The size of the follicle is 33 mm, is ovulation possible? Ovarian volume: norm and deviation from the norm. How big should a follicle be?
Every month, an egg matures in the female ovary. It emerges from a special “bubble” that is formed even before birth, gradually matures, and then bursts. This "vesicle" is the dominant follicle. Sometimes it is called dominant, but doctors prefer the first option.
The size of the follicle by day of the cycle is very important. The ability of a woman to conceive depends on this factor.
What is a dominant follicle? This is a "leader" who has overtaken his "colleagues" in growth and development. Only he has a chance to burst and produce a mature egg, which will then be fertilized by a sperm. Physicians distinguish four stages of its development:
What should be the follicle on different days of the cycle: medical standards
If on ultrasound you were told that there is a dominant follicle in the left ovary (or in the right, it does not really matter), you need to ask about its size. Unfortunately, it happens that the size does not correspond to the day of the cycle, that is, a full-fledged egg does not mature.
The size of the follicle on the days of the cycle depends on the length of the menstrual cycle (namely, its first phase). The longer it is, the slower the egg matures, and the smaller it is on a certain day. For example, on the 10th day of the cycle, a follicle of 10 mm can be considered a relative norm if the monthly cycle is 35 days. But with a cycle of 28 days - this is no longer the norm.
If the cycle, on the contrary, is short, then the follicle will mature faster and reach its maximum size as early as 11-12 days.
Therefore, the rules that we give below should not be taken as absolute. Much depends on your individual characteristics. But for reference they will be useful. So, here are the norms for a healthy woman with a 28-day menstrual cycle.
- From the 1st to the 4th day of the cycle on ultrasound, you can see several antral follicles 2-4 mm in size.
- Day 5 - 5-6 mm.
- Day 6 - 7-8 mm.
- Day 7 - 9-10 mm. The dominant follicle is determined, the rest “lag behind” it and no longer grow. In the future, they will decrease in size and die off (this process is called atresia).
- Day 8 - 11-13 mm.
- Day 9 - 13-14 mm.
- Day 10 - 15-17 mm.
- Day 11 - 17-19 mm.
- Day 12 - 19-21 mm.
- Day 13 - 22-23 mm.
- Day 14 - 23-24 mm.
So, from this table it can be seen that normal growth is about 2 mm per day, starting from the 5th day of the MC.
If the size is not correct
If the follicle is 11 mm on the 11th day of the cycle or 13 mm on the 13th day of the cycle, then this size is not the norm. This means that the egg matures too slowly and ovulation is hardly possible. The reason for this condition is most often in hormonal abnormalities: in the malfunction of the thyroid gland, pituitary gland, ovaries, or this entire “bundle”.
This condition requires additional examination (in particular, it is necessary to find out the level of hormones) and medical correction. Often gynecologists use hormonal drugs, but this is not always the case. In some cases, there are enough vitamins, drugs that improve blood circulation, herbal medicine, physiotherapy.
Experienced doctors know that many women do not ovulate every cycle. And they are not in a hurry to prescribe hormonal drugs, based on folliculometry for only one month. Perhaps in the next cycle, the egg will mature at the “correct” rate.
Sometimes anovulation (lack of ovulation) is due to natural causes:
- Stress, fatigue, lack of sleep;
- Malnutrition (strict diets, in particular low-fat ones);
- Obesity or extreme thinness;
- Hard physical work or exhausting sports training.
If you exclude these factors, there is a chance that ovulation will return on its own.
Size for ovulation
When the follicle bursts, at what size does ovulation occur? This usually happens on the 12-16th day of the menstrual cycle. With a 28 day cycle, ovulation occurs around day 14 (plus or minus two days). With a cycle of 30 days - on day 15.
At ovulation, the size of the follicle is 24 mm. The minimum figure is 22 mm.
In order for the follicle to burst, the coordinated action of various hormones in the woman's body is necessary. Namely - estradiol, LH, FSH. After ovulation, progesterone also enters the process.
How to understand that ovulation has occurred? The following methods will help you:
- Folliculometry (a type of ultrasound). This is by far the most reliable way;
- Ovulation tests. They are quite truthful and easy to apply, but they are not 100% accurate;
- . In this case, it is necessary to build a BT schedule: the method is painstaking, not always reliable, but affordable.
Some girls (though not all) feel ovulation physically, here are the characteristic symptoms of a ruptured follicle:
- Pulls the lower abdomen and lower back;
- Small spotting in the middle of the cycle is possible;
Some experience irritation and increased fatigue. Others, on the contrary, a surge of strength and sexual energy.
Now the egg has 12-24 hours to meet the sperm. If this does not happen, she regresses, and after 12-14 days menstruation comes.
If the follicle does not burst
It happens that a follicle that has reached 22-24 mm in diameter does not burst, but turns into a follicular cyst. This is due to a deficiency of certain hormones in the body. This condition can be determined by ultrasound.
Sometimes the cyst is single, and it "resolves" itself. If this does not happen, then at first they try to eliminate it with medication. And only if it is large and does not decrease in size, then they resort to surgical intervention.
Sometimes there are many such cysts. They deform the ovaries, interfere with their proper work. This condition is called polycystic ovary syndrome and requires treatment.
If it turns out that the dominant follicle in the ovary matures, but does not burst, then doctors can apply hormonal drugs. For example, .
Where do twins come from
The "main" follicle is determined approximately on the 7-10th day of the cycle. All others shrink and naturally die off. But sometimes it happens that there are two “leaders” at once. In a natural cycle (that is, without the use of hormones to stimulate ovulation), this happens quite rarely - in one woman out of ten, and not every monthly cycle.
It happens that two dominant follicles in different ovaries (or in one - this is also possible) ovulate, that is, burst. And then there is a chance that both eggs will be fertilized. So, fraternal twins will be born.
Unlike twins (when one egg is fertilized by two sperm), twins are not the same, not the same person. They can be different sexes or the same sex, and look alike, like ordinary brothers and sisters.
So, the correct growth of the dominant follicle and subsequent ovulation are clear signs of women's health. And possible violations should alert you (and your doctor), but not scare. Indeed, in most cases, such deviations are successfully treated.
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.
Video: how the follicle grows
Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.
Did you find an error in the text? Select it, press Ctrl + Enter and we'll fix it!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.
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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.
The ovarian follicle is a structural component of the ovary, the main functions of which are to protect the egg from negative effects and the formation of the corpus luteum during ovulation. At early development, there are approximately 4 million follicles in the ovary of the fetus, during the process of birth the figure decreases to 1 million, and during puberty it drops to 400 thousand. As a result, only about 400 follicles will have a chance to finally mature at the time of ovulation and form a corpus luteum.
Menstrual cycle
Early phase
At the beginning of the menstrual cycle, the ovary contains 5-8 follicles less than 10 mm in size. In the process of maturation, one of them (in rare cases, two) becomes dominant, reaching a size of 14 mm. On the 10th day of the cycle, it begins to distance itself and increase daily by about 2 mm until the moment of rupture. The remaining follicles begin to undergo a slow process of involution (atresia), their small fragments can be seen on ultrasound throughout the entire menstrual cycle.Follicle maturation time
The blood supply to the ovaries is significantly increased during the onset of ovulation under the influence of the pituitary hormones - gonadotropins FSH and LH. The formation of new blood vessels leads to the appearance of a follicle shell called the theca, which gradually begins to surround it from the outside and inside.Ovulation period
Two criteria that allow you to determine the maturity of the follicle and impending ovulation with ultrasound:- the size of the dominant follicle should be from 20 to 25 mm;
- the cortical plate of the follicle, under the influence of an increase in the internal fluid, slightly deforms one of the walls of the shell.
luteal phase
After ovulation, the walls of the empty follicle thicken, and its cavity is filled with blood clots - a red body is formed. In case of unsuccessful fertilization, it quickly overgrows with connective tissue and turns into a white body, which disappears after a while. In case of successful fertilization, the red body under the influence of the chorionic hormone slightly increases in size and turns into a corpus luteum, which begins the production of a hormone called progesterone. It increases the growth of the endometrium and prevents the release of new eggs and the onset of menstruation. The corpus luteum disappears at the 16th week of pregnancy.empty follicle syndrome
In a small number of cases, during the process of ovarian stimulation in the treatment of infertility, patients may experience the so-called empty follicle syndrome. It manifests itself with adequate levels of estradiol (a hormone produced by follicle cells) and normally growing follicles, while “dummy” can only be identified by examining them under a microscope.The exact cause of the symptom is unknown. However, experts managed to find out that the frequency of the appearance of empty follicles increases with the age of a woman. In most cases, the appearance of the syndrome does not reduce the patient's fertility: follicular maturation and the number of eggs remain normal.
polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a set of symptoms caused by abnormal ovarian function, high levels of insulin in the blood, estrogens and androgens (male hormones) in women. PCOS causes menstrual irregularities, excess weight, acne and age spots, pelvic pain, depression, and excess body hair.Currently, the most common definition of polycystic ovary syndrome is the 2003 consensus wording of European experts. According to its content, the diagnosis is made if the examination is carried out during the first six days of the cycle and the woman simultaneously has two of the three symptoms:
- enlarged ovaries: surface area greater than 5.5 sq.cm, volume greater than 8.5 kb.cm;
- the presence of at least twelve immature follicles less than 10 mm in size, most often located on the periphery of the ovary;
- the presence of stromal hypertrophy.
The main treatments for the syndrome are: lifestyle changes, medication, and surgery. Treatment goals fall into four categories:
- decrease in the level of insulin resistance;
- restoration of reproductive function;
- getting rid of excess hair growth and acne;
- restoration of a regular menstrual cycle.
