The size of the follicle is 33 mm, is ovulation possible? The size of the follicles by day of the cycle. What should be the size of the follicle in the norm. Solitary follicles in the ovary
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.
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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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.
Answers on questions
How big does a follicle need to be for ovulation to occur? The size of the follicle should be between 20 and 25 mm. If there is a dominant follicle in the ovary, will there be ovulation? Ovulation will occur if an egg develops in the follicle and it is not empty. Can ovulation occur without a dominant follicle? No, he can not. In this case, it occurs in which fertilization and pregnancy is impossible. When does ovulation occur with a follicle size of 14 mm? Approximately after 4-5 days when this size is reached. How many follicles does it take to ovulate? One dominant follicle, in rare cases two.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.
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.
