The dominant follicle is missing which means. Follicles in the ovaries: normal number, treatment of folliculogenesis deficiency. Dominant follicle in the right ovary: what is it, what are the features of development, common abnormalities and risk factors

When a girl reaches puberty, her body already has an ovarian reserve. This phrase defines a specific supply of eggs in the ovaries. They are immature, each placed in a special sac of functional cells. This "construction" is called a follicle.

Every month, due to the action of the hormone follitpopin, several follicular sacs develop. One of them is dominant, noticeably progressing, growing. Its development indicates that there will be ovulation, probably conception.

A mature female reproductive cell comes out of the right or left ovary, but it happens that only one of them is active. What does a dominant follicle in the left ovary mean, what consequences can such a feature of its formation lead to?

Why does a dominant follicle appear in the left ovary

According to the medical norm, the phenomenon is considered ideal when, in the female body, eggs ready for fertilization develop and exit alternately from two ovaries. But there are several factors when only the female sex gland, located on the left, is active.

Often the dominant follicle in the left ovary is formed due to family, genetic characteristics. If close female blood relatives have confirmed activity of this particular sex gland, there is a high probability that a similar phenomenon will be confirmed in their heirs after medical research.

Violation of the functions of the right organ leads to the fact that the left begins to work actively.

Experts name several situations when such a situation is observed:

the presence of inflammation;
development ;
deviations in the maturation of the egg, its release from the follicle.

Incorrect structure, underdevelopment of the female gonad on the right, its injuries, surgical operations, medical removal after the detection of pathologies or as a consequence of an ectopic pregnancy are reasons that complement the list.

Another reason that a dominant follicle is formed in the left ovary is a violation of the functions of the organs of the endocrine system. Prolonged stay in a state of emotional excitability, stressful situations, malnutrition, excess weight or its lack become possible "provocateurs" of such a phenomenon. Other causes include the presence of diseases of a chronic nature.

How many dominant follicles can form

In order for the desired fertilization to occur in a woman’s body, one mature germ cell is enough. It is normal if several follicles are “preparing” to become dominant at once - from 4 to 8. If their number is more than 9, there is a high probability of developing a pathological process, it is defined as a multifollicular ovary.

Statistics confirm that two dominant follicles can form simultaneously in the left ovary. This phenomenon is not common, it is observed in women with genetic prerequisites.

A similar result is observed after a course of hormonal treatment, which was aimed at stimulating the ovulation process. In the organ on the left, two (or more) eggs can mature, ready for fertilization. With a favorable course of pregnancy in the mother, the development of fetuses without pathologies, fraternal twins are born.

To determine or confirm that the egg is forming, developing and exiting the ovary, located on the left side, an ultrasound is required. An intravaginal examination is required, which is prescribed for several cycles.

The doctor will determine the echo signs of the dominant follicle in the left ovary. The main one is the visual definition of a follicle with an egg actively developing inside.

Its size will be 18 mm or more, and the layer of granulosa cells is noticeably thickened. Inside such a “pouch”, the specialist will examine the egg-bearing tubercle. If the study was carried out immediately after the release of the egg, the doctor will note the signs - a decrease or disappearance of the follicle, the appearance of fluid behind the uterus.

Is pregnancy possible with a dominant follicle on the left

Is it possible to count on the development of pregnancy if it is established that the "main" follicle develops only in the gonad on the left? Gynecologists confirm that such a process is one of the possible options for the normal functioning of the female reproductive system.

But it becomes rarer due to the special structure, the development of the gonad in this side - its smaller size, a small number of "laid" eggs compared to the right. If the menstrual cycle is regular, there is a high chance of conception.

For it to happen, you need to reliably know on which days ovulation occurs. To determine it, gynecologists advise using special tests that can be purchased at a pharmacy, track.

If there was a delay in the cycle, pregnancy did not occur, the risk of developing several pathologies that are dangerous for reproductive health, a woman's life increases:

hormonal imbalance;
hyperplasia of the tissues of the epithelium of the uterus;
prolonged absence of menstruation;
the occurrence of breakthrough uterine bleeding;
growth of benign or malignant tumors.

The absence of menstruation is always a reason for an extraordinary appointment with a gynecologist.

Conclusion

If the processes of formation of the dominant follicle, subsequent ovulation occur stably in the left ovary, pregnancy may be less likely than when the right gonad is functioning or both at the same time.

To increase the chance of conception, it is necessary to determine exactly why the right organ has lost its efficiency. After confirming the diagnosis, the doctor prescribes treatment - surgical, medication, conducts.

Video: Follicle maturation

Folliculogenesis is a cyclic process that occurs in the ovaries under the control of the nervous and endocrine systems. Its main mechanism is the transformation and transformation of the follicle into a mature egg.

The main stage of folliculogenesis is the formation of a dominant (main) follicle.

The dominant follicle is formed by successive steps:

The beginning of the formation of many small ,

Growth and development of small follicles,

maturation of the dominant follicle

Ovulation.

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

The formation of small follicles begins from the first days of the menstrual cycle. However, their growth begins only in the hormone-dependent stage, which occurs immediately after the completion of the luteal phase. At the same time, the amount of estradiol and progesterone decreases, but the amount of follicle-stimulating hormone (FSH) increases.

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

5-7 days after the onset of menarche, small follicles begin to form. They are also called tertiary or antral. There are quite a large number of them - about 10 pieces. This phase of folliculogenesis is called early proliferation or the beginning of the formation of small ones. The diameter of these small formations does not exceed 5 mm. They are located in the form of "beads" on the periphery of the ovary. For some time, part of the follicles increases in size and gains strength.

Therefore, the dominant follicle is formed after about 10 days of the menstrual cycle, and at this time its size reaches 15 millimeters. Other follicles that could not gain the desired mass regress and die. As a result, we can conclude that there may be more than one dominant follicle. When two or more eggs mature and are subsequently fertilized, a multiple pregnancy develops. This process is not common, but such cases have been recorded. Most often this is an iatrogenic cause: hormone-based drugs, or IVF. But the physiological reason for the birth of twins and triplets is not excluded.

By the immediate moment of ovulation, the dominant follicle should reach a diameter of about 20 millimeters (maybe more). In place of the follicle, a yellow body should form, slightly smaller than its predecessor.

If fertilization does not occur, then within a week after the release of the egg from the ovary, the corpus luteum begins to decrease in size - it regresses. By the time of rejection, the endothelium of the uterus, as a rule, dies off, and in its place there can only be a site of disturbed echogenicity.

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

A persistent follicle is one that goes through all stages of folliculogenesis, except for immediate ovulation. What reasons may lead to this phenomenon is not fully understood. However, doctors often accept persistence as a variant of the norm, unless, of course, it is constantly recurring.

Sometimes it happens that a persistent follicle turns into a small ovarian cyst. Patients who develop a cyst should be monitored. If this process does not cause complaints, then treatment is not required.

As a rule, persistent follicles rupture, but it is almost impossible to get pregnant in such a situation, because the endometrium of the uterus is too thin for implantation.

The female body is much more complex than it might seem at first glance. Very many processes in it are controlled exclusively by hormones, and how coordinated they are depends, for example, on whether a woman can conceive and bear a child, how long her reproductive health will remain. One of these complex invisible processes is the formation of a dominant follicle in the ovaries.

What it is?

The follicle is a component of the sex glands of a woman. Follicles are formed even when the girl develops in the womb. By the time they are born, newborn girls have the richest supply of germ cells - from half a million to a million. Each immature egg is located in several shells, which together form a kind of vesicle or sac, and it is called a follicle.

As soon as the girl begins the process of puberty, the production of the hormone FSH starts in her body - it is responsible for the growth of follicles, and folliculogenesis begins - a continuous and constant process of maturation and death of follicles. This continues until menopause, until the ovarian reserve runs out.

Follicles are different. Those with which nature generously endows a girl from birth are very small, they cannot be seen with the naked eye. They are called primordial. Under the influence of FSH, they begin to grow and become preantral, and then some of them will be destined to become antral, that is, having a cavity with liquid contents inside. Antral follicles are formed at the very beginning of the menstrual cycle, after menstruation it is already possible to detect them on ultrasound and count them. But none of the listed types of follicles makes a woman fertile. In order for there to be a chance of pregnancy, a mature and full-fledged egg is needed, and only one type of follicle can give it - dominant or dominant.

Antral follicles at the beginning of the cycle grow in both ovaries. However, by the 7th-8th day of the cycle, one of them becomes more noticeable, it grows and develops faster than its antral counterparts. This is the dominant, the bubble that will provide ovulation in the current menstrual cycle. As soon as it is determined, the woman's body throws all its strength into its growth, and the development of the remaining follicles slows down.

This is very important for saving the ovarian reserve, because the number of follicles given to a woman by nature for her entire life is not replenished.

The dominant follicle can be located in the right or left ovary. Sometimes (quite rarely) there is such a phenomenon as double ovulation, in this case there are two such follicles and they are located either in one or in different ovaries. Inside the dominant vesicle, a cavity filled with liquid expands every day, an egg grows in it. On the surface of the "pouch" an egg-bearing tubercle is formed.

By the middle of the cycle, when the follicle reaches its maximum size, under the influence of the hormone LH and estrogens, its shell becomes thinner, it bursts and frees the female germ cell. The egg begins its independent existence in the fallopian tube and within 24-36 hours it can be fertilized. If this does not happen, then the germ cell dies, and the likelihood of pregnancy will become real now only in the next menstrual cycle, after the rupture of the next dominant follicle.

The process of rupture of the follicular membrane and the release of the germ cell - this is ovulation.

Ovulation Calculator

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Enter the first day of your last menstrual period

Ovulation occurs 14 days before the start of the menstrual cycle (with a 28-day cycle - on the 14th day). Deviation from the mean value is frequent, so the calculation is approximate.

Also, along with the calendar method, you can measure basal temperature, examine cervical mucus, use special tests or mini-microscopes, take tests for FSH, LH, estrogen and progesterone.

You can definitely set the day of ovulation through folliculometry (ultrasound).

Sources:

Losos, Jonathan B.; Raven, Peter H.; Johnson, George B.; Singer, Susan R. Biology. New York: McGraw-Hill. pp. 1207-1209.
Campbell N. A., Reece J. B., Urry L. A. e. a. Biology. 9th ed. - Benjamin Cummings, 2011. - p. 1263
Tkachenko B. I., Brin V. B., Zakharov Yu. M., Nedospasov V. O., Pyatin V. F. Human Physiology. Compendium / Ed. B. I. TKACHENKO. - M.: GEOTAR-Media, 2009. - 496 p.
https://ru.wikipedia.org/wiki/Ovulation

The remnants of the follicular membranes after ovulation are grouped and begin to form the corpus luteum - a temporary gland designed to produce progesterone. If pregnancy does not occur, the corpus luteum resolves after 10-12 days, and after another 2 days, against the background of a decrease in progesterone levels, menstruation begins. Everything repeats from the beginning.

Thus, without a dominant follicle, conception is impossible, and any disturbances in the stages of folliculogenesis that do not lead to the development of the dominant, cause a violation of its rupture, and can cause infertility.

Quantity and dimensions

Nature ordered that for the rest of her life a woman should be given about 450-500 germ cells. This means that from the beginning of puberty to menopause, this reserve should be enough to ensure monthly menstruation and the conception of offspring. Therefore, in the vast majority of cases, in one cycle in a woman who does not take hormones, 1 dominant follicle matures. If 2 such "vesicles" are found in the same ovary or different ones, then there are chances for multiple pregnancy.

There are situations when one dominant follicle is not enough. These include assisted reproductive technologies such as IVF. In order for doctors to carry out fertilization in the laboratory and transfer embryos into the uterine cavity, more than one egg is required. Therefore, in the IVF protocol, hormonal stimulation of the ovaries is carried out. After taking certain drugs, a woman in the follicular phase has 3, 4, 5, or more dominant follicles. The more you can get them, the higher the chances of getting pregnant with the help of reproductologists.

The size of the dominant bubble plays a big role. If for antral follicles, which are evaluated by ultrasound at the very beginning of the cycle, such an indicator as quantity is more important, then quality is also important for the dominant follicle. The dominant bubble begins to be determined on average on the 7th day of the menstrual cycle (if you count from the first day of menstruation). Further, its dimensions can be quite individual, but there are also average statistical norms by which you can track the dynamics of development by day of the cycle:

Diameter table "dominant"

cycle day	Dominant follicle size	Notes
		For the first time since the beginning of the menstrual cycle, the dominant is clearly visible, the antral follicles begin to disappear, they are no longer needed.
		The dominant vesicle continues to grow and already stands out strikingly from the few remaining antral vesicles.
		On ultrasound, it becomes possible to examine the cavity with fluid inside the dominant follicle. While it occupies less than half of its area.
		The internal follicular cavity expands.
		An oviparous tubercle is formed on the surface of the follicular membrane.
		A protrusion is formed on the shell of the bubble - stigma. At the location of its location, the ultrasound doctor can tell exactly where the rupture of the membrane should occur during the period of ovulation.
	21-22 mm (allowable 23, 24 and 25 mm)	The follicle is ready for ovulation. It can happen in the shortest possible time.

Of course, a lot depends on the individual characteristics of the female body, but folliculometry (a type of ovarian ultrasound) will help answer the main question, is it worth waiting for ovulation in this cycle. Measurements are also important for monitoring the effectiveness of hormonal treatment if a woman is undergoing it.

Therefore, the growth of the follicle is regarded more as an ovarian response to stimulation, as an indicator that the internal processes in the female body are normal. Only by the size of the follicle, it is not worth drawing conclusions about when to wait for ovulation.

With a size of 15 mm, according to statistics, ovulation will occur only after 4-5 days, but in practice everything is possible, because the growth rate of the bubble can slow down, speed up, and it can even stop developing on any day of the cycle at any size.

Daily height measurements are for women not receiving hormonal treatment, with a regular standard cycle of 28 to 30 days.

In women with a cycle of more than 30 days, ovulation occurs later than 14-15 days, and in women with a cycle of less than 28 days - earlier (12-13 days). Therefore, it is necessary to undergo the first folliculometry immediately after the end of menstruation, and then the attending physician will prescribe the frequency of measurements.

Possible problems

A small follicle can cause big problems for a woman, because in the pathological conditions of the "dominant" a woman not only cannot conceive a baby, but also experiences a variety of inconveniences due to violations of her menstrual cycle.

Here are the most common problems.

persistence- the dominant vesicle appears on time, is well defined, grows normally. But on the day of the alleged ovulation, it does not break. If the follicle does not burst, the oocyte inside dies after a few days. Conception is impossible. The reasons why the dominant follicle does not burst may be different, but they are usually based on insufficient levels of the LH hormone. The follicle continues to be determined on the ovary on the right or left, and before the next menstruation, it is delayed. Often, a cyst forms from a persistent follicle.

cystic formation- The liquid cavity is usually formed as a result of hormonal failure, after an abortion, the use of emergency post-coital hormonal contraception, as well as in violation of blood circulation in the tissues of the ovaries. Follicular cysts are benign, rushing to the surgeon for help is not required. In 95% of cases, they generally resolve on their own, without the help of doctors and without treatment for several menstrual cycles. Complications of cysts can be dangerous - ruptures and torsion of the legs. In this case, there is acute surgical pain, bleeding from the genital tract, the woman may need the help of a surgeon. With a follicular cyst, the dimensions of the dominant vesicle may be higher than normal - 26, 27, 29 or more millimeters. There are cases of cysts about 80 mm in diameter.

Luteinization- a situation in which the corpus luteum begins to form before the rupture of the follicular membrane itself occurs, that is, before the moment of ovulation. In this case, secretion of progesterone begins inside the dominant, further maturation of the follicle becomes impossible, ovulation does not occur, conception is impossible. Treatment is hormonal.

Atresia- a disorder of folliculogenesis, in which the dominant follicle, having reached a certain stage, does not grow, the process of maturation of the oocyte stops inside it (the egg does not mature). This also means that a woman cannot conceive a child in this cycle. If atresia becomes chronic, they speak of persistent infertility. The issue of the advisability of stimulating ovulation with hormonal agents or IVF will be decided.

Can it be absent?

The absence of a dominant follicle should not always be considered a pathology. Normally, every woman has cycles without ovulation, in which none of the antral follicles becomes dominant. If at the age of 20-30 years ovulation is absent no more than 1-2 times a year, this is considered normal. With age, the frequency of anovulatory cycles increases, and after 35 years, a woman can already experience up to 5-6 such cycles in the norm.

Can "dominant" be empty?

This phenomenon is called "empty follicle syndrome" or SPF. With it, no eggs are found at all inside the dominant follicles with normal growth. According to statistics, up to 7% of in vitro fertilization protocols fail precisely for this reason - in the follicular fluid taken during the puncture of the follicles, not a single egg suitable for fertilization is found.

In fact, many specialists in the field of reproductive medicine are skeptical about SPF, because they believe that the reason for the absence of eggs should be sought in the protocol itself, incorrectly selected dosages of drugs, as well as banal errors during puncture. After changing drugs, their dosages, a good rest between protocols, the situation is usually corrected, and repeated SPF is set only in 1% of cases.

This 1% is a topic of special discussion. Usually the true absence of oocytes is a genetic problem associated with a violation in the X chromosome. There is no cure.

But even with such a diagnosis, you can become a mother - IVF with a donor egg will help. Today, such a service is in great demand, and not only because women suffer from genetic anomalies. Many build a career and miss a favorable age, and then face the depletion of the ovarian reserve and SPF.

In the female reproductive system, there are cells that allow you to conceive embryos called follicles, and they are located in the ovaries. If a deviation from the established norm is found, this indicates that a pathology is developing, as a result, infertility may occur.

The concept of follicles and their functions

The luteal and follicular phases make up the entire ovarian cycle. We are only interested in the follicular cycle. The finished egg is enveloped by a pair of balls of connective tissue, as well as a ball of epithelial cells, and it is part of the follicle. Complete protection of the egg will guarantee the ability to conceive and bear a healthy baby. That is why the main task of the follicular cycle is the reliable preservation of the egg and its protection from external negative factors. The period of maturation of one such egg is 28 - 30 days.

Important! Each ovary contains a follicle containing an incompletely mature egg. Only after fertilization does it mature to the end.

The hormone estrogen is also produced only during the follicular cycle. Throughout life, these cells are formed in women. Only 0.01% survive the ovulation period, the rest die. According to statistics, only a few cells are subject to ovulation.

The role of dominant follicles

A mature and sufficiently large follicle that provides complete protection for the egg ready for fertilization is called dominant. Its size can reach a couple of centimeters just before ovulation. Most often it is located in the right ovary.

The process of ovulation occurs during the period when, under the influence of hormones, the dominant cell reaches its maximum size and breaks. The finished egg is sent to the tubes of the uterus. Ovulation does not occur if the dominant cell remains in an immature state.

Attention! It also happens that dominant follicles mature in both ovaries at once. Such cases are very rare. This shouldn't be a cause for concern. The simultaneous maturation of dominant formations suggests that during the period of ovulation, a woman has every chance of conceiving two embryos.

Common deviations from the norm

Deviated from the normal cells in the ovary, this is when there are more than 10 of them. In medicine, several terms are used when diagnosing abnormalities, these are “multifollicular” and “follicular ovaries”. Before making this diagnosis, a woman must undergo an examination and do an ultrasound.

Having heard such a diagnosis, you should not be upset and think that this is an indicator of infertility. Multifollicular ovaries can be after nervous breakdowns, constant stress or overwork. In such a situation, there is no need to panic and you should not take any medications. Having eliminated the cause that caused such a diagnosis, by the next period of ovulation, normalization of cells in the ovaries can be expected.

Factors that provoke deviations from the norm:

improperly selected contraceptives;
problems with the thyroid gland;
after the period of feeding the baby (excess of prolactin in the body);
the endocrine system is not working properly.

Attention! How to act in such a situation? After examination by a specialist and confirmation of the diagnosis, a treatment method is prescribed, which is followed relentlessly. With improper treatment, infertility develops, so you can not start it.

There are two types of menstrual cycle and they pass depending on the number of dominant follicles.

Types of the menstrual cycle:

normal;
a cycle with deviations, in the absence of a mature dominant follicle.

With a large accumulation of hormones and multifolliculosis, infertility develops.

Absence of bursting dominants

There are such cases that a fully developed and mature dominant follicle does not burst during the period of ovulation. In such a situation, fertilization does not occur, since the egg does not come out. The medical name for this condition is persistent follicle. The menstrual cycle begins a week after the dominant follicle does not burst in the left ovary. If this situation is repeated in the left ovary, then over time a cyst may form there.

At what stage of folliculosis a specialist can only tell by the results of an ultrasound examination.

Complete absence of follicles

The complete absence of follicles in the ovaries can occur after an early menopause or dysfunction. For doctors, it is very difficult, if even impossible, to restore the follicles in the body. Most often, in such a situation, the gynecologist prescribes hormone treatment.

Failure of the menstrual cycle will be the first signal that the follicles are missing. They turn to a gynecologist if the menstrual cycle does not return to normal within 30-35 days.

Folliculosis is not always a problem, but the complete absence of follicles suggests that you should immediately undergo treatment.

What are antral glands

Eggs began to be scrutinized after artificial insemination became widespread. Thanks to research, leading gynecologists have been able to figure out why some women can easily give birth to a child, while others suffer from infertility. That is why scientists have taken control of the antral follicles. What is it?

Follicles that reach a size of 8 mm are called antral. On ultrasound, you can see how many reserve eggs have gathered for further fertilization. With small sizes of antral follicles, the probability of positive fertilization is very low. If the size of the antral formation reaches 5 mm, then stimulation of the gynecologist is required for conception. With a size of more than 5 mm, a woman does not need stimulation. During pregnancy, the development of the follicle stops.

What is polycystic ovaries?

Various factors influence the number of cells in the ovaries. Their increase can be influenced, and this is far from uncommon in our time. With a detailed study, the gynecologist can tell exactly why an excess of cells appeared in the body. In medicine, this phenomenon is called polycystic.

Depending on the cause of polycystic disease, methods of its treatment are chosen.

Goals of treatment for PCOS:

low male hormone in the body of a woman. There is no increase in cells to dominant, in the presence of an excess of testosterone;
violation and restoration of menstruation;
voluntary fertilization. To conceive a child on your own, it is necessary to normalize the growth of follicles in the female body;
normalization of food metabolism.

During treatment, hormone therapy, diet, or surgery may be prescribed by specialists.

Excess or lack of cells does not play a role, you must always bring them back to normal. You should not self-medicate and if you find a problem, you should immediately consult a doctor.

In the life of every young family, sooner or later the question of conceiving a child arises. At this time, the woman is looking forward to the positive conclusion "Pregnant". However, often the representatives of the beautiful half of humanity in the process of conception face various problems associated with the maturation of eggs and ovulation. What determines the growth and development of follicles, what is a dominant follicle, and what to do if it develops incorrectly - let's figure it out.

Briefly about follicles

In the genitals of the female body, complex biological processes regularly occur, due to which the conception of a new life becomes possible. Every month, eggs ripen in the ovary, ready for.

The conditional receptacle for such immature eggs is the follicle, which is a component of the female reproductive system, consisting of eggs surrounded by a layer of epithelial cells. On top of the nodule are several balls of connective tissue that act as a protective layer.

The main function of the follicles is to protect the eggs from the negative effects of environmental factors and create comfortable conditions for their maturation.

Important! At the stage of fertilization, the maturation of the egg is of paramount importance, therefore it is so important to identify possible pathologies in the development of follicles in time.

Even in the womb, when the genital organs of the fetus are laid, about 500,000 follicles are formed in the ovaries. Over time, during the puberty of the girl, half of them die and approximately 200,000 remain. However, not all of them can mature and take part in the process of fertilization.

What is it and why is it needed

Every month, 7-8 follicles begin to develop in a woman's body. Further, their growth stops and only one of them (in rare cases - two) continues to actively form. It is he who is called dominant.

During the day, the size of the dominant can increase by 2-3 mm. During its length reaches 18-20 mm. During this period, it bursts and releases the egg, ready for fertilization. With the normal release of the egg, that is, ovulation, occurs on the 13-15th day.

If for some reason the dominant follicle does not develop or does not form at all, then the egg loses its ability to mature and fertilize.

It is by the process of development and growth of the dominant that doctors can determine the general female condition and make preliminary conclusions about the possibility of conceiving a child.

Pathologies and deviations in the formation of a lymph node can cause cysts or.

Did you know? The egg is the largest single cell in the body. The spermatozoon is 85 times smaller than it.

Some gynecologists are able to determine the sex of the future baby at the location of the dominant. If it develops in the left ovary, then the woman should prepare for the birth of a girl, if in the right, then there are high chances of having a boy. Although there is no scientific confirmation of such a theory yet.

Stages of development of the dominant follicle

The maturation process of the dominant is very complex and takes place in several stages, each of which has its own scientific name.

Primordial

Primordial lymph node- this is not yet a mature egg, covered with connective tissue. It is located in the subcapsular zone and has a flat shape and sizes up to 5 mm.

During the period of menstruation, up to 30 follicles can develop in the ovary, but only a small part of them are able to move on to the next stage of growth.

preantral

When the follicles are already entering the maturation phase, they are called preantral. They grow, increase their height by almost three times, surround themselves with a membrane, acquire the shape of a cube, “overgrow” with a special shiny shell, which is based on complex protein compounds.

They are located near the germ cell in two layers.

Antral

At the next stage, the development of secondary, or antral, follicles occurs.

It is their number that determines a woman's chances of conceiving. If they are up to 10 units, then the chances of pregnancy are very small, with a number from 15 to 25 units, the probability of conception is very high.

During this period, the follicular fluid is formed, the cells of the granulosa layer grow, the epithelium "acquires" several layers. The follicle may have cavities with fluid that contains estrogen.

The advantage of a secondary lymph node is also that it is equipped with an additional protective sheath. This phase of development is observed on the 8-9th day of the menstrual cycle.

Dominant

Final stage- dominant, when the formation of the “main”, the largest and largest nodule, which is filled with a huge number of cells of the granulosa layer, directly occurs.

It is with its help that a woman can determine the beginning of ovulation.

Due to the fact that during the previous stages there is an increase in the volume of fluid inside the nodules, the dominant grows and reaches a diameter of up to 20 mm.

It is quite simple for an experienced doctor to see the dominant: on one side it rises above the surface of the ovary. Its second wall is located in the center of the ovarian stroma, and the egg itself is located in the middle of the tubercle.

How is the diagnosis, or what is folliculometry

For successful conception, the presence of a mature egg is necessary, the appearance of which is preceded by the stage of maturation of the dominant. The nodule may mature in either the left or right ovary, or both.

To find out the condition of the follicles, and thereby increase the chances of fertilization, monitoring is carried out using an ultrasound machine -.

Did you know? The female X chromosome contains 433 genes, while the male has only 29, so girls inherit more parental traits than boys.

During the study, the doctor determines:

the size of the ovaries;
the presence of nodules and their number;
the presence of a dominant and its size;
the presence of a yellow body;
the condition of the lymph nodes and the presence of any abnormalities in their development.

As a rule, folliculometry is carried out several times, on different days of the menstrual cycle. Monitoring is carried out with a special transvaginal sensor intended for insertion into the vagina, or with a transabdominal sensor, which is used to examine the surface of the abdomen.

To properly prepare, a woman should refrain from consuming flatulent foods.

If there are chronic problems with the intestines, then the day before it is recommended to take drugs that normalize gas formation.

Before monitoring (in the case of an intravaginal examination), it is necessary to empty the bladder. When using a transabdominal sensor, on the contrary, you need to drink up to 1.5 liters of water.

To obtain the most accurate results of folliculometry, it is necessary to conduct several studies: the first is carried out on the 7-9th day of the cycle, the second - on the 13-15th day, the third - on the 20-21st day, the final - on the 25-28th day .

It is on the second ultrasound that the doctor determines the presence of a dominant follicle, the state of its growth and development, and also measures the size of the endometrium, which should normally have three layers and be 4-5 mm thick.

Through such an examination, it is possible to identify various irregularities in the menstrual cycle and track the effectiveness of drugs used in the treatment of infertility or other diseases of the reproductive organs.

Possible deviations and their causes

The release of the egg cannot occur without the proper development of the dominant follicle.

There are many pathologies that slow down the growth process of the dominant:

diseases associated with the functioning of the thyroid gland - hyper- and hypofunction of the thyroid gland. In this case, violations in the maturation of the lymph node will not be the only problem in the female body;
dysfunction of the ovaries;
the presence of tumor neoplasms in the pituitary gland and hypothalamus;
taking contraceptive pills. In a large number of girls, after taking contraceptives, some pathologies are noticed in the process of egg formation. However, after the termination of their use, the fertile function is restored;
systematic diseases of the body: infections, viral and bacterial diseases, diseases of internal organs;
gene diseases, which, unfortunately, at this stage of development of modern medicine are not treatable;
some diseases of the endocrine system, hormonal disorders, including increased blood sugar levels;
the onset of early menopause;
emotionally unstable position of a woman: stress, depression, fears, etc.;
excess prolactin. During breastfeeding, in the first six months of a child's life, the female body produces the hormone prolactin, which blocks the development of an egg. After the end of HB, the level of the hormone returns to normal.

Important!Among the underdeveloped follicles, one can stand out, which in the middle of the cycle begins to grow, develop and become dominant. In this case, the probability of conceiving a child is quite high.

There is also a possibility that none of the follicles are released, grow and mature, which leads to the absence of an egg and, as a result, the absence of menstruation. During this period, the level of the male hormone, testosterone, increases in a woman's body. This situation can lead to the development of infertility.

Then doctors prescribe a special drug therapy aimed at restoring the menstrual cycle.

A deviation from the norm is premature or, conversely, late maturation of nodules. In such cases, special hormonal therapy is also carried out.

It should be noted that innovative developments in the field of medicine make it possible to cope with almost all types of pathologies associated with impaired maturation of follicles. And the sooner deviations are detected, the more effective and successful the result will be.

No dominant follicle

During an ultrasound examination, the doctor may detect the absence of a dominant follicle.

Several aspects can affect this:

very small follicle size. At the same time, the level of hormones during the test will correspond to the norm, but ovulation will not occur;
ovarian pathology, the so-called "sleeping" ovaries, which do not lead to the development of the dominant, and as a result, the onset of ovulation;
regression- the reverse process of development, when the nodule grew normally, and then, at some stage, stopped its development;
failure to release an egg when the follicle, normal in size and maturation, cannot burst and release the cell.

To restore the normal functioning of the ovary, adequate treatment will be required based on ultrasound data, hormonal examinations and a medical examination.

Incorrect development of the dominant follicle

One of the most common pathologies associated with the abnormal development of the lymph node is considered to be its degeneration into a benign formation. Such a phenomenon in medicine is known as.

Its main causes are hormonal imbalances. In addition, an excessive or insufficient amount in the second half of the cycle can serve as a "provoker" of cyst formation.

In such a case, ovulation does not begin, and the follicle degenerates into a cyst, the size of which can reach 100 mm in diameter.

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The following can also cause the onset of a follicular cyst:

strict diet;
big number ;
irregular sex life;
fatigue and exhausting physical activity;
mental disorders;
pelvic disease.

Often there are cases when the follicle matures normally, but, at a certain stage of the cycle, it cannot burst due to thickening of the connective tissue, hormonal failure. Under any conditions, the absence of a rupture of the nodule is provoked by serious disorders in the body.

Among the key reasons, physicians distinguish:

hormonal imbalance: malfunction of the reproductive system and an imbalance of the two main hormones - and androgen;
lack of vitamins and minerals responsible for maintaining a normal level of hormones.

In the presence of a cyst, menstruation does not occur in due time, and a woman may suspect pregnancy. Neoplasm treatment is based on application.

It is they who give a favorable result: in most cases, the cyst resolves and menstruation resumes. If medical treatment is not successful, the cyst is removed through surgery.

Should I be worried when 2 dominant follicles are found

As a rule, only one follicle fully matures in one cycle in the ovaries. But sometimes there can be two of them in one ovary or in two at once. This is not considered a pathology, on the contrary, the chances of pregnancy are doubled. It is also not excluded the conception of two children at once.

When the dominant follicle develops and grows normally in the female genital organs, the chances of successful fertilization of the egg are extremely high. However, if something goes wrong, you should not panic: modern treatment methods allow you to cope with almost any deviations, except for genetic ones.

But even with incurable ailments, innovative reproductive technologies will help give a woman the joy of motherhood.