A follicle is a component of the ovary that is surrounded by connective tissue and consists of an egg. The follicle contains the nucleus of the oocyte - the “germinal vesicle”. The oocyte is located inside a glycoprotein layer surrounded by granulosa cells. The granulosa cells themselves are surrounded by a basement membrane, around which there are cells - theca.
Internal processes of follicle evolution
The primordial follicle consists of oocytes, stromal cells, and follicular cells. The follicle itself is practically invisible, its size is on average 50 microns. This follicle is laid before birth. It is formed thanks to germ cells, they are also called oogonia. The development of primordial follicles is promoted by puberty.
A single-layered ordinary follicle consists of a basal plastic, a follicular cell forming a transparent membrane, and a multilayered primary follicle consists of a transparent membrane, inner cell, granulosa cells. During puberty, follicle-stimulating hormone (FSH) begins to be produced. The oocyte grows and is surrounded by several layers of granulosa cells.
The cavitary (antral) follicle consists of a cavity, an inner layer of Theca, an outer layer of Theca, granulosa cells, and a cavity containing follicular fluid. Granulosa cells are already beginning to produce progestins. The diameter of the antral follicle is on average 500 microns. The gradual maturation of the follicle with the formation of its layers gives rise to the production of female sex hormones, including estrogen, estradiol, and androgen. Thanks to such hormones, this follicle turns into a temporary organ of the endocrine system.
A mature follicle (Graafian vesicle) consists of an outer layer of the theca, an inner layer of the theca, a cavity, granulosa cells, a corona radiata, and an ovarian tubercle. Now the egg is located above the oviductal tubercle. The volume of follicular fluid increases 100 times. The diameter of a mature follicle varies from 15 to 22 mm.
What size should a follicle be?
It is impossible to answer this question unequivocally, since the size of the follicles changes during the menstrual cycle. Follicles are fully formed by the age of fifteen on average. Their sizes are determined only with the help of ultradiagnostics.
We will most accurately analyze the norm of follicle size by day of the menstrual cycle.
In the first phase of the menstrual cycle (days 1–7 or the beginning of menstruation), the follicles should not exceed 2–7 mm in diameter.
The second phase of the menstrual cycle (8-10 days) is characterized by the growth of follicles, their diameter generally reaches 7-11 mm, but one follicle can grow faster (it is usually called dominant). Its diameter reaches 12 - 16 mm. On the 11th -15th day of the menstrual cycle, normally the dominant follicle should increase every day by 2 - 3 mm, at the peak of ovulation it should reach a size of 20 - 25 mm in diameter, after which it bursts and releases the egg. Meanwhile, other follicles simply disappear.
This is what the follicle growth pattern looks like. This is repeated monthly until pregnancy occurs. For a more visual and understandable definition, we provide you with a table by which you can understand whether your follicles are maturing normally.
What is a dominant follicle?
A dominant follicle is considered to be a follicle that is ready for successful ovulation. During natural ovulation, it stands out due to its size. As we said earlier, although all the follicles begin to grow, only one of them (in rare cases - several) grows to a size of 22 - 25mm. It is he who is considered dominant.
Generative function as a priority. Let's figure out what it is.
There are two components to the function of the ovaries.
The generative function is responsible for the growth of follicles and the maturation of an egg capable of fertilization. Hormonal function is responsible for steroidogenesis, which changes the uterine mucosa, helps not to reject the fertilized egg and regulates the hypothalamic-pituitary system. It is generally accepted that the generative function is a priority, so if it fails, the second one loses its abilities.
At what follicle size does ovulation occur?
Ovulation is the release of an egg from a ruptured mature follicle. In this case, the size of the follicle during ovulation becomes 15 - 22 mm (in diameter). To make sure that you have a full-fledged follicle by the time you ovulate, you need an ultrasound examination.
Empty follicle syndrome
Currently, two types of this syndrome are described: true and false. Distinguishes them hCG level. We can say that thanks to IVF technology, scientists have examined under a microscope the phenomenon when the follicle is “empty”.
According to statistics, in women under 40 years of age, this syndrome occurs in 5 - 8% of cases. The older a woman gets, the higher the number of empty follicles. And this is no longer a pathology, but a norm. Unfortunately, it is impossible to accurately and immediately diagnose this syndrome. To do this, you will need to completely exclude damage to the ovaries (structural abnormalities), lack of ovarian response to stimulation, premature ovulation, hormonal imbalance, defects (pathologies) in follicle development, premature aging ovaries. That is why there is no such diagnosis as “empty follicle”.
But scientists have found the reasons that accompany the development of the syndrome. Namely: Turner syndrome, incorrect time of administration of the hCG hormone, incorrect dose of hCG, incorrectly selected IVF protocol, incorrect technique for collecting and washing the material. As a rule, a competent reproductive specialist will carefully collect anamnesis before making this diagnosis.
Polycystic ovary syndrome
Otherwise it is called Stein-Leventhal syndrome. It is characterized by impaired ovarian function, absence (or altered frequency) of ovulation. Due to of this disease Follicles do not mature in a woman’s body. Women with this diagnosis suffer from infertility and lack of menstruation. It is possible that menstruation occurs rarely - 1-3 times a year. This disease also affects the disruption of hypothalamic-pituitary functions. And this, as we wrote earlier, is one of the functions of the proper functioning of the ovaries.
Treatment here can proceed in two ways. These are surgical and medicinal (conservative). Operative method more often it involves resection with removal of the most damaged area of ovarian tissue. This method in 70% of cases it leads to the restoration of a regular menstrual cycle. For conservative method treatments mainly use hormonal drugs (Klostelbegit, Diana-35, Tamoxifen, etc.), which also help regulate the menstrual process, which leads to timely ovulation and the desired pregnancy.
Folliculometry: definitions, possibilities
The term folliculometry is commonly understood as monitoring a woman’s reproductive system during the menstrual cycle. This diagnostic allows you to recognize ovulation (whether it happened or not), determine the exact day, and monitor the dynamics of follicle maturation during the menstrual cycle.
Monitoring the dynamics of the endometrium. For this diagnosis, a sensor and a scanner are used (it’s more common for us to call it ultrasound). This procedure absolutely identical to the procedure for ultrasound of the pelvic organs.
Folliculometry is prescribed to women to determine ovulation, evaluate follicles, to determine the day of the cycle, for timely preparation for fertilization, to determine whether a woman needs ovulation stimulation, to reduce (in some cases increase) the likelihood of multiple pregnancies, to determine the reasons for the absence of a regular menstrual cycle , detection of diseases of the pelvic organs (fibroids, cysts), to control treatment.
This procedure does not require strict preparation. It is recommended only during these studies (usually an ultrasound is done more than once) to exclude from the diet foods that increase bloating (soda, cabbage, brown bread). The study can be carried out in two ways: transabdominal and vaginal.
Values of indicators of norm and pathology of follicle development
We described the normal indicators both by day and during ovulation above (see above). Let's talk a little about pathology. Main pathologies the absence of follicular growth is considered.
The reason could be:
- in hormonal imbalance,
- polycystic ovary syndrome,
- dysfunction of the pituitary gland,
- inflammatory processes of the pelvic organs,
- STD,
- neoplasms,
- severe stress (frequent stress),
- breast cancer,
- anorexia,
- early menopause.
Based on practice, health workers identify the following group: hormonal disorders in a woman's body. Hormones suppress the growth and maturation of follicles. If a woman has a very small body weight (plus there are also STD infections), then the body itself recognizes that it cannot bear a child, and the growth of the follicles stops.
After normalizing weight and treating STDs, the body begins to correct height follicle, and then it is restored menstrual cycle. During stress, the body releases hormones that contribute to either miscarriage or stopping the growth of follicles.
After complete emotional recovery, the body itself begins to stabilize.
Ovulation stimulation
Stimulation is usually understood as a complex of hormonal therapy that helps achieve fertilization. Prescribed to women diagnosed with infertility for IVF. Infertility is usually diagnosed if pregnancy does not occur within a year with regular sexual activity (without protection). But there are also contraindications for stimulation: impaired patency of the fallopian tubes, their absence (except for the IVF procedure), if it is not possible to conduct a full ultrasound, low follicular index, male infertility.
The stimulation itself occurs using two schemes (they are usually called protocols).
First protocol: increasing minimum doses. The purpose of this protocol is the maturation of one follicle, which excludes multiple pregnancies. It is considered gentle, since its use practically eliminates ovarian hyperstimulation. When stimulated with drugs according to this scheme, the size of the follicle usually reaches 18 - 20 mm. When this size is reached, enter hCG hormone, which allows ovulation to occur within 2 days.
Second protocol: reduction of high doses. This protocol is prescribed to women with low follicular reserve. But there are also requirements for it that are considered mandatory indications: age over 35, previous ovarian surgery, secondary amenorrhea, FSH above 12 IU/l, ovarian volume up to 8 cubic meters. When stimulating this protocol, the result is already visible on days 6-7. With this protocol there is a high risk of ovarian hyperstimulation.
Follicles are the components of the ovary. They are needed to protect the egg from various influences. The size of the follicle during ovulation differs from the original one. If it remains unchanged, then this is a sign that the woman is not fertile and is not ovulating.
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Follicle size before ovulation
To conceive, they must develop normally so that a full-fledged egg is released from them. Let's consider what the dominant undergoes during the month.
Norm
What size should a follicle be before ovulation? When they reach seven days of age, their size is between 3-7 mm. On an ultrasound examination, the specialist will see several structural elements that have various stages development. There shouldn't be more than a dozen of them. From the eighth to the tenth day, the dominant follicle is already visible, which grows to 14 mm. Everyone else becomes smaller and disappears. In 24 hours it increases by 3 mm.
1-2 days before the release of the egg, a vesicle is approximately 18-22 mm in size. It all depends on the menstrual cycle, on days 12-16 the ovulatory phase begins and it bursts. 
Deviations
What follicle size before ovulation is abnormal? If before this, and on any day of the cycle, they are all approximately the same size and there is no dominant one, this is a bad signal. This can be seen on ultrasound diagnostics. If one follicle does not mature, then the egg will not be released, as it will not be able to conceive.
Sometimes there are two or three dominant follicles. Afterwards there may be two (three eggs) and the outcome is positive, that is, twins or triplets. Otherwise, the follicles freeze and do not develop further - this is called persistence. There is no ovulation.
Another deviation is complete absence follicles. In this case, the reproductive system is completely disrupted and infertility occurs.
Such deviations arise as a result of:
- improper functioning of the ovaries;
- failure, dysfunction of the endocrine system;
- the presence of pituitary or hypothalamic formations;
- frequent inflammatory processes V reproductive organs;
- regular nervous breakdowns, stress or depression;
- climate change (moving to another country);
- early menopause.
To avoid serious complications, you should not neglect preventive examinations at the gynecologist. If you experience the slightest discomfort or abnormality in the pelvic organs, seek medical help immediately. The gynecologist will clearly tell you at your appointment what size the follicle should be during ovulation.
Sometimes the doctor makes a diagnosis of polycystic disease in question. Why? Everything is very simple. Not in all cases, the presence of multiple follicles indicates pathology. This may be temporary and will go away after ovulation. This sometimes happens after birth control pills, improper functioning of the thyroid or adrenal glands, excess prolactin. To find out the cause and installation accurate diagnosis, you should do an ultrasound examination on certain days of the cycle, which will help you see the dynamics. In addition, hormone tests are taken, the doctor examines the patient in a gynecological chair, and only after all this can we say something more confidently.
Follicle size at ovulation
The woman herself will not be able to find out the size of the dominant follicle; even an obstetrician-gynecologist will not do this during an examination. To measure, you will need special equipment. Size plays a big role, because only a developed egg is capable of fertilization. When ovulation occurs, certain symptoms appear. Knowing them, it will be easier for a woman to protect herself from unwanted pregnancy or vice versa, choose the best day for conception.
Norm
What is the size of the follicle at ovulation? Immediately at the time the egg is released, the size of the dominant follicle is already 23-24 mm. After its rupture, the egg is alive for 2 days, no more. This is the most favorable period for fertilization.
Can ovulation occur if the size of the bubble formed is smaller than normal? This is unlikely, but if this happens, the underdeveloped egg will not be ready for fertilization.
Deviations
Sometimes deviations occur in the form of atresia and persistence. Atresia is a disorder in which the follicle does not break its integrity during ovulation. On the contrary, it began to shrink again, the unruptured follicle develops into a cyst-like formation.
For atresia:
- there is low progesterone;
- no corpus luteum;
- there is no free fluid behind the uterus.
This pathology is accompanied by the presence of amenorrhea and periodic bleeding, which occurs 3 to 4 times a year, similar to menstruation. Women who have this dysfunction cannot become pregnant.
The disease develops from the very beginning, that is, during puberty or as a result of hormonal failure, in which the level of lutropin and follicle-stimulating hormone decreases and the follicle does not reach the right size. As a result, there are menstrual irregularities, amenorrhea and polycystic ovaries appear. The worst thing is infertility.
With persistence, rupture of a mature follicle does not occur. It is in the size of 22-24 mm for a week, then menstruation begins. Sometimes they are not there, and the unruptured blister degenerates into a cyst. This happens due to hormonal imbalances. The symptoms of this pathology are as follows:
- progesterone is reduced;
- estrogens are elevated;
- follicle on systematic ultrasound of the same size;
- there is no fluid in the space behind the uterus and corpus luteum;
- delay of menstruation;
- heavy menstruation.
To correct the situation, doctors prescribe hormone therapy, which normalizes hormone levels. Sometimes laser therapy, ultrasound or electrical stimulation are indicated. Necessarily good nutrition, healthy sleep, vitaminization. It is necessary to exclude stress and physical activity.
What size is needed to conceive?
In order for fertilization to occur in the future, the size of the follicle must be optimal.
The maximum follicle size is no higher than 25 mm and no less than 18 mm. If the indicators do not correspond to the norm, then fertilization is unlikely. If such a deviation is repeated from cycle to cycle, then an examination is necessary. The cause of the pathology must be treated immediately. Delay can lead to infertility. 
What to do if the size does not correspond to the norm?
If the size of a mature follicle is smaller than normal, ovulation does not occur. This pathology needs to be treated. First of all, a woman must undergo diagnostics. The doctor will determine the cause of the dysfunction.
This usually happens due to hormonal imbalance. IN modern medicine There are many drugs that help follicles develop normally and as a result, a full-fledged egg appears.
They can appoint:
- "Clomid";
- "Citrate""
- "Clomiphene";
- “Klostilbegit”, etc.
Treatment will begin between the 5th and 9th day of the menstrual cycle. The dose is prescribed by a specialist, who gradually increases it. The regimen is selected individually for each woman; starting to use such products on your own is strictly prohibited. The doctor will see whether there will be ovulation on an ultrasound examination, which monitors the entire therapeutic course.
No one can say how long to wait for normalization; some become pregnant after the 1st course, while others need 2 or more months.
In addition to medications, a woman should adjust her diet. A balanced and rational diet is an important point. It is necessary that the body receives vitamins, macro and microelements. Iodine is important folic acid, magnesium, vitamin E, etc. This is necessary for the normal functioning of the female reproductive system and for strengthening immune system. You need to eat vegetables, fruits and grains every day.
The thyroid gland and the levels of all hormones are also checked. Hormonal drugs everything is brought back to normal, after which the eggs will appear normally during ovulation.
You can also try traditional methods, but before you start taking any herbs, you need to consult a doctor again.
Conclusion and Conclusion
Women who are planning pregnancy or those who for a long time If you are unable to conceive a baby, you should know at what size of the follicle ovulation occurs. If the vesicle from which the finished egg should be released has not reached the appropriate size, then attempts to become a mother will be unsuccessful.
For ovulation, you should adjust your hormonal levels, be less nervous, eliminate overwork and eat well.
Attention! It is necessary to understand that hormones have a huge influence on the timing of egg release (ovulation).
If, during the ovulatory phase, the development of follicular tissue is monitored, it is possible to see sharp increase epithelial cocoon, release of the egg, and then decrease. As a result, in its place there remains only corpus luteum, which is the remnant of this very cocoon.
Growth chart
For the clearest visualization of the development process, we provide below a table of its growth. The data in it are calculated for women 29-32 years of age who do not use oral products, whose menstrual cycle is strictly regular and lasts the prescribed 28 days.
| Cycle day | Follicle size and number |
|---|---|
| 1-4 | Several follicles, the diameter of each of which does not exceed 4 millimeters. |
| 5 | Several follicles develop evenly (atresia of some of them is acceptable). Size - 5-6 millimeters. |
| 7 | One dominant follicle is determined, the size of which reaches 8-9 millimeters. The rest are starting to decline. |
| 8 | Here and below, the sizes of only the remaining dominant follicle are indicated. He has already grown to 12 millimeters. |
| 9 | 14 millimeters |
| 10 | 16 millimeters |
| 11 | 18 millimeters |
| 12 | 20 millimeters |
| 13 | 22 millimeters |
| 14 | 24 millimeters. Ovulation occurs. |
Why isn't development happening?
The reasons for improper development or even cessation of growth can be many factors. Let's consider the most relevant of them:
- The hypothalamus or pituitary gland is not working properly.
- Infections or inflammations of the female genital organs.
- Body mass index is less than 17.5.
- Availability .
- Underdevelopment or pathology of the ovaries.
- Oncology.
- Early onset of menopause.
- Stress.
The search for causes should begin in violations hormonal levels V female body. Most often, this pathology is the main factor that stops the growth of the follicle in the ovary.
With dysfunction of the pituitary gland or tumors, a deficiency of the hormone FSH begins to be observed in the female body, a violation of the regulation of secretion thyroid gland and ovarian active substances.
Also, inhibition of follicle development can be observed due to poor functioning or underdevelopment of the ovaries.
What happens before your period?
Before the onset of menstruation, a sequential transformation of follicles of the primordial order into those of the preantral, antral and preovulatory order occurs. This process is called folliculogenesis.
Normally, folliculogenesis ends with ovulation - the release of an egg that is mature and completely ready for fertilization. Where the follicle was located, the formation of endocrine active occurs.
Immediately before the onset of menstruation, the dominant follicle ruptures, releasing a mature egg ready for ovulation. Healthy woman You may not even feel the symptoms of a ruptured follicle.
Folliculogenesis begins with FSH, back in late stage luteal phase. This process ends at the peak of gonadotropin release.
One day before the start of menstruation, the body again experiences an increase in FSH levels, which starts the process all over again. The follicular phase, in the absence of any disorders or pathologies, lasts for 14 days.
After menstruation
Most often, menstruation occurs 15-17 days after the onset of folliculogenesis. After the dominant follicle has completed its development, it bursts, as described above, releasing an egg ready for fertilization.
She goes into the uterus and the fallopian tubes to meet spermatozoa, and in place of the ruptured dominant follicle, a corpus luteum is formed.
As for the latter, this neoplasm is a very important transient hormonally active body, functioning for 14 days after its appearance.
It is the main source of androgens, progesterone and estradiol. Further, everything depends on whether fertilization of the egg occurs or not. If fertilization does not occur, then the corpus luteum gradually degrades and is excreted along with the rest of the secretions and the unfertilized cell.
In the event of fertilization, the corpus luteum temporarily provides a sufficient level of necessary hormones for the successful development of pregnancy.
Features of the follicular phase
The follicular phase occurs every time you start monthly cycle. The main hormone for this period is FSH, which is responsible for stimulating the follicles, as well as ensuring the start and maintenance of the process of formation of ovarian elements.
The duration of the follicular phase can vary between 7 and 22 days. In addition to the active development of follicles, this phase is also characterized by the separation and removal of dead endometrium of the uterus.
The follicular phase can be briefly characterized by three processes:
- cleansing the walls of the uterus;
- development and growth of follicles;
- compaction of the renewed endometrial layer in the uterus.
What is the menstrual cycle
The menstrual cycle is the period between the regular processes of exfoliation and removal from the body of the spent layer of the endometrium of the uterus.
The cycle must include the first day of menstruation and ending with the first day of the next one.
As is known, in the cortical layer of the ovary of the intrauterine fetus there is a huge number of primary follicles, and each follicle contains one (very rarely two) germ cells. According to available not entirely accurate calculations, total There are at least 200,000 primary follicles contained in both ovaries.
Each primary follicle can reach full development and produce an egg cell suitable for fertilization. However, during the entire period of a woman’s puberty, which lasts an average of 30–35 years, only 400–500 follicles fully mature. All the remaining primary follicles die sooner or later. The death of follicles is usually preceded by incomplete, stopped development. In this case, the egg cell dies first; then the follicular, or granular, epithelium (granulosis) undergoes fatty degeneration and vacuolization, the follicle fluid is absorbed, its cavity becomes empty and is obliterated by the connective tissue that grows in it. This process of death of follicles that have begun to mature is called follicular atresia.
Follicular atresia begins during intrauterine life, apparently under the influence of maternal sex hormones. By the end of the girl's second year of life, the process of follicular atresia usually stops for a number of years. Later, at approximately 7-10 years of age, it resumes again. In this case, waste products of developing, although prematurely dying, follicles enter the tissue layers and influence development through a neurohumoral route. female type. In this regard, a special role is played by the specific female sex hormone produced by the follicles - estrogen hormone (follinulin).
Follicular development begins with the division of follicular cells and their transformation from initially flat to cubic and then highly prismatic. Proliferating cells, now called granular or granulosa, fill the entire follicle. As further development the fluid secreted by the granular cells begins to push them apart, pushing them to the peripheral layers of the follicle. Inside the follicle, a cavity is formed filled with follicular fluid. The follicle itself becomes large in volume, stretches, and from the compact formation it was before, turns into a hollow formation called a mature follicle, graafian follicle or graafian vesicle. A developing follicle inhibits the maturation of other follicles. Follicles that have begun to mature undergo atresia, with the exception of one (or rarely 2-3 follicles), which reaches full development during puberty and turns into a mature follicle. This usually occurs by the age of 14–15 years.
The size of the follicle (mature) reaches 1 cm. It is surrounded on the outside by fibrous connective tissue (theca folliculi), consisting of two layers: an outer thin layer of dense connective tissue it becomes bleeding, thins and finally ruptures. The Graafian follicle is opened and the mature egg is released. The maturation of the egg and its release from the Graafian follicle is the second of the two main functions of the ovary - the generative function.
A woman's ability to conceive and bear a child is determined by the number of follicles in the ovary. Future mom must have an idea of the processes occurring in the reproductive organs. Knowing how many follicles should be in the ovaries normally will allow her to receive timely medical help if danger arises.
Follicles are 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 pubescent 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, then 4, then 3. By the time of ovulation, there is only one of them left.
No need to worry
Normally, the number of follicles in the ovaries is determined by the day of the cycle. If, a couple of days after the end of your period, 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.
The number of follicles in the ovaries can be determined using ultrasound of the appendages. This procedure is carried out using a vaginal sensor. 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 is normal;
- 7-16 - low level;
- 4-6 - low probability of conceiving;
- less than 4 - probability of infertility.
An ultrasound scan 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 follicle maturation. Therefore, during the course of the study, from 4 to 6 mature elements may be discovered.
Size by day
With everyone critical days There is an increase in the volume of follicles by day. Until day 7, their size ranges from 2-6 mm. Starting from the 8th, active growth of the dominant follicle is observed. Its size reaches 15 mm. The remaining elements gradually decrease and die. On days 11-14, an increase in follicles is observed. The volume of a ripe element often reaches 2.5 cm. 
Deviation from the norm
It is important to know what level of follicles is considered a deviation from the norm. More than 10 elements are called . Sometimes during the examination many levels of miniature bubbles are detected. This phenomenon is called polyfolicularity.
If more than 30 elements are detected during the study, then the woman is diagnosed. This pathology is an obstacle to the formation of a dominant follicle. Ovulation and conception become questionable. If the disease develops due to stress or emotional overstrain, then no treatment is carried out. Health care needed when polycystic disease is provoked by:
- Sharp weight loss.
- Rapid gain of extra kilos.
- Endocrine pathologies.
- Incorrect selection OK.
The follicular component may be completely absent or stop in its development. Often there is a delay in its formation or delay in maturation. 
If the number of follicles decreases, the woman also has problems conceiving. In order to find out the exact cause, the doctor prescribes a test ultrasound examination. It is carried out when the follicular apparatus is in the antral stage. This is observed on days 6-7 of the cycle. The main provocateur of a decrease in the number of follicles is a decrease in hormonal levels.
In some women, follicle maturation occurs during lactation. If their size varies from 6 to 14 mm, this indicates that a mature egg will soon be released. Then ovulation will occur and your period will begin.
Development of dominant and persistent follicle
Uneven development of follicles in the ovaries is often observed. Some women reveal the presence of dominant elements in both organs. If they ovulated at the same time, this suggests that the woman can conceive twins. But this is rarely seen.
You need to sound the alarm when a follicle is identified. This often indicates improper development of the dominant, which prevents the egg from being released. Over time, it appears against this background.
Persistence occurs on the left or right. The main provocateur is the increased production of male hormone. Incorrect treatment leads to infertility.
For resuscitation reproductive system the woman is assigned to undergo hormonal treatment. Therapy is carried out in stages. From days 5 to 9 of the cycle, the woman is prescribed the use of pharmacological medicines. 8 days before arrival 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 pass laser therapy and massage.
Main reasons for absence
When there are no follicles in the ovaries, we can talk about hormonal imbalance. Other factors that provoke the lack of follicle development include: 
- natural early menopause;
- improper functioning of organs;
- surgical early menopause;
- decreased estrogen production;
- pituitary gland disorders;
- the presence of an inflammatory process.
Presence of single elements
Some women are diagnosed with ovarian depletion syndrome. Due to the cessation of organ functioning, a woman cannot conceive and bear a child. Single follicles develop poorly, ovulation is absent. This leads to early menopause. The main reason such a condition is excessive physical activity. The risk group includes professional athletes and women performing men's work. Other reasons include menopause, a sharp increase in weight, and hormonal imbalances. This phenomenon is often observed in women who adhere to a very strict diet.
Timely treatment helps many women. Prevent development dangerous disease you can by calculating your menstrual calendar. If the cycle is irregular and often goes astray, then you should immediately consult a doctor.
Over the course of a woman's entire life, the ovaries produce a strictly defined number of follicles. Deviation from the norm does not always indicate the occurrence of a dangerous pathological process. But if a woman ignores this signal from the body, this will lead to dire consequences.
