Multifollikulyarnye ovaries - is a term that came with the introduction of general clinical practice of ultrasound (US). The most common are multifollikulyarnye ovaries are normal, but sometimes they are difficult to distinguish from polycystic ovary - a disease that requires treatment and monitoring gynecologist.

Causes of ovarian multifollikulyarnyh

Multifollikullyarnye ovaries (MFYA) - is a sign that in healthy women may appear at puberty Puberty child - stages of a complex path As well as in patients receiving oral contraceptives (OC). At the same time about a week after the start of the menstrual cycle in ovarian tissue in the US can be seen up to 7 follicles with the same degree of maturity, whereas normally by this time should be allocated "leader" - one follicle, which matures the egg coming out of the ovary middle of the menstrual cycle as a result of ovulation.

Symptoms persist multifollikulyarnyh ovaries when in the anterior pituitary underfunded luteinizing hormone (LH). LH is released in the second half of the menstrual cycle. The main objectives of this hormone is to stimulate ovulation, then the female sex hormone secretion of the second half of the menstrual cycle, progesterone. With a lack of LH increasingly allocated pituitary follicle-stimulating hormone (FSH), which stimulates the maturation of follicles, which leads to the simultaneous maturation of multiple follicles.

Multifollikulyarnye ovaries and ovulation is related as follows: a few at a time of maturing follicles secrete large amounts of female sex hormones estrogen, which delays passage of the menstrual cycle in the second phase. Sometimes the second phase of the menstrual cycle does not occur due to insufficient secretion of LH (LH stimulates the release of release of an egg from the ovary - ovulation). Since ovulation occurs, the egg in the ovary is formed by the so-called anovulatory menstrual cycles. And this is fraught with infertility (no ovulation Ovulation - How to determine as accurately as possible?   - There is no egg to fertilize nothing).

Reducing LH levels may be due to rapid weight loss or, conversely, obesity, oral contraceptives, endocrine diseases (diabetes, thyroid disease, various diseases of the pituitary gland and hypothalamus), feeding the baby Breastfeeding - a personal choice   feeding (pituitary hormone prolactin suppresses ovulation), prolonged high physical or emotional stress, heavy stress, adolescence.

In some cases, an ultrasound MFYA can be confused with a serious disease - polycystic ovaries (PCO), which requires long-term treatment and surveillance. Multifollikulyarnye polycystic ovaries and sometimes impossible to distinguish at a single ultrasound, so ultrasound is performed several times during the menstrual cycle. It is important to promptly identify MFYA and, if necessary (if there is a disruption of the menstrual cycle) to treat.

In most cases, multifollikulyarnye ovaries and pregnancy - a phenomenon compatible as MFYA often still is one of the variants of the rules and does not prevent the onset of pregnancy and pregnancy and childbirth. But this is only the case when the syndrome is not accompanied by a menstrual irregularities.

Symptoms of ovarian multifollikulyarnyh

Multifollikulyarnyh ovarian syndrome, is not accompanied by a decrease in the secretion of LH and menstrual irregularities, it can be seen only in the US for the fifth-seventh day of the menstrual cycle The days of the menstrual cycle: Four phases   and this is a normal variant. If at the same time there is a disruption of the menstrual cycle, they appear long menstrual cycles and rare but significant menstrual bleeding. If such violations last long, may develop iron deficiency anemia.

In that case, when ovulation does not occur at all, multifollikulyarnaya transformation manifested ovarian infertility.

Diagnosis MFYA

Diagnosis "Multifollikulyarnye ovaries" - this is actually not a diagnosis, and the conclusion of US. In the case where the detection of an ultrasound MFYA accompanied by a violation of the menstrual cycle, a woman carefully examined to determine the cause of violations. First of all, the blood examined for hormones. Since the hormonal system, which provides reproductive function of women is complex device failure can be caused by different reasons. It can be as a consequence of dysfunction of the pituitary, and dysfunction of the hypothalamus (part of the brain responsible for the operation of the whole endocrine system) and other endocrine glands, including the ovaries (between endocrine glands and pituitary gland there is a direct and Feedback).

Echographic signs of ovarian multifollikulyarnyh - a normal size and thickness of ovarian capsule and number of follicles did not exceed 7-8, and their relatively small size (4-8 mm). If polycystic by ultrasound can see a significant permanent (sometimes twice), ovarian enlargement, and the presence of greatly thickened capsule. The number and appearance of follicles in the PCO are also different: with PCOS are more than 10 times and the value of twice higher than that at MFYA. All these differences allow to distinguish functional disorders resulting from the MFYA from organic (in violation of the tissue structure and persistent hormonal disorders) for PCO.

One of the most common benign tumors in women is uterine fibroids. Dimensions uterine fibroids, as well as its location in the uterine wall and the disease symptoms are important for the choice of treatment. The size of fibroids is usually compared to the size of the uterus during pregnancy.

How to determine the size of uterine fibroids

Myoma - a benign tumor of muscle layer of the uterus. Dimensions hysteromyoma directly dependent on hormonal women, mostly from the blood levels of female sex hormones estrogen. With an increase in estrogen and growing myoma node. The size of fibroids obstetricians compared with the size of the uterus during pregnancy. But some experts now believe this method of estimating the size of fibroids obsolete, because during the ultrasound (US) can be measured by the size of fibroids in centimeters. The size of fibroids are divided into:

• fibroid small size - up to five weeks of pregnancy or up to 2, 5 cm;
• fibroids medium (small) sizes - up to 10-12 weeks of pregnancy;
• fibroids large size - more than 12-15 weeks of pregnancy.

The size of uterine fibroids is particularly important during pregnancy. For example, when young and small myomas pregnancy usually occurs without any special features. And with large myomas conception and childbearing are often impossible because of the overlap of the lumen of the fallopian tube (sperm can not get into it, and fertilize the egg), miscarriage, premature birth. At birth these women are also often bleeding complications, labor disturbances, infectious and inflammatory processes and so on.

What other criteria evaluated uterine fibroids

Another important criterion for the evaluation of uterine fibroids is its location (located in the wall of the uterus). Fibroids located immediately below the inner lining of the uterus, called the submucosal in the middle muscular layer of the uterus - interstitial, under the outer serosa - subserous. Submucous knot growing inside the uterus, could further disrupt the menstrual cycle of women, increasing cyclic and acyclic bleeding. Especially dangerous are these nodes during pregnancy because they can squeeze the blood vessels of the placenta and fetus.

Large subserous nodes compress the pelvic organs. Particularly affected in this case the kidneys and urinary tract - an obstacle to the flow of urine can lead to its stagnation, the formation of stones, the development of infections and reduced kidney function.

No less important criterion for evaluation of myoma node is the speed of its growth. Growth is considered fast if within a year fibroids increased by five weeks.

It has the value of identifying all fibroids - it is not difficult, as the US they can not only see, but also to measure.

What determines the choice of treatment

The most important diagnostic criteria state of uterine fibroids are the size, location and speed of growth. On these indicators it depends on the choice of treatment of fibroids. Fibroid growth depends on many factors. But usually this tumor grows long enough. To accelerate the growth of fibroids can pregnancy, abortion, trauma, infectious-inflammatory process in the uterus, and so on.

The rapid increase in fibroids usually occurs pain in the abdomen Abdominal pain: when to sound the alarm?   and in the lumbar region, which sometimes give up, unpleasant sensations in the neighboring organs. Sometimes women are showing signs of acute abdomen - condition requiring immediate medical care. There are usually at such signs of uterine torsion legs and partial dying off (necrosis) of its cells.

For rapid growth more likely submucous or interstitial myoma.

In some cases, the tumor shrinks and may even disappear. Small fibroids disappear after menopause - this contributes to a reduction in the blood of female sex hormone estrogen. Small and medium-sized fibroids, not prone to growth usually observed or treated conservatively.

The size of uterine fibroids in combination with the rapid growth and its location are the main criteria in the evaluation of uterine condition, its possible complications and treatment shaven.

Galina Romanenko