tired of being treated for secondary infertility. That month, I had a delay of 7 days, then my period began with pieces of something incomprehensible (3 days), then brown water also poured with pieces (about 4 days), I went to the doctor, she said that I had residual sanious discharge after a miscarriage. Now again, in anticipation of menstruation, my husband and I made all attempts to get pregnant, up to 6 days of menstruation, my stomach does not hurt, but my back just breaks and I am in a terrible depression. I passed all kinds of tests and drank a bucket of various pills over these 2 years, for three months my morning starts with a thermometer, everything is in order with ovulation, there is constant stress at work, and it seems to me that I am fixated on trying to get pregnant, I really want to please my husband. We will be in Moscow in June-July, will we be able to get an appointment with you or will you be on vacation?

No, my vacation is in August. When you arrive in Moscow, call immediately and make an appointment. Bring all BBT charts and test results. I will be glad to help you.

05/21/2003, Oksana
I had low progesterone. Three cycles took dufaston 1t. from 15-25 days of the cycle. BT in phase 2 did not rise above 36.8. I read your answers on similar cases and for the first month I take Utrozhestan 2t vaginally from the 16-27th day of the cycle. Today, at 24dmc, progesterone-109, estradiol-992, v-hCG-7. Is it necessary to take Utrozhestan at this dose after 26 dmc if there is pregnancy? What time? Very swollen and sore chest. Maybe you can change something (reduce the dose, switch to another drug)?

Utrozhestan can be continued if it is a pregnancy, it will not hurt, it will only improve the condition of the embryo. If pregnancy is not confirmed, then it will be necessary to check prolactin on the eve of menstruation, without taking hormones, which may be the main cause of phase 2 failure.

05/21/2003, Julia
I have been unable to conceive for 3.5 years. Endometriosis. There was a laparoscopy in February 2002 with the removal of foci of endometriosis and endometrioid ovarian cysts (resection). At that time, the pipes were passable. Treatment with duphaston from 5 to 25 days m.c. 6 cycles. My husband has a varicocele. the spermogram is not very good: only 1 ml of ejaculant, 50% mobile, there is a pathology of the head. We have already decided on IVF (I am 29 years old, my husband is 36). But I was again diagnosed with an endometrioid cyst of the right ovary. It has doubled since March. A pulling pain on the right began to disturb. Is it necessary to remove the cyst before IVF? Or is it possible to take medication?

Unfortunately, the cyst can only be removed by surgery. Such a terrible thing - endometriosis - if left untreated, it grows and spreads. It is necessary to put my husband in order: to operate on a varicocele, start taking Proviron (an androgenic hormone that improves the production and quality of spermatozoa) + food supplement Sperm-active (Pharma-med companies). It is necessary to take DNA (PCR) tests for chlamydia, gardnerella, mycoplasma and ureaplasma. When all this is normal, it is necessary to decide on a second laparoscopy, with the restoration of tubal patency. Immediately after the operation, you should try to get pregnant, stimulate ovulation in the first 3-5 weeks after the operation. Save IVF for last. This is also not a 100% method, it turns out in 1 out of 5 women. But after IVF, there is nothing left to try.

05/22/2003, Irina
The day before yesterday I had 16DC, BT 36.6, an ultrasound scan revealed a follicle in the left ovary 22 mm. The doctor prescribed 3 thousand HCG to stimulate ovulation. Yesterday I raised my BT to 36.9, my left side hurt terribly. Today BT 36.9, I went for an ultrasound - the follicle is 33 mm, the doctor said that it is possible that the follicle has grown into a follicular cyst and there is nothing to wait for. Made another 2 thousand HG. Please, tell me, can there still be ovulation or is 33 mm already a cyst? Why does the follicle not burst? and more - in the right ovary follicles are 2-5 mm, one can hope that ovulation will occur in the right ovary.

Unfortunately, 33 mm is already a follicular cyst, which was formed as a result of ovarian hyperstimulation. Therefore, there were pains in the side. She releases a large amount of estrogen hormone into the blood, which inhibits the growth of the remaining follicles, there will be no additional ovulation. Now you need to apply large doses of progesterone. Enter in the morning and at night 2 capsules of Utrozhestan vaginally. This should be carried out for at least 10 days, up to the 26-28th day of the cycle, under the control of BT. After menstruation, the cyst should go away.

05/22/2003, Alena
Tell me please. I am 25 years old, my husband is 31 years old. After two unsuccessful IVF attempts (embryo rejection). An HLA typing analysis was done: DRB1 07.10(s) 07.01(male) DQA1 0201.0101 (s) 0201.0101 (male) DQB1 0201.0501 (s) 0201.0501 (male). The doctor who did IVF said that next time I would need immunoglobulin drips (sorry if I wrote it wrong). Is it so? Is it possible to get pregnant with such test results? And what do these results mean? The doctor said it was incompatibility - What with what?

And whether you checked presence of mycoplasmas, ureaplasmas and chlamydias. herpes and cytomegaly viruses by DNA diagnostics? If not, then you should definitely do it. Because of these infections, the rejection of the embryo mainly occurs. They break its contact with the wall of the uterus. You can contact me, the test results will be ready the next day. When they are ready, I can give you advice on how to keep the pregnancy.

05/23/2003, Tatiana
Now I can’t get to my doctor, and I don’t want to go to another one, because. everyone treats in their own way and they often say that the treatment prescribed by the previous doctor is wrong and everything should be done differently (personal experience), so I ask you to give some clarifications to a few more questions. I had an ultrasound, here is the result: Date of the last menstruation: May 1-5, 2003. The body of the uterus, position in retroflexio - rejected to the right, to the left. The boundaries are clear. The contours are even. Irregular saddle shape. Dimensions: length - 56 mm, PZR - 38 mm, width - 59 mm. The structure of the myometrium is not changed. M-echo: thickness. 9 mm, the boundaries are clear, the contours are even. The echostructure is not changed. The endometrium corresponds to the secretion phase. The uterine cavity is not deformed, not expanded. The contents of the cavity are homogeneous. The cervix is of normal size. The echostructure is changed due to echo-negative inclusions D- up to 4 mm, singly. The left ovary is defined. Dimensions: 42x26x40 mm. The echostructure was changed due to a large number of echo-negative inclusions d up to 9 mm. The right ovary is defined. Dimensions: 42x24x40 mm. Echostructure changed due to. identical to the left. Pathological formations in the pelvic cavity are not determined. Free fluid in the retrouterine space is not determined. Conclusion: 1) Retrodeviation of the uterus. 2) Saddle uterus. 3) Multifollicular ovaries. I would like to know what it all means (ultrasound refused to explain), can it be the result of taking medications, can it be cured and can I still get pregnant with such results? P.S. According to the results of the previous ultrasound, I had only multifollicular ovaries.

Such ovaries and should have a young woman. Read carefully on my portal an article about polycystic ovaries. The saddle uterus is a defect in its formation in the embryonic period. This does not interfere with the onset of pregnancy, but sometimes the threat of miscarriage is associated with this. To determine your ability to become pregnant, you need to undergo not only and not so much ultrasound. DNA analysis for sexual infections, 3-month BT schedule, test for patency of the fallopian tubes, husband's spermogram, hormonal tests. Here is a sample checklist.

05/23/2003, Katerina
My husband and I want to have a child, but for 1.5 years it has not been possible. I took hormone tests on different days of the cycle and it turned out that I had too much female hormones. I was prescribed to drink Regulon for three months, and then come for an ultrasound and see if I ovulate or not, since now I don’t have it. The question is whether this problem is serious in order to get pregnant or not, how long it will have to be treated and how to treat it. I really want a baby, please tell me what to do.

You have been given the right treatment. Indeed, synthetic hormones, OK, are prescribed to suppress a large number of ovarian hormones. You just need to go through an additional examination: a DNA analysis for sexual infections, a 3-month basal temperature chart (after using Regulon), a test for patency of the fallopian tubes, a husband's spermogram, hormonal tests when you finish drinking Regulon.

For every woman of childbearing age, it is very important to know the state of health of her internal organs, especially, such as the ovaries. This is not accidental, because it is on them that a woman's ability to have children depends. Consider the main parameters and indicators that the ovaries of a healthy woman should have.

Only women are endowed with ovaries by nature, which is associated with the function of childbearing. The ovaries are a special type of female, where the complete formation, development and maturation of the eggs takes place. Every woman has in her body two paired ovaries located in. By location, the paired ovaries occupy a position on the sides of the uterus, due to which they become quite distinguishable during an ultrasound examination of the body. If, due to some circumstances, the detection of one of the two ovaries becomes inaccessible, the doctor focuses on the region of the iliac vein. Thus, under any circumstances related to the state of health of a woman, the ovaries are clearly distinguishable in her body.

In a healthy woman, the shape of the ovary is somewhat flattened, but it is quite mobile and visible during examination. The flattened shape indicates their healthy condition. The size of the right and left ovaries varies and this is the norm. This is especially noticeable in the fair sex, who are in reproductive age. At the same time, they fully perform the functions assigned to them.

The size of the female ovary is affected by its age characteristics, the number of pregnancies with childbirth, the stages of menstruation and methods of preventing unwanted pregnancy by using oral contraceptives.

The size of one ovary relative to the other can vary and fluctuate significantly.

Features of the ovaries:

In the internal structure of the ovary, two layers are distinguished: cortical and cerebral. Both layers are clearly distinguishable upon detailed examination through special magnifying devices.
Outside, each ovary is covered with a special layer of the albumen.
The outer or cortical layer of the ovary is characterized by the presence of follicles of different maturity.These follicles are represented by two main varieties: primary immature, they are also called primordial and mature, also referred to as preovulatory. All types of follicles perform certain functions in the female body.

With the help of ultrasound examination, specialists can detect changes occurring in their structural structure, including those of a negative nature. Usually such procedures are carried out during the first week of menstruation. Conducting this type of study, experts pay great attention to the volumetric indicators of each ovary. After all, the state of health of each ovary depends on their numbers, and the type of a particular pathology in the body is determined.

Dimensions of the ovaries of a healthy woman

In a healthy woman, the size of the ovaries is in the following ranges:

The volume is from 4 to 10 cubic centimeters
Width varies from 18 to 30 mm
The thickness is in the range from 16 to 22 millimeters
Length occupies the limit from 20 to 37 millimeters

For a more detailed examination of the internal structure, the anatomy of the ovaries is examined taking into account the phases of menstruation. In a woman in the early follicular phase, which falls out from the fifth to the seventh day of the menstrual cycle, an ultrasound examination shows a protein capsule with ten follicles located on the periphery, measuring up to six millimeters. Already in the middle follicular stage, which falls on the tenth menstrual day, we can clearly distinguish the dominant follicle, reaching a size of fifteen millimeters. This follicle does not end its development on this, but continues to develop further. Smaller follicular cells nearby finish developing in the female body. This happens even if they have scored in the order of ten millimeters.

At the late follicular stage, which falls on the fourteenth menstrual day, there is a period of active growth of the dominant follicle.

Sometimes the growth process of this follicle becomes so active that the increase occurs by several millimeters daily. When an actively growing follicle becomes equal in size to eighteen millimeters, doctors ascertain the speedy process of ovulation in the body. This usually happens when the follicle reaches eighteen millimeters in size. At the same time, the ongoing changes in the structure of its internal and external structure become noticeable.

In addition to the follicular stage, the luteal phases play a special role:

So in the early luteal phase, which falls on the fifteenth day, a corpus luteum is formed in the female body. Its dimensions range from fifteen to twenty millimeters. All this happens in the position of ovulation.
With the onset of the middle luteal stage in the female body, an active and rapid growth of the corpus luteum begins. Usually, this process falls into phase on the twentieth day of the menstrual cycle. The corpus luteum grows, acquiring dimensional indicators ranging from 25 to 27 millimeters.
Then the late luteal phase begins, ending on the twenty-seventh day. During its period, the process of reducing the corpus luteum and its slow extinction is clearly manifested. It becomes similar to a ten-millimeter object. As soon as a woman begins menstruation, the fading corpus luteum completely disappears.

If a period begins in the female body, a period of activity begins for the corpus luteum, lasting up to almost two weeks. At the same time, progesterone is actively synthesized in the female body. At this stage, the release of a new egg is completed.

Useful information from the video about inflammation of the ovaries.

With pregnancy, there is a marked increase in the size of the ovaries.This is observed in all women in this position. The reason for this increase is the active blood flow that carries blood to these organs. Pregnancy is also associated with a change in their position, compared with the original. The change in the position of the ovaries goes towards the upper part of the small pelvis. This is facilitated by the uterus increasing in this position.

With the onset of the postmenopausal stage in the fair sex, there is a noticeable reduction in the size of both ovaries.

They even become equal in volume. In this case, the dimensions of the ovaries will be as follows: the volume is from 1.5 to 4 cubic centimeters, the width varies from 12 to 15 millimeters, they occupy a limit of 20 to 25 millimeters in length, and thickness - from 9 to 12 millimeters. Such dimensional indicators are considered the norm for a healthy woman.

If the doctor found a difference in the volumetric parameters of the ovaries of the female body, exceeding the figure of one and a half cubic centimeters, or one of the ovaries is almost twice as large as the other, then the woman develops a pathology. In such cases, appropriate tests are immediately prescribed for an accurate diagnosis, and treatment begins.

One of the most common types of pathological changes in the structural structure of the ovaries is the appearance of formations in them, referred to as a cyst. A cyst on the ovary is the formation of a small vesicle that is filled with fluid. This vesicle can form both on the surface of the body of the ovary, and in its thickness. The resulting cyst can have different sizes. They vary in the range from millimeter to centimeter indicators.

If the ovarian cyst is of considerable size, then it is easy to detect it during an ultrasound examination of the woman's ovaries.

The cause of the occurrence of cysts on the ovaries is the functional activity of the data. Often this pathology does not pose a big threat to the health and life of a woman, but there are cases when a cyst that has appeared is a symptom of the development of a serious disease in the body. To dispel all doubts about the cyst that is forming, the woman is sent to the hospital for a complete examination and delivery of the necessary ones. If the cyst carries signs of a pathological nature, then the woman is prescribed special treatment.

Every month in the body of a healthy woman occursthe formation of one cyst that differs in size from other vesicles:

The cyst occurs in the ovary and becomes clearly distinguishable among the rest of the follicles. It is called the dominant or Graf's follicle.
This type of follicle contains in its structure an egg cell immersed in a special liquid and at the stage of its maturation.
The follicle containing it has a significant size - from 25 to 28 millimeters. Therefore, it stands out more than others.
As soon as the menstrual cycle approaches its middle, the dominant vesicle ruptures, and the female sex cell present in its composition is released. This cell goes directly into the cavity of the fallopian tube.
At this time, this egg can be fertilized. Conception is associated with the development of a new life in the female body.

In the place where the dominant follicle has burst, the “yellow body” referred to in medical language is formed. The corpus luteum is considered to be a small compaction of a part of the ovary in the center of which lies a small vesicle. During this period, there is an active production of hormones, due to which the maintenance of a developing pregnancy is promoted.

Sometimes the dominant vesicle filled with liquid in the structural structure of the ovary does not burst, but rather continues to grow actively.

The volume of liquid inside it also increases. Such a bubble is considered a follicular cyst. In medical practice, even such cases are known and described when the corpus luteum also becomes a formation that is very reminiscent of a cyst. In other words, the formation of cysts on the ovaries occurs during their normal functioning in the body of a healthy woman.

Another fairly common type of ovarian pathology is the formation of a cancerous tumor on them. In the first stages of the appearance of this pathology, it does not betray itself at all and is almost invisible. This helps the disease to spread without much resistance of the body. Of all women with cancer, only a third were diagnosed with its development in the early stages. In other cases, the disease did not manifest itself practically in any way. Typically, ovarian cancers become noticeable when the disease progresses to advanced stages. In order not to start this disease in the body, women should periodically check their internal organs, especially the ovaries, because their ability to become mothers depends on them.