Multifollicular structure of the ovaries: causes, symptoms, diagnosis

A fairly common ultrasound conclusion is multifollicular ovaries (MFO). Let's consider the features of this condition, causes, symptoms, and correction methods.

The ovaries are a paired organ of the female reproductive system, they are located in the pelvic cavity on both sides of the uterus. They are endocrine glands and produce sex steroid hormones: estrogen, androgen, progestin.

The appendages function from the moment of completion of puberty until menopause, performing the following functions:

1. Generative – reproduction of eggs capable of fertilization. The cortex of the appendages contains primordial follicles, in each of which the maturation of eggs occurs. During puberty, there are about 40 thousand follicles in the ovaries, and after its completion, their number gradually decreases, which is manifested by regular menstruation.
2. Hormonal – ensures continuous production of hormones. In this case, the secretion of estrogen and progesterone is controlled by the anterior pituitary gland. Estrogens are produced with the help of follicle-stimulating hormone in the first phase of the cycle, and luteinizing hormone is responsible for hormonal changes in the second phase.
3. Vegetative – responsible for the development of external female sexual characteristics, maintains femininity.

The sex glands contain a certain number of follicles, in each of which an egg matures. Normally, 4-7 follicles mature monthly, one of which is dominant and slows down the development of the others. An egg matures in it, ready for fertilization during ovulation. If conception does not occur, the follicles dissolve, making room for the next batch.

If the number of follicles exceeds the norm, this indicates multifollicularity. The peculiarity of this condition is that the follicles do not reach full maturity. This is manifested by menstrual cycle failures, absence of menstruation for 6 months or more. But in some cases, a large number of structural components is a variant of the physiological norm. This is typical for adolescents, when the hormonal function has not yet been fully formed.

This is observed in women who have used hormonal contraceptives for a long period of time. In any case, comprehensive correction of disorders with restoration of menstrual function and elimination of associated problems is necessary.

What does multifollicular ovaries mean?

To describe the structural features of the appendages, ultrasound diagnostics specialists use a term such as multifollicularity. It means a large number of structural elements of the ovary in its stroma - more than 7, and normally 4-7 follicles. At the same time, both organs look the same.

In this conclusion, special attention is paid to the presence of the following symptoms:

• Hormonal imbalances.
• Menstrual cycle disorders.
• Pulling pain in the lower abdomen.
• Inability to conceive and more.

Such a structure may be one of the variants of the physiological norm. But in some cases it indicates pathological processes, for example, polycystic disease. To determine the cause of the appearance of a large number of follicles, differential diagnostics is carried out.

Multifollicular structure of the ovaries

A condition in which there are more than 7 structural elements in the ovarian stroma is multifollicularity. Such multifollicular changes in the ovaries can occur due to the action of various factors or be one of the normal variants.

There are several main reasons that cause multifollicular changes:

• Long-term use of hormonal drugs.
• Puberty period.
• Hereditary predisposition.
• Excess or underweight.
• Dysfunction of the pituitary gland.
• Endocrine pathologies.

Multifollicular transformation of the ovaries is detected during an ultrasound examination. The ultrasound reveals 12 or more mature follicles. The symptoms of this condition do not always make themselves known. To determine the nature of the MFO and the risk of complications for the reproductive function, a comprehensive diagnosis is carried out. Based on the results of the studies, corrective methods can be prescribed aimed at restoring the normal functioning of the reproductive organs.

Epidemiology

MFOs are a large number of follicles that form once or during each menstrual cycle. Statistics indicate that about 25% of healthy women of reproductive age face this diagnosis. Of these, more than 70% have hormonal problems and are overweight. In 11% of cases, multifollicularity leads to the development of polycystic disease and more serious complications.

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Causes multifollicular ovaries

In most cases, multifollicularity is genetically determined and manifests itself with a decrease in luteinizing hormone. Hormonal changes occur with sharp fluctuations in body weight and endocrine disorders.

The conducted studies indicate that the causes of multifollicular ovaries can be divided into external and internal, let's consider the main ones:

• Genetic predisposition.
• Sudden changes in body weight.
• Emotional shocks, stress.
• Long-term use of hormonal drugs.
• Use of oral contraceptives.
• Endocrine disorders.
• Puberty period.
• Breast-feeding.
• Inflammatory and infectious diseases of the genitourinary system.
• Hypofunction of the pituitary gland.

Having established what caused the deviation, the need for medical correction is determined. If the patient is healthy and has a normally functioning reproductive system, then the provoking factors should be eliminated. In other cases, additional examination is carried out and treatment is prescribed.

Multifollicular ovaries after discontinuation of oral contraceptives

Oral contraceptives are very popular, and are taken by about 60% of women. After stopping taking oral contraceptives, the body begins to change:

• The gestagens stop being delivered.
• The ovulation period accelerates.
• The gonadotropic function of the pituitary gland is restored.

Against this background, a large amount of luteinizing and follicle-stimulating hormones are produced. Within 2-3 months, reproductive function is restored and the menstrual cycle is stabilized.

As a rule, contraceptives are not harmful to the female body. Very often they are prescribed not only to prevent unwanted pregnancy, but also to treat gynecological diseases: amenorrhea, myoma, dysfunctional uterine bleeding, endometriosis and others.

But in some cases, long-term use of birth control pills leads to the development of multifollicularity. After the cancellation of OC, this condition requires correction, since there is a risk of developing polycystic disease with subsequent transformation into scleropolycystic disease.

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Risk factors

An increased number of structural elements in the female sex glands occurs due to the impact of endogenous and exogenous factors on the body. Let's consider the main risk factors that can provoke MFI:

• Heredity.
• Long-term use of oral contraceptives.
• Obesity or underweight.
• Stress.
• Lactation.
• Diabetes mellitus.
• Disorders of luteinizing hormone synthesis.
• Adolescence.
• Age over 35 years.

Very often, multifollicularity develops due to obesity, which affects 35-60% of women. The deposition of excess fat is directly related to an increase in the concentration of triglycerides and insulin in the blood plasma. This leads to a decrease in glucose tolerance and diabetes. Another common factor in MFO is arterial hypertension and dyslipidemia.

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Pathogenesis

The mechanism of development of multifolliculosis is still not sufficiently studied today. MFO occurs due to the action of various reasons and factors. Pathogenesis is based on the disruption of normal functioning of organs. Normally, each appendage produces no more than 10 antral follicles at the beginning of the cycle. Under the influence of hormones, one of them turns into a dominant one, its capsule diverges and ovulation occurs.

Due to this, the ovarian reserve is gradually used up and the possibility of becoming pregnant remains until the age of 45. Incorrect functioning of the adrenal cortex leads to increased production of follicles. This condition entails the development of multifollicularity, and in some cases, polycystic disease.

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Symptoms multifollicular ovaries

In most cases, MFO is detected during an ultrasound examination. But there are a number of symptoms that indicate the development of multifolliculosis, let's consider them:

• Menstrual cycle failure.
• Pulling pain in the lower abdomen.
• Excessive hair growth on the body and face.
• Acne and pimples.
• Increased oiliness of the scalp.
• Infertility.
• Change in body weight towards increase.

The presence of the above symptoms in combination with the ultrasound conclusion is a reason for further diagnostics. Based on the results of the studies, methods of correction or treatment will be prescribed. If the symptoms are ignored, this can lead to polycystic changes in the organs.

The symptoms of MFI can be both indirect and direct. The first signs are the absence of menstruation for a long period of time without pregnancy. Also, many patients note a decrease in the tone of the voice, weight gain and the appearance of excess hair on the body.

A large number of structural elements leads to anovulatory cycles, which can occur up to 5 times a year. They appear due to incomplete maturation of the dominant follicle or due to a follicular cyst.

Anovular cycles are characterized by ovulation disorders, which in turn creates problems with conception. It is the inability to become pregnant, that is, infertility of unknown origin, that can be a reason for undergoing an ultrasound and identifying MFO.

Read also: Multifollicular ovaries and pregnancy

Multifollicular ovary syndrome

A fairly common ultrasound sign that occurs due to a deficiency of luteinizing hormone and a number of other factors is the MFY syndrome. This ultrasound examination conclusion is characterized by the following signs:

• The ovaries are slightly enlarged in size.
• The echogenicity of the body of the uterus is higher than the echogenicity of the appendages.
• Multiple antral follicles diffusely distributed in the stroma.
• The dominant follicle has a non-thickened capsule.

The syndrome can cause menstrual cycle disorders: prolonged absence of menstruation or rare periods. Weight gain, increased facial and body hair are also possible. The symptoms of multifollicularity are very similar to polycystic disease, so to confirm the diagnosis, a set of laboratory tests is carried out to determine the hormonal background.

Treatment of multifollicular syndrome is carried out during anovulatory cycles. The main goal of therapy is to normalize hormonal levels and restore reproductive functions.

According to the studies, multifollicularity is more often observed in the right appendage. While the left branch is diagnosed less often. In this case, the most unfavorable option is considered to be a simultaneous increase in structural elements in both organs.

In most cases, the pathological condition is associated with disorders in the functioning of the endocrine system. MFO occurs with hormonal imbalances, as well as with long-term use of oral contraceptives, which block the natural formation of follicles.

Often, there are no obvious signs of deviation. But menstrual irregularities, inability to get pregnant, weight gain, and excess hair growth on the body allow one to suspect a problem. Lack of ovulation in combination with other symptoms can lead to the transition of multifollicularity to polycystic ovary syndrome in either or both ovaries at once.

Delayed periods, no periods

One of the main signs of MFO is a violation of the menstrual cycle. Delayed menstruation and multifollicularity are interrelated concepts. Menstruation becomes irregular, long delays appear.

In this case, the cycle may remain normal, but stretch out for a long time. In some cases, the cycle lasts from 2-3 months to half a year. Against this background, the problem of conception arises, since the follicles do not mature and are not ready for fertilization. To restore menstruation and the ovulation process, hormonal drugs are used that stimulate the normal production of female sex hormones.

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Spotting with multifollicular ovaries

The effect of MFC on menstrual flow is due to the hormonal nature of this condition. The cycle is disrupted towards an increase, the flow becomes scanty and painful. If spotting with diagnosed multifollicular changes appears in the middle of the cycle, this can be caused by both ovulation and more serious problems:

• Stress and emotional experiences.
• Presence of an intrauterine device.
• Taking hormonal contraceptives.
• Thyroid diseases.
• Fibromatous nodes.
• Inflammatory processes in the uterus and cervix.
• Vaginal trauma.

To establish the true cause of bloody discharge, a laboratory test is conducted to determine the level of hormones and an ultrasound scan of the organs that affect the functioning of the reproductive system. Based on the test results, corrective treatment is selected to restore normal discharge during menstruation.

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Lower abdominal pain with multifollicular ovaries

The appearance of painful sensations in the lower abdomen with MFO is most often caused by increased production of prostaglandins. Similar symptoms occur when the pelvic organs are compressed by enlarged appendages, but in this case, polycystic disease is diagnosed. Most often, discomfort occurs from the ovary in which the egg has matured.

• Lower abdominal pain is explained by the maturation process of the egg. The walls of the maturing follicles are stretched and discomfort occurs. In the case of multifollicularity, several dominant structural elements are observed simultaneously.

• Painful sensations may be felt due to the rupture of vessels located at the base of the ruptured follicle. Follicular fluid gets onto the uterine epithelium and abdominal wall, causing tissue irritation and discomfort. In this case, in addition to pain, minor spotting appears.

The discomfort lasts from a couple of minutes to 1-2 days. In addition to pain, libido increases, the consistency and viscosity of the mucus from the vulva changes.

But do not exclude the option when unpleasant sensations are associated with the development of a gynecological disease or an inflammatory process. Aching pain on the right in combination with elevated temperature can be a sign of appendicitis. Such symptoms are characteristic of adhesive disease in the small pelvis. In any case, pain is a reason for examination and consultation with a gynecologist.

Multifollicular polycystic ovaries

If the number of follicles in the ovaries exceeds the norm, this indicates their multifollicularity. These changes can be determined using ultrasound. MFO is diagnosed in healthy women in the first week of the menstrual cycle. But if the changes persist in other periods of the cycle, this is a reason for a comprehensive examination and correction.

Despite the fact that MFO is detected in every 4-6 ultrasounds, polycystic disease is diagnosed in 4% of women. Multifollicular polycystic disease or Stein-Leventhal syndrome is a rare disease that occurs due to the action of such factors:

• Excess body weight.
• Genetic predisposition.
• Complications of infectious and inflammatory processes.
• Long-term emotional experiences, stress.
• Hormonal imbalance.
• Increased production of androgens.
• Brain pathologies.
• Insulin resistance.

The disease occurs with a decrease in the level of female hormones estrogens and an increase in testosterone. The concentration of insulin increases and the ratio of luteinizing and follicle-stimulating hormones changes from 1.5-2 to 2.5-3. The main signs of polycystic disease include:

• Irregular menstrual cycle.
• Secondary amenorrhea.
• Obesity.
• Hirsutism.
• Acne and pimples.
• Lowered voice timbre.
• Infertility.
• Frequent painful sensations in the lower abdomen.
• Increased oiliness of the scalp and face.

Polycystic changes are divided into primary and secondary. Primary changes do not cause insulin surges and develop in patients with normal body weight. This form is characterized by a severe course and is difficult to treat. Secondary disorders are more often diagnosed in women with excess body weight. In this case, the disease develops due to the fading of organ function during menopause. Treatment of the secondary form does not cause difficulties.

In addition to ovarian damage, polycystic disease can develop in other organs. For example, polycystic kidney disease is a genetic disease. And when diagnosing polycystic uterine disease, we are talking about cystic damage to the cervix of the organ. The main danger of the disease is that it significantly increases the risk of developing pathologies of the cardiovascular system and diabetes.

Multifollicular ovarian cysts

Tumor benign formations, usually unilateral, formed inside the ovary are multifollicular cysts. This pathology refers to functional cysts and occurs as a result of physiological processes in the organ. The cyst is a follicle in which a cell with liquid matured during ovulation.

The main causes of follicular cysts are:

• Congestive hyperemia of the pelvic organs.
• Inflammatory processes in the uterine appendages.
• Infectious diseases.
• Abortions and gynecological interventions.
• STDs.
• Hormonal disorders.
• Ovulation hyperstimulation in infertility.
• Stress and increased physical activity.
• Childbirth.

If the size of the follicular cyst does not exceed 5 cm in diameter, then, as a rule, it does not cause clinical symptoms. But against this background, menstrual cycle disorders may occur due to an increase in the level of estrogens in the bloodstream. In this case, women complain of delayed menstruation, spotting between periods and painful sensations in the second phase of the cycle. The following symptoms may also appear:

• Increase in basal body temperature.
• A feeling of distension and heaviness in the lower abdomen.
• Painful sensations in the second phase of the cycle, which intensify with physical activity.
• General weakness and malaise.

Treatment consists of laparoscopy, i.e. surgical intervention to remove neoplasms and a course of drug therapy. If multifollicular cysts are left untreated, it is dangerous due to the following complications: cyst rupture, partial or complete ovarian torsion, organ rupture.

Hypoplasia of the uterus and multifollicular ovaries

Underdevelopment of the uterus with a decrease in its size in comparison with the age physiological norm is hypoplasia. This condition occurs due to insufficient production of female sex hormones. As a result of hormonal imbalance, the organ has a long conical neck, a small and hyperanteflex body.

In most cases, hypoplasia is hereditary, but can develop due to the action of such factors:

• Ovarian insufficiency.
• Increased gonadotropic activity of the pituitary gland.
• Hypovitaminosis.
• Intoxication.
• Nervous disorders and increased physical stress.
• Frequent infectious and inflammatory diseases.

As for clinical symptoms, there is a late onset of menstruation, irregular cycle with increased pain, decreased libido, multifollicularity, miscarriages, and abnormal labor. In this case, MFOs are caused by hormonal disorders.

Treatment consists of replacement or stimulating hormone therapy. This allows to achieve an increase in the size of the organ, restore the normal menstrual cycle and reproductive functions.

Endometrial hyperplasia and multifollicular ovaries

The formation of an excess amount of structural tissue elements is hyperplasia. Thickening and proliferation of the uterine mucosa is endometrial hyperplasia. It has several varieties that differ from each other in histological indicators, that is, the structure of the thickening areas.

Endometrial hyperplasia and MFY may occur due to hormonal disorders, i.e. increased production of estrogens and progesterone deficiency. This condition is often diagnosed in patients with diabetes, excess body weight, arterial hypertension, chronic inflammatory processes of the reproductive system.

Symptoms of the disease:

• Anovulatory uterine bleeding.
• Bloody discharge between periods.
• Delayed menstruation.
• Increased weakness and fatigue.
• Anemia.
• Headaches and fainting.
• Decreased appetite.

The danger of this painful condition is that it can lead to infertility and malignant degeneration of uterine tissue. Both medicinal and surgical methods are used to treat endometrial hyperplasia in combination with multifollicular syndrome. In the first case, the patient is prescribed hormonal therapy. Ablation, i.e. removal of the endometrial layer, is performed as a surgical treatment. Particular attention is paid to prevention, which consists of normalizing body weight, minimizing stress and timely treatment of any infectious and inflammatory diseases.

Multifollicular ovaries and ovulation

Insufficient production of luteinizing hormone by the anterior pituitary gland is one of the causes of the development of MFO. The hormone is released in the second half of the menstrual cycle and is responsible for stimulating the ovulation process.

A decreased level of luteinizing hormone can be caused by sudden changes in weight, long-term use of hormonal drugs, endocrine diseases and a number of other reasons. Hormone deficiency leads to the follicles not being able to mature or, on the contrary, several dominant ones appear at the same time.

Multifollicular ovaries and ovulation are interconnected. If several follicles mature at the same time, this leads to increased production of estrogen. This causes a delay in the menstrual cycle. If an egg is not released during ovulation, this causes anovulatory menstruation, which is dangerous for infertility.

Complications and consequences

Multifollicular ovaries caused by hormonal disorders or more serious reasons require treatment. If MFO is left without attention and medical care, it will only worsen the painful symptoms, cause a number of consequences and complications:

• Inability to conceive a child.
• Metabolic disorders in the body.
• Persistent increase in blood pressure.
• Violation of blood supply to the heart muscle.
• Uterine cancer due to atypical cells that form on the endometrial mucosa due to long-term dysfunction of the appendages.
• Spontaneous termination of pregnancy.
• Hyperglycemia.

To reduce the risk of developing the above complications, it is necessary to undergo regular gynecological examinations and begin treatment at the first signs of MFI.

What is the danger of multifollicular ovaries?

The main danger of MFOs is that they cause menstrual irregularities, which in turn leads to anovulatory cycles. Because of this, there is a risk of developing the following problems:

• Infertility.
• Anovulatory dysfunctional uterine bleeding.
• Anemia.
• Ovarian dysfunction.

In order to prevent possible dangers, it is necessary to follow all medical prescriptions during the period of correction of MFO. Hormonal therapy in combination with general strengthening methods allows to restore normal functioning of female sex glands and reproductive function.

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Diagnostics multifollicular ovaries

MFI requires medical supervision, especially if accompanied by pathological symptoms. Diagnosis of this syndrome is carried out using a set of different methods. But special attention is paid to ultrasound examination, which confirms the change in the number of structural elements of the organ.

The following methods are used for diagnostics:

• Ultrasound diagnostics of the ovaries.
• Magnetic resonance imaging of the pelvic organs.
• MRI of the brain.
• Dopplerography.
• Blood test for hormones.
• Determining the presence of ovulation.

Particular attention is paid to the anamnesis. The doctor asks the patient about the characteristics of the menstrual cycle, its regularity and the nature of the discharge. Unsuccessful attempts to get pregnant, the presence of endocrine disorders, and hormonal deviations are also taken into account.

The main goal of diagnosing multifollicular ovaries is to distinguish them from a more serious disease – polycystic ovary syndrome. Based on the results of the studies, the doctor makes a treatment plan, i.e. a method for correcting existing disorders.

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Tests

A mandatory component of diagnostics in case of suspected MFI is laboratory tests. Tests are necessary to assess the general condition of the body and the level of hormones, the disruption of which can cause painful symptoms.

To detect polycystic ovary syndrome and polycystic ovary syndrome, laboratory determination of the concentration of the following hormones is carried out:

• Androgen DHEA-S – produced by the adrenal glands, is detected in hirsutism, reproductive dysfunction, alopecia, multifollicularity and PCOS.
• Free testosterone - if its value is more than 1%, then symptoms of hyperandrogenism occur.
• Estradiol is an active estrogen, values above or below the norm indicate certain disorders in the body.
• Cortisol - if its level is more than 20 or less than 9 mg/dL, then this indicates a severe stress condition, which can be the cause of MFI.
• FSH and LH – reveal disorders in the pituitary gland. FSH stimulates the appendages and prepares the follicles for ovulation. If the ratio of these hormones is increased, then there are disorders of the pituitary gland and reproductive system.
• Prolactin is produced by the pituitary gland, its elevated level may indicate neoplasms in the organ that activate excessive hormone production. High prolactin inhibits FSH and the possibility of fertilization. Also, values above the norm occur with tumors of the hypothalamus, pituitary gland, Cushing's syndrome.

In addition to the above studies, it is necessary to take tests for thyroid hormones. Dysfunction of this organ is manifested by an irregular menstrual cycle, lack of ovulation. Another mandatory test is an assessment of glucose metabolism, that is, determining the level of sugar in the blood, a glucose tolerance test, insulin.

Laboratory diagnostics are carried out in certain phases of the menstrual cycle: at the beginning, during ovulation, at the end. The results obtained are compared and analyzed, which allows for a final diagnosis.

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Instrumental diagnostics

One of the most important methods for detecting an increased number of structural components of the ovary is ultrasound. Instrumental diagnostics determines echoscopic signs of changes, the number of follicles and other features of the pelvic organs.

Ultrasound examination is necessary to examine the thyroid gland and adrenal glands. Visible changes in these organs may be the cause of hormonal disorders that caused multifollicularity.

Magnetic resonance imaging of the brain is also performed, in particular the hypothalamus. This endocrine organ regulates metabolic processes and is responsible for reproductive and hormone-forming functions. MRI reveals any changes in the structure of the pituitary gland and hypothalamus.

Ultrasound, echo signs of multifollicular ovaries

Symptoms of MFO can be both direct and indirect. To confirm the syndrome of multifollicularity, an ultrasound examination is performed.

The main echo signs of MFI according to transvaginal ultrasound:

• The ovaries are slightly enlarged in size or within normal limits.
• Echogenicity of the body of the uterus is higher than the appendages.
• The sex glands contain multiple antral follicles (12 or more), about 9 mm in diameter.
• One or more dominant follicles are present.
• The dominant has a non-thickened capsule.
• Antral follicles are characterized by a diffuse (scattered) location in the stroma.

In addition to ultrasound, folliculometry can be performed to determine the presence of ovulation if it has not occurred for several cycles.

Multifollicular echostructure of the ovaries

Normally, in female patients of childbearing age, the ovaries are 15 mm thick, 30 mm long and about 25 mm wide. In MFO, these parameters are slightly increased. The appendages also contain structural components:

• Capsules of small parameters no more than 7-9.
• Dominant follicle.
• Corpus luteum.

In multifollicularity, there are more than 12 antral follicles no larger than 9 mm with a high probability of maturation. The dominant follicle does not have a thickened capsule; in some cases, several dominants are formed.

Another feature of the MFY syndrome is the diffuse location of the antral capsules. With MFY, the echostructure of the organ is smaller than that of the uterus. Normally, the echostructure is uniform, minor fragments of fibrosis in the capsule are possible.

Differential diagnosis

If MFO syndrome is suspected, a set of laboratory and instrumental studies is carried out. Particular attention is paid to differential diagnostics. Multifollicularity is compared with diseases in which menstrual disorders, infertility, hyperandrogenism, hirsutism and other symptoms are observed.

Differentiation of MFN is carried out with the following pathologies:

• Adrenogenital syndrome.
• Tumors of the adrenal glands and ovaries.
• Itsenko-Cushing syndrome (hypercortisolism).
• Tumor lesions of the pituitary gland.
• Thyroid diseases.
• Endocrine disorders.

Both laboratory and instrumental methods are used for diagnostics. Particular attention is paid to the results of hormone analysis and ultrasound examination.

Difference between polycystic and multifollicular ovaries

Two diseases similar in symptoms and nature of origin are polycystic ovary syndrome and multifollicular ovarian syndrome. An increased number of follicles is detected in every fourth ultrasound, but polycystic ovary syndrome is diagnosed in only 30% of such patients. Polycystic ovary syndrome is a pathology of the structure and function of the ovaries. Unlike multifollicular ovarian syndrome, it occurs with chronic anovulation (with multifollicular ovarian syndrome, an anovulatory cycle) and hyperandrogenism. At the same time, multifollicularity can be one of the causes of PCOS.

Let's look at the main differences between PCOS and MFO:

• Echogenicity – the density of the appendages in MFY does not exceed the echogenicity of the uterus. In polycystic disease, the organ tissue is much denser than the uterine tissue.
• Size of ovaries – with multifollicularity their volume is slightly larger than normal. With PCOS the length is more than 40 mm, with the norm being 34-37 mm.
• Follicles - in both syndromes, multiple structural elements are observed. In MFY, their diameter is no more than 9 mm, and in PCOS, they significantly exceed the norm. The follicle capsule in polycystic disease is greatly thickened, which prevents the egg from exiting and provokes the growth of follicular cysts.
• Localization of follicles - with MFO, antral follicles are scattered throughout the ovary, with polycystic ovary syndrome they are located in the form of a necklace, that is, on the periphery.
• The hormones DEH and 17-OH progesterone are produced by the adrenal glands; in MFO they are within normal limits, while in PCOS their values are elevated.

When making a final diagnosis, the results of differentiation of MFO with polycystic disease and the risk of transformation of multifollicularity into PCOS are taken into account. A properly composed treatment regimen allows for the restoration of reproductive functions with minimal consequences for the body.

Treatment multifollicular ovaries

The methods of treatment of multifollicular ovaries depend on the results of the diagnostics, causes and symptoms. It is impossible to completely cure multifollicularity. But with the help of hormonal correction, diet therapy and vitamin therapy it is quite possible to restore a stable menstrual cycle, the ability to ovulate and reproductive function.

Prevention

The female body, and especially the reproductive system, are very sensitive to any changes. Therefore, prevention of multifollicular ovaries comes down to the following rules:

• Regular preventive examinations by a gynecologist.
• Weight control to prevent hormonal imbalance.
• Balanced nutrition.
• Moderate but regular physical activity.
• Timely treatment of any diseases.
• Minimizing stressful situations and emotional shocks.
• Taking any medications, especially hormonal contraceptives, only as prescribed by a doctor.

If MFOs are a normal variant and do not cause harm to the reproductive system, then regular ultrasounds are recommended to prevent any complications for timely detection of changes.

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Forecast

Multifollicular ovaries are diagnosed in many women. Their appearance may be related to age-related features and be the norm or indicate certain disorders in the body.

The prognosis for MFY syndrome depends on its cause, the patient's age, and symptoms. In 90% of cases, after complex correction, a woman's ovulation and ability to conceive are restored. However, there is a risk of early miscarriage, multiple pregnancy, and gestational diabetes.

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