Poor follicle development

　　Poor follicle development in women may be the result of the combined effects of various physiological reasons. It is speculated that the causes of poor follicle development may include the following:

　　1. Pituitary problems

　　One of the reasons for poor ovarian development is a common disease that causes abnormal ovulation, including pituitary prolactinoma, hyperprolactinemia, and Sheffield syndrome, etc. High prolactin levels can suppress ovulation.

　　2. Hypothalamic anovulation

　　Primary organic factors, primary functional factors, secondary organic lesions, and secondary functional factors.

　　3. Early ovarian failure

　　Some women have poor follicle development due to early menopause. Patients have normal menstruation in the early stage, even have a history of childbirth, but then the menstrual periods become sparse and eventually stop. These patients have exhausted all the follicles in the ovary and cannot be stimulated to develop by ovulation-inducing drugs. Or there may be primordial follicles, but they do not respond to gonadotropins.

　　4. Polycystic ovary syndrome

　　Polycystic ovary syndrome is one of the reasons for poor follicle development. Polycystic ovary syndrome is the most common cause of female anovulation. The characteristic of the ovary is that the volume of the ovary increases, with multiple small follicles, but they cannot mature, and medication is needed to promote follicle development.

　　Patients with poor follicle development may be accompanied by endocrine disorders, infertility, and other complications. Persistent poor follicle development will affect female pregnancy and may have an adverse impact on family life, so timely treatment is required.

　　Only when the follicle matures can its function be sound, and the ovum released will be mature and healthy. If the follicle does not develop properly, it cannot ovulate normally or the quality of the ovum released is poor, which will affect normal conception and fertility.
　　Manifestations of poor follicle development:
　　1. Non-development:The follicle does not develop, and it is only at a very small level.
　　2. Small follicle:The follicle develops but is not mature, with a diameter often less than 18 millimeters.
　　3. Non-round follicle:It is not round, showing an oval shape, even a 'date kernel' shape, and has no fertilization ability.
　　4. Non-rupture of the follicle:The follicle matures but does not rupture, and cannot ovulate

　　To prevent poor follicle development in women of childbearing age, it is important to maintain good work and rest habits, avoid staying up late as much as possible; eat less spicy or刺激性 food; actively participate in outdoor sports, relax the mind; do not put too much pressure on yourself, and learn to reduce stress in a reasonable way.

　　Generally, starting from the 8th day of the menstrual cycle, an ultrasound is monitored every 2 days, and when the follicle diameter reaches 17 millimeters, it should be monitored daily. When the follicle develops to maturity with a diameter of 20~23 millimeters, it is necessary to measure twice a day if necessary, until ovulation. Other examinations include:
　　One, endocrine hormone examination:The levels of FSH and LH are significantly elevated, and the level of E2 is significantly decreased, all reaching the menopausal level, and it is necessary to test 3 times before diagnosis. Blood PRL is normal.
　　Two, vaginal smear cells:It shows low estrogen levels, with the presence of basal cells or predominantly low-level cells.
　　Three, laparoscopic examination:Ovarian atresia patients may show a small, atrophic ovary, with unclear follicles; no primordial follicles are seen under the microscope, and there is fibrosis of the ovarian stroma. Anti-ovary antibodies can be found in the ovary: in unresponsive ovary syndrome, a normal-sized ovary is seen, with multiple small follicles visible to the naked eye and under the microscope. Anti-follicular membrane cells, anti-granulosa cells, and anti-FSH antibodies can be found in the ovarian tissue.
　　Four, follicular development ultrasound:Ovarian atresia is indicated by a small ovary and the absence of follicles; a normal-sized ovary with multiple small follicles is indicative of an unresponsive ovary syndrome.
　　1. Appearance time of follicle: At the beginning of each menstrual cycle, multiple follicles develop simultaneously, but generally only 1 or 2 follicles develop to maturity, known as the dominant follicle, while the other follicles close successively. It is reported that more than 90% of cycles have only one follicle rapidly growing to maturity, and 5%~11% have 2 dominant follicles developing. The earliest time for follicular ultrasound imaging can be as early as the 5th to 7th day of the menstrual cycle, showing the smallest diameter of 4~5mm.
　　2. Growth rate of follicle: Ultrasound can detect small follicles in the ovary from the 3rd to 5th day of the menstrual cycle, which gradually grow larger, reaching the largest size on average on the 14th day and can cause ovulation. From the 5th day of the menstrual cycle to the day before ovulation, the average daily growth of the dominant follicle is 1.5mm; before the 10th day, the average daily growth is 1.2mm, and the average daily growth is 1.9mm in the 4 days before ovulation, until the follicle matures.
　　Mature follicles can show the following characteristics: ① The follicle is round or oval, with a diameter of 15~30mm (21.2+-0.53mm), and the interior of the follicle is an echo-free area, clear and pure, with clear boundaries and thin walls. ② On the day before ovulation, 20% of mature follicles can show the cumulus oophorus image, presenting as a short strong echo near the wall inside the follicle.
　　3. Ultrasound images of follicles close to ovulation: ① The incidence rate of cumulus formation is about 20%, mostly appearing in mature follicles >18mm, predicting ovulation to occur within 24 hours. ② The ultrasound ring around the follicle, with the rise of lh value, the membrane tissue swells, and the granulosa cells separate from the membrane cells to form. Predicting ovulation to occur within 24 hours. Currently, the probability shown by ultrasound is very low. ③ The granulosa cells in the follicle wall are completely separated from the basal membrane tissue, and the follicle wall has a tooth-like appearance.

　　Women with poor follicle development should pay attention to ovarian maintenance in their daily diet. The following are several food therapy recipes suitable for ovarian maintenance:

　　1. Erxian Mutton Soup

　　Xianmao, Xianlingpi each 12 grams, ginger 15 grams, mutton 250 grams, a little salt, cooking oil, and monosodium glutamate. Cut the mutton into slices, put it in a pot with an appropriate amount of water, then put the Xianmao, Xianlingpi, and ginger wrapped in gauze into the pot, boil the mutton over low heat until it is tender, add the seasonings, and it is ready to eat. Remove the medicine bag when eating, eat the meat and drink the soup. This food therapy method for maintaining the ovaries has the effect of nourishing the kidneys.

　　2. Shenyu Lean Pork Soup

　　50 grams of fish bladder and lean pork, 20 grams of Chinese wolfberry and Taiizi参, 18 grams of raw earth. Soak the fish bladder in clean water to soften, cut into strips; wash the lean pork, cut into shreds; wash the rest of the materials. Put all the materials in a pot, add an appropriate amount of water, boil for 1-2 hours over low heat, add salt to taste, drink the soup and eat the fish bladder, Chinese wolfberry, and lean pork, finish it within a day. It has the effect of nourishing yin and reducing fire, helping women to maintain their ovaries.

　　If the follicle develops poorly, force the use of ovulation-inducing drugs in a short period of time, and force ovulation, although the eggs can be released, since the eggs released in this way are not mature, they cannot conceive normally. Even if the sperm and egg combine, it is easy to have a miscarriage, stillbirth, and other situations. For women with poor follicle development, ovulation-inducing drugs can generally be used, and the commonly used western medicine is clomiphene citrate, and trophoblastic gonadotropin can also be used.