What to do and how to treat multifollicular ovaries?

Treatment of multifollicular ovaries consists of:

1. Elimination of metabolic disorders and pathologies of the endocrine system. Patients are prescribed medications, most often oral contraceptives and other hormonal agents. OCs reduce the level of androgens and make cells less sensitive to them. In case of MFO in adolescents, homeopathic preparations are used for treatment. The duration of such therapy is at least 3 months.
2. The doctor gives recommendations on nutrition and physical activity to reduce weight and restore normal functioning of the body. For women with excess body weight, a diet of 1500-1800 kcal per day is recommended, and for patients with a weight deficit, the daily calorie content is increased. Particular attention is paid to BJU.
3. Vitamin therapy – regardless of the cause of MFI, patients are prescribed multivitamin complexes with increased content of tocopherol and B vitamins.
4. If after the restoration of the hormonal background and menstrual cycle there is no ovulation, then stimulation of the ovulation cycle is carried out. This allows you to get pregnant.
5. Psychotherapy. One of the causes of multifollicularity is stress and emotional experiences. To eliminate this factor and minimize its impact in the future, conversations with a psychologist are held. In particularly severe cases, sedatives, antidepressants or tranquilizers may be prescribed.

Treatment of multifollicular ovary syndrome is carried out by a gynecologist-endocrinologist and a number of related specialists. The doctor's task is to eliminate hormonal imbalance and prevent its violations in the future, as well as to restore the patient's reproductive abilities.

Medicines

The choice of medications for the treatment of multifollicular ovarian syndrome depends on the cause of this condition. Let's look at the medications prescribed for MFOS:

1. Utrozhestan

A medicinal product with the active component – progesterone (a hormone of the corpus luteum of the ovary). Normalizes secretory transformations in the uterine mucosa. Promotes the transition of the endometrium to the secretory phase. Potentiates changes in the endometrium during fertilization for implantation and development of the embryo. Has antiandrogenic properties, normalizes the formation of dihydrotestosterone.

• Indications for use: correction of endogenous progesterone deficiency, anovulatory menstrual cycle, premenstrual syndrome, infertility, ovulation disorders, mastopathy. Hormone replacement therapy for climacteric syndrome. The drug supports the luteal phase of the menstrual cycle in preparation for reproductive technologies.
• Method of administration: orally in a dosage of 200-300 mg, divided into 2 doses. In case of MFO and corpus luteum insufficiency of the ovary, Utrozhestan is taken from the 16th to the 25th day of the menstrual cycle. Intravaginal use is prescribed for non-functioning ovaries or for egg donation.
• Side effects: intermenstrual bleeding, spotting, headaches and dizziness, hypersensitivity reactions. Overdose has similar signs. Treatment is symptomatic with a reduction in dosage.

Contraindications: allergic reactions to the components of the drug, bleeding from the genital tract of unknown origin, tendency to thrombosis, incomplete abortion, malignant lesions of the mammary glands and reproductive organs, porphyria, severe liver dysfunction. Use during pregnancy is possible only on medical prescription.

Utrozhestan is available in capsules of 100 and 200 mg, 30 and 14 pieces in a blister.

2. Acetomepregenol

A drug with high progestogenic activity. The active component is related to female sex hormones produced by the adrenal glands and the corpus luteum of the ovary. It causes changes in the endometrium and the inner layer of the uterus, ensuring the normal course of pregnancy.

• Indications for use: risk of miscarriage in the first trimester of pregnancy, menstrual irregularities, prevention of unwanted pregnancy.
• Method of administration: orally 0.5-1 mg 2-3 times a day for 5 days with a repeated course in one cycle. The total dose for one course is up to 15 mg. For preventive purposes, 0.5-1.0 mg is prescribed 2-3 times a day for 6 days. For dysfunctional uterine bleeding, 0.5-2.5 mg per day from day 15 to day 24 of the cycle. Treatment lasts 3-6 cycles.
• Side effects: headaches and dizziness, swelling of the mammary glands, insomnia, allergic reactions.
• Contraindications: increased blood clotting, liver dysfunction, tumors.

Release form: tablets for oral administration of 0.5 mg, 30 pieces per package.

3. Dimestrol

A synthetic drug with an estrogen-like effect. It is used for ovarian failure. The drug is administered intramuscularly in a 0.6% oil solution. The dosage is individual for each patient. As a rule, injections are given once a week at 12 mg/2 ml of solution. The course of treatment consists of 2-3 injections. The effect of the first injection appears on the 3rd-6th day of therapy.

With prolonged use of the drug, there is a risk of uterine bleeding. Dimestrol is contraindicated in neoplasms of the genitals, mammary glands and other organs. It is not used in mastopathy, endometritis, a tendency to uterine bleeding, as well as in the hyperestrogenic phase of menopause. It is produced in ampoules of 2 ml of 0.6% oil solution in a package of 10 pieces.

4. Norkolut

A medication with an active component from the gestagen group – norethisterone. It has the properties of estrogens and androgens. It promotes the transition of endometrial proliferation to the secretion stage. It maintains the endometrium in an optimal condition for embryo development. It inhibits the production of pituitary gonadotropic hormones, which disrupt the maturation of follicles and the ovulation process.

• Indications for use: menstrual cycle disorders of various etiologies, PMS, mastodynia, endometriosis, dysfunctional uterine bleeding during menopause, adenomyoma of the uterus. Cystic-glandular changes in the endometrium, termination of breastfeeding or prevention of lactation.
• Method of application: 5-10 mg from day 16 to day 25 of the cycle. The drug is allowed to be used simultaneously with estrogens. The number of courses of treatment is determined by the attending physician, individually for each patient.
• Side effects: dyspeptic disorders, headaches, changes in body weight, asthenia, breast engorgement.
• Contraindications: malignant neoplasms in the reproductive organs. With special caution, it is prescribed for epilepsy, severe pathology of the liver, heart, kidneys, bronchial asthma, a tendency to thrombosis, blood clotting disorders.

Release form: tablets for oral use of 5 mg, 20 capsules per package.

5. Regevidon

Combined oral contraceptive. Refers to monophasic drugs, contains equal amounts of estrogenic and gestagen components. The active substance is levonorgestrel, a synthetic derivative of 19-nortestosterone. It has progesterone activity, but exceeds it in strength of action. Another active component is ethinyl estradiol, a synthetic analogue of endogenous estradiol.

• Indications for use: contraception in women of childbearing age, correction of functional disorders of the menstrual cycle, dysmenorrhea, functional uterine bleeding. PMS, pain syndrome in the middle of the cycle.
• Method of administration: orally 1 white tablet once a day for 21 days. Further therapy is continued with red-brown tablets, 1 tablet per day for a week. The next course of treatment can be started only 4 weeks after the start of the previous one.
• Side effects: dyspeptic disorders, nausea, vomiting, headaches and dizziness, emotional instability. Increased irritability and fatigue, cramps in the calf muscles, decreased/increased libido. Engorgement of the mammary glands, skin allergic reactions, intermenstrual bleeding.
• Contraindications: hypersensitivity to the components of the drug, severe liver dysfunction, gallstones, cholecystitis, hepatitis, chronic colitis. Cardiovascular diseases, lipid disorders, endocrine pathologies, anemia, vaginal bleeding of unknown origin, blood clotting disorders. Not used during pregnancy and lactation.
• Overdose: nausea, vomiting, pain in the epigastric region, vaginal bleeding. There is no specific antidote, treatment is symptomatic with gastric lavage and enterosorbents.

Release form: enteric-coated tablets. The package contains two blisters of 21 and 7 tablets.

6. Remens

Normalizes the functioning of the hypothalamus-pituitary-ovarian system. Helps restore hormonal balance. Contains plant components that have an anti-inflammatory effect in diseases of the pelvic organs, reduce blood pressure and reduce the symptoms of menopause.

• Indications for use: amenorrhea, oligomenorrhea, dysmenorrhea, algomenorrhea, PMS, menopause. Complex treatment of adnexitis and endometritis.
• Directions for use: 10 drops/1 tablet 8 times a day on days 1-2, starting from day 3, 10 drops/1 tablet 3 times a day. Duration of treatment is 3-6 months.
• Side effects: allergic reactions, hypersalivation.
• Contraindications: individual intolerance to the components of the drug. Use during pregnancy is possible in cases where the potential benefit to the mother is higher than the risks to the fetus.

Release form: tablets in blisters of 12, 24, 36 and 48 pcs., drops for oral use in bottles of 20 ml, 50 ml and 100 ml.

The above-mentioned medications can only be used as prescribed by a doctor, observing the dosage and duration of therapy.

Stimulation for multifollicular ovaries

If the MFY syndrome has become the cause of female infertility, then the method of ovulation stimulation is used for treatment. Its main goal is to help the body form an egg capable of fertilization and its exit from the follicle. This method involves influencing the ovaries with hormonal medications that increase the release of hormones necessary for ovulation.

Stimulation of multifollicular ovaries is performed in the following cases:

• Anovulatory cycle.
• High/low body mass index.
• Hormonal dysfunction that is incurable by other means.
• Infertility of unknown etiology.
• Preparation for IVF and other methods of artificial insemination.

Before the procedure, the woman is prescribed a set of tests to exclude contraindications to ovulation stimulation: obstruction of the fallopian tubes, inflammatory processes in the pelvic organs, hormonal imbalances.

Particular attention is paid to the assessment of the ovarian reserve. This study determines the intensity of ovulation and the probability of its occurrence during stimulation. For analysis, blood is taken after taking hormonal drugs. The results allow choosing the optimal treatment regimen with the most effective drugs.

There are several groups of drugs for stimulating ovulation:

• Medicines based on human menopausal gonadotropin.
• Medicines based on follicle-stimulating hormone.
• Drugs that suppress estrogen and increase FSH.
• Hormones that stimulate the rupture of the follicle membrane and the release of the egg.

Stimulation is performed no more than 6 times, as it can cause exhaustion and rupture of the ovaries, cystic neoplasms. There is also a risk of disorders of the central nervous system, gastrointestinal tract, excess weight gain, hormonal disorders. If pregnancy does not occur after the therapy, the patient is prescribed other treatment methods.

Treatment of multifollicular ovaries with hormonal agents

Today, the pharmaceutical market offers a variety of drugs for the treatment of multifolliculosis and its complications. Therapy is carried out using hormonal drugs, as a rule, these are the following:

• Follicle-stimulating and luteinizing hormones – stimulate ovulation and growth of follicles in the ovaries, increasing the chances of successful conception.
• Human chorionic gonadotropin preparations support the dominant follicle and help bring the egg to the sperm for fertilization.
• Progesterone – prepares the inner lining of the uterus for the embryo to attach to. Helps to safely carry the fetus to term.

Let's consider popular hormonal drugs for the treatment of multifollicular ovaries and the features of their use:

1. Lindinet

Combined oral contraceptive. Contains three active components: lindinet, ethinyl estradiol and gestodene. Reduces the secretion of pituitary gonadotropic hormones. Regulates the menstrual cycle, changes the nature of cervical mucus. Reduces the risk of dysmenorrhea, functional ovarian cysts and ectopic pregnancy. Prevents congestion and inflammation in the pelvic organs, improves the general condition of the skin in acne.

• Indications for use: prevention of unwanted pregnancy, functional disorders of the menstrual cycle.
• Method of administration: orally from the first day of the menstrual cycle, 1 capsule per day for 21 days. After a week's break, continue treatment.
• Side effects: breast engorgement, spotting, increased blood pressure. Nausea, vomiting, diarrhea, decreased bile flow. Changes in libido, vaginal fungal infections, headaches and dizziness, lower abdominal pain, allergic reactions.
• Contraindications: individual intolerance to the components of the drug, severe liver dysfunction, thrombosis, cardiovascular pathologies, metabolic disorders. Tumor neoplasms, tendency to uterine bleeding of unknown etiology, epilepsy, pregnancy and lactation, age over 35 years.
• Overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote, treatment is symptomatic.

Release form: film-coated tablets, 21 pcs. in a blister, 1, 3 blisters per package.

2. Puregon

A medicinal product with recombinant follicle-stimulating hormone – follitropin beta. Stimulates the growth and maturation of follicles, normal synthesis of steroid hormones of the reproductive system in women with ovarian dysfunction.

• Indications for use: anovulatory cycles, infertility, polycystic ovary syndrome. The drug is prescribed to control ovarian hyperstimulation during the induction of multiple follicle development in assisted reproduction. Peregon can be used to treat men with spermatogenesis deficiency due to hypogonadotropic hypogonadism.
• Method of administration: parenterally (subcutaneously, intramuscularly), the dosage and duration of treatment is determined by the attending physician, individually for each patient.
• Side effects: local reactions in the area of drug administration, swelling, soreness, skin rashes, allergic reactions. Headaches and dizziness, breast engorgement, nipple pain, vaginal bleeding.
• Contraindications: individual intolerance to the components of the drug, hormone-dependent tumors and any other neoplasms, vaginal bleeding of unknown etiology, disorders of the anatomy of the genitals, uterine fibroids, endocrine diseases. Not used during pregnancy and lactation.
• Overdose: development of ovarian hyperstimulation. Treatment is symptomatic.

Release form: vials of 50 or 100 IU.

3. Diphereline

Synthetic analogue of natural gonadotropin-releasing hormone. Active component – triptorelin. Stimulates gonadotropic function of the pituitary gland and inhibits it. Suppresses functions of the ovaries and testicles.

• Indications for use: anovulatory cycles, stimulation of fertilization in IVF programs. Higher doses of the drug are effective in prostate cancer, breast cancer, uterine fibroids, endometrioid cysts. The method of administration and dosage are individual for each patient.
• Side effects: bone demineralization, allergic reactions, decreased libido, ureteral obstruction, headaches and increased sweating. Vaginal dryness, ovarian hyperstimulation syndrome, hypogonadotropic amenorrhea. Nausea and vomiting, hot flashes, emotional lability. Peripheral edema, weight gain. Overdose has similar symptoms, treatment is symptomatic.
• Contraindications: hypersensitivity to the components of the drug, osteoporosis, pregnancy and lactation, hormone-resistant prostate cancer.

Release form: lyophilisate in vials of 0.1 mg, 3.75 mg and 11.25 mg.

4. Gonal

A medicinal product with the active substance follitropin alpha. Recombinant follicle-stimulating hormone of the human body. Affects the growth and development of follicles. Has gonadotropic properties, stimulates the ovulation process.

• Indications for use: anovulation, ovarian hyperstimulation, stimulation of spermatogenesis, ovarian stimulation in severe deficiency of FSH, LH. The drug is available in syringe pens for subcutaneous administration. The dosage and course of treatment are selected by the doctor, individually for each patient.
• Side effects: skin hyperemia, headaches, nausea and vomiting, acne, itching, formation of ovarian cysts, diarrhea, thromboembolism, multiple pregnancy. Hyperstimulation syndrome, weight gain, pain in the epigastric region.
• Contraindications: hypothalamic-pituitary tumors, ovarian and breast cancer, premature menopause, hypersensitivity to the components of the drug, ovarian insufficiency, uterine fibroids, pregnancy and lactation.
• Overdose: ovarian hyperstimulation syndrome. Treatment is symptomatic.

Release form: injection solution, lyophilisate of 0.5 ml, 0.75 ml and 1.5 ml.

5. Folliculin

Natural follicular hormone, has an estrogenic effect. It is used for diseases that occur with ovarian failure, acne, virile hypertrichosis. The drug is effective for amenorrhea, dysmenorrhea, hormonal disorders.

The dosage and duration of therapy are determined by the attending physician. Folliculin Contraindicated in neoplasms of the genitals and mammary glands, mastopathy, tendency to uterine bleeding of unknown genesis. Long-term use may cause uterine bleeding. The drug is available as an oil solution in ampoules of 1 ml, 6 pcs. per package.

6. Choragon

The drug contains chorionic gonadotropin of natural origin. The active component is isolated from the urine of pregnant women, purified and sterilized. When it enters the body, it has an effect similar to the activity of the luteinizing hormone of the pituitary gland. Due to this, the corpus luteum matures, the synthesis of progesterone and estrogens increases, and ovulation occurs.

• Indications for use: hypofunction of the sex glands in dysfunction of the hypothalamic-pituitary system, dysmenorrhea, anovulatory cycle, corpus luteum insufficiency, ovarian superstimulation in reproductive technologies, threat of spontaneous miscarriages. Adiposogenital syndrome, hypogenitalism, oligoasthenospermia.
• Method of administration: the lyophilisate solution is administered intramuscularly. The dosage and duration of treatment are determined by the attending physician.
• Side effects: hypersensitivity reactions, pain at the injection site, headaches and asthenic condition, increased anxiety, suppression of the synthetic functions of the pituitary gland, etc.
• Contraindications: hypersensitivity to the components of the drug, ovarian cancer, hyperprolactinemia, androgen-dependent tumors, pregnancy and lactation, hypothyroidism, obstruction of the fallopian tubes, early menopause, thromboembolic disorders, history of ectopic pregnancy. Cystic ovarian formations (not associated with polycystic disease), adrenal insufficiency, gynecological bleeding of unknown etiology.
• Overdose: ovarian hyperstimulation syndrome. Treatment is symptomatic.

Release form: lyophilisate powder for parenteral administration of 1500 and 5000 IU, 3 ampoules per package.

All of the above medications are used only as prescribed by the attending physician.

Duphaston for multifollicular ovaries

A medicine based on female sex hormones is Duphaston. The drug contains dydrogesterone 10 mg in 1 capsule. The active component is an analogue of natural progesterone. It does not have an androgenic, corticoid or estrogenic effect.

Does not affect metabolic processes, but selectively affects progestin receptors of the uterine mucosa. Causes secretory transformations in the endometrium with sufficient estrogen saturation. Does not affect follicular ovulation, does not have virilizing properties.

• Indications for use: endogenous progesterone deficiency, endometriosis, PMS, menstrual irregularities, amenorrhea. Habitual loss of the fetus, threatened abortion, dysmenorrhea. Hormone replacement therapy.
• The method of application and dosage scheme are selected by the attending physician, individually for each patient. To obtain the maximum therapeutic effect, the clinical signs of the disease and the phase of the menstrual cycle are taken into account.
• Side effects: bleeding, individual reactions of drug intolerance. Overdose has similar symptoms. Symptomatic therapy is indicated for treatment.
• Contraindications: hypersensitivity to the components of the drug, Rotor syndrome, Dubin-Johnson syndrome. The drug can be used during pregnancy, but during lactation, breastfeeding should be discontinued, since the active component penetrates into breast milk.

Duphaston is available in tablet form for oral administration.

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Clostilbegit

Antagonist of female sex hormones with the active component - clomiphene. The active substance belongs to the group of antiestrogens, which stimulate the ovulation process. Stimulation is carried out by increasing the synthesis of sex hormones through the effect on estrogen hormones in the ovaries and hypothalamus.

• Indications for use: Chiari-Frommel syndrome, Stein-Leventhal syndrome, galactorrhea, amenorrhea and other conditions with absence of ovulation.
• Method of administration: if the menstrual cycle is maintained, then treatment begins on the 5th day of the cycle. The patient is prescribed 50 mg per day until the 10th day of the cycle. Ovulation occurs on the 11th-15th day of the cycle. If ovulation does not occur, then in the next period the dosage is increased to 100 mg. The total dose for the course of therapy should not exceed 750 mg.
• Side effects: headaches, nausea, dizziness, increased anxiety, asthenic condition, depression, pain in the epigastric region, vomiting, weight gain. In rare cases, an increase in the ovaries to 5-8 cm, skin allergic reactions, urinary disorders and chest pain are noted. When treating with this drug, it should be taken into account that it significantly increases the risk of multiple pregnancy.
• Contraindications: intolerance to the components of the drug, pregnancy, liver disease, history of uterine bleeding, oncological processes in the body, decreased pituitary function, ovarian cyst.
• Overdose: nausea, vomiting, epigastric pain, visual impairment, ovarian enlargement. Treatment is symptomatic, there is no antidote.

Clostilbegyt is available in tablet form, 50 mg in each tablet, 10 capsules per package.

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AMH in multifollicular ovaries

Anti-Müllerian hormone (AMH) – produced by granulosa cells of the ovaries. Actively affects the growth and formation of tissues. Participates in sexual function, affects the reproductive system. Impaired production of this substance or a change in its level negatively affects the ability to become pregnant. An AMH test is prescribed in the following cases:

• Infertility of unknown origin.
• High levels of follicle-stimulating hormone.
• Multifollicularity.
• Polycystic ovary syndrome.
• Suspected granulosa cell tumor lesions of the ovaries.
• Unsuccessful attempts at artificial insemination.
• Monitoring the effectiveness of antiandrogen treatment.

The level of anti-Müllerian hormone is used to assess the functional capacity of the ovaries and the number of eggs. The level of AMH depends on the woman's age. Before puberty, that is, the first menstruation, the hormone is not determined at all. Its values are zero during menopause. Maximum values are recorded at 20-30 years, that is, at the peak of female fertility.

When studying the results, the ovarian period is taken into account, that is, the number of remaining eggs that can ovulate and be fertilized.

• With multifollicular ovaries, AMH is elevated and such women have a higher chance of successful in vitro fertilization. High levels are characteristic of polycystic disease, tumor lesions of the ovaries, delayed sexual development, anovulatory infertility.
• Low hormone levels can make it difficult to conceive naturally. This condition is observed during menopause, with ovarian dysfunction, obesity, and early puberty.

The AMH test is performed on the third day of the cycle. To obtain reliable results, several days before the test, you should minimize physical activity and stress overexertion, and quit smoking. However, ARVI and flu are contraindications for taking the test. Venous blood is collected for the test, and the results are ready in 2-3 days. A gynecologist will interpret the test results.

Metformin for multifollicular ovaries

Very often, insulin resistance is observed with MFI, that is, a disrupted biological response of the body to the action of insulin. In this case, it does not matter where the hormone comes from - the pancreas or injections. To treat this condition, medications are used, one of which is Metformin.

The drug belongs to the oral antidiabetic drugs of the biguanide class. Its mechanism of action is based on the inhibition of gluconeogenesis in the body by the active component. Due to this, the transport of electrons of the mitochondrial respiratory chain slows down, which entails a decrease in ATP and stimulation of glycolysis.

• Indications for use: diabetes mellitus type 1, 2. Supplement to basic insulin therapy or in combination with other antidiabetic drugs. Obesity, need to control blood glucose levels.
• Method of administration: orally after meals, with a sufficient amount of liquid. The initial dosage is 1000 mg per day, divided into 2-3 doses. After 10-15 days, the dosage is increased. The maintenance dose is 1.5-2 g per day, the maximum permissible dosage is 3 g per day. A persistent therapeutic effect is observed after 10-14 days of using the drug.
• Side effects: bowel disorders, nausea, vomiting, pain in the epigastric region, loss of appetite, metallic taste in the mouth, allergic skin reactions.
• Contraindications: hypersensitivity to the components of the drug, age under 15 years, diabetic precoma or ketoacidosis, gangrene, dehydration. Renal/hepatic dysfunction or failure, diabetic foot syndrome. Lactic acidosis, chronic alcoholism, severe infectious diseases, diet with a daily caloric content of less than 1000 kcal. Pregnancy and lactation, extensive injuries and surgeries, intra-arterial or intravenous use of iodine-containing drugs.
• Overdose: vomiting, diarrhea, nausea, muscle weakness and pain, fever, headaches and dizziness. Treatment is symptomatic, hemodialysis is effective.

Metformin is available as film-coated tablets of 500 and 850 mg, 30, 120 tablets in a blister.

Yarina for multifollicular ovaries

A combined estrogen-progestogen-containing hormonal agent with contraceptive properties. Contains two active components: 3 mg drospirenone and 0.03 mg ethinyl estradiol. The contraceptive effect is due to the inhibition of ovulation and changes in the viscosity of cervical mucus. Because of this, the endometrium remains unprepared for implantation of the egg, and the viscosity of the cervical mucus makes it difficult for sperm to penetrate the uterine cavity.

Yarina has antiandrogenic activity, reduces acne formation and decreases sebaceous gland production. Does not affect the level of globulin, which binds sex hormones. In combination with ethinyl estradiol, it improves the lipid profile, increasing the concentration of HDL. It has a positive non-contraceptive effect on the body: reduces the risk of anemia, reduces PMS symptoms, makes menstrual bleeding easier and shorter.

• Indications for use: prevention of unwanted pregnancy, hormone-dependent edema, seborrhea, acne.
• Directions for use: 1 capsule every day at the same time for 21 days. Each subsequent package is started after a week-long break, during which menstrual-like bleeding is possible. Therapy is recommended to start on days 2-5 of the cycle with additional use of barrier contraception.
• Side effects: breast tenderness, breast discharge, headaches and dizziness, decreased libido, mood changes. Nausea, vomiting, changes in vaginal secretion, fluid retention, weight changes, hypersensitivity reactions.
• Contraindications: hypersensitivity to the components of the drug, thrombosis or conditions preceding thrombosis, diabetes mellitus with vascular complications. Liver disease, renal/hepatic insufficiency, liver tumors. Vaginal bleeding of unknown origin, pregnancy and lactation.
• Overdose: nausea, vomiting, slight vaginal bleeding. There is no specific antidote, treatment is symptomatic.

Yarina is available in packages of 21 capsules for oral use.

Cyclovita for multifollicular ovaries

A biologically active supplement that affects the genitourinary system and normalizes cyclic processes in the body. The drug is designed for women of fertile age to eliminate pathological conditions during the menstrual cycle and gynecological diseases.

Cyclovita contains a complex of vitamins and minerals: A, group B, C, D3, E, PP, copper, selenium, zinc, iodine, manganese, rutin, lutein. Each tablet is intended for a certain period of the menstrual cycle.

• Indications for use: normalization of the menstrual cycle in case of vitamin and mineral deficiency, regulation of the abundance of discharge, elimination of complications of hormonal changes and blood loss.
• Method of application: treatment begins from the first day of menstruation and up to the 14th, taking 1 red tablet. From the 15th day, start taking a blister with blue tablets, 2 capsules per day. If the cycle is less than 28 days, then stop taking the drug on the first day of menstruation. If the cycle is more than 28 days, then you should take a break from treatment before the start of the 1st day of menstruation.
• Contraindications: hypersensitivity to the components of the drug, age under 14 years, male patients, pregnancy and lactation. No cases of overdose have been recorded.

Release form of Cyclovita: 14 red and 28 blue tablets per package.

Inofert for multifollicular ovaries

Biologically active food supplement, contains two active components:

• Inositol is a vitamin factor of group B. It is found in citrus fruits, whole grains, peanuts, wheat sprouts, legumes, and yeast. It is present in phospholipids in the body and stimulates endogenous synthesis of lecithin. It controls the metabolism of fats and sugars, and cellular functions of the nervous system. It regulates the parameters of follicle-stimulating hormone. It restores the regularity of the menstrual cycle and the ovulation process. It eliminates metabolic and reproductive disorders.
• Folic acid is a water-soluble vitamin B9, involved in amino acid metabolism. Synthesizes proteins, nucleic acids and takes part in chromosome reparation. Contained in green vegetables, liver, eggs, legumes, meat and milk.

The drug is used as an additional source of folic acid and inositol. It is used in controlled ovarian hyperstimulation protocols, in polycystic and multifollicular diseases due to insulin resistance, prediabetes and type 2 diabetes,

Method of administration and dosage: 1 sachet during meals. Dissolve the contents of the sachet in a glass of water. Duration of treatment is 30 days. Inofert is contraindicated in case of hypersensitivity to its active components.

Jess for multifollicular ovaries

Hormonal contraceptive, contains two active components: ethinyl estradiol (as betadex clathrate) 0.02 mg, drospirenone 3.00 mg. Restores the regularity of the menstrual cycle, prevents unwanted pregnancy. Reduces the risk of ovarian and endometrial cancer.

It has an antimineralocorticoid effect, reduces the risk of swelling due to the action of estrogens and fluid retention. It alleviates painful symptoms of the premenstrual period. It reduces acne symptoms, oiliness of the skin and hair. The mechanism of action of the drug is similar to the activity of natural progesterone produced by the body.

• Indications for use: contraception, severe premenstrual syndrome, moderate acne.
• Directions for use: Take the tablets in the order indicated on the package at the same time each day. Treatment should be continuous for 28 days.
• Contraindications: thrombosis and prethrombotic conditions, coronary artery and cerebral vascular diseases, arterial hypertension, prolonged immobilization due to surgery. Pancreatitis, liver tumors, renal/hepatic insufficiency. Hormone-dependent malignant processes in the body, pregnancy and lactation. Hypersensitivity to the components of the drug, vaginal bleeding of unknown etiology.
• Side effects: nausea, vomiting, abdominal and mammary gland pain, irregular uterine bleeding, bleeding of unknown origin. Arterial and venous thromboembolism, mood swings, decreased libido, allergic reactions.
• Overdose: nausea, vomiting, spotting bloody vaginal discharge. Treatment is symptomatic, there is no specific antidote.

Jess is available in blisters of 28 tablets for oral administration.

Vitamins

A weakened immune system is one of the causes of many diseases. In combination with hormonal imbalance, it causes problems with the menstrual cycle, reduces libido. Headaches, increased anxiety, urinary tract infections and a number of other disorders appear, the progression of which can cause MFI.

Let's look at the most useful vitamins for patients with MF:

• B6 – maintains hormonal balance, helps normalize the level of progesterone, estrogen, androgens and glucocorticoids. Participates in the formation of glucose and amino acid metabolism. Pyridoxine is found in the following products: bananas, chicken, turkey, beef, cod, tuna, salmon, perch, halibut.
• B8 – increases sensitivity to the hormone insulin, promotes the transfer of glucose to the body’s cells. Inositol reduces testosterone and restores ovulatory function.
• B9 – has a beneficial effect on the functioning of the entire reproductive system. Folic acid protects against neural tube defects in the fetus, which can occur in the early stages of pregnancy. The vitamin is prescribed both at the stage of pregnancy planning and during gestation.
• B12 – essential for patients taking oral contraceptives. Cyanocobalamin normalizes estrogen levels in the blood and maintains mental health. Contained in salmon, beef, lamb, shrimp, scallops.
• C – prevents damage to healthy cells by free radicals. Reduces cortisol levels and reduces stress, which increases with hormonal imbalance. Ascorbic acid regulates the production of thyroid hormones, reduces histamine levels, and stimulates the immune system. Products with increased antioxidant content: red pepper, broccoli, strawberries, cauliflower, kiwi, melon, oranges.
• D – deficiency of this vitamin is one of the factors of metabolic disorders in MFO. According to studies, about 30% of women with multifollicularity and PCOS experience a deficiency of this substance. In combination with calcium, it reduces the risk of diabetes, improves insulin sensitivity.
• E – improves progesterone production and normalizes estrogen levels. Tocopherol reduces prolactin levels in the blood. Its antioxidant properties regulate vitamin A levels, improve skin condition, and reduce wrinkles. The vitamin relieves menstrual pain. Contained in the following products: sunflower seeds, blueberries, olives, spinach, almonds.

Vitamins for multifollicular ovaries are prescribed at all stages of correction of this condition. The doctor selects useful substances individually for each patient. This is due to the fact that some vitamins induce ovulation, others reduce the level of cortisol and testosterone in the blood, lower prolactin or increase progesterone.

Physiotherapy treatment

Physiotherapeutic methods are often used to speed up recovery processes in gynecology. In case of MFY, physiotherapy is aimed at normalizing hormonal levels, reducing pathological processes in the ovaries and strengthening the body.

The use of physiotherapy causes the following reactions:

• Normalization of metabolic processes.
• Reduction of inflammatory processes.
• Thinning of the dense membrane of the appendages.
• Reduction of pain.
• Ovulation stimulation.
• Improvement of microcirculation and lymph flow in the sex glands.

The main methods used in multifollicular ovary syndrome are:

1. Galvanophoresis is a procedure performed using various active drugs, most often with vitamin B1 or Lidase. Under the influence of low-voltage galvanic current, the drug bypasses the epidermis and gets to the sex glands. Lidase improves blood flow, triggers enzymatic activity in the organs. B1 affects metabolic processes in the body.
2. Magnetotherapy – a low-frequency magnetic field is used for treatment. The effect is directed at the collar zone, which regulates the work of the pituitary gland and hypothalamus.
3. Mud therapy – therapeutic mud is applied to the abdomen in the area of the appendages. This improves metabolic processes and softens the ovarian capsules.
4. Hydrotherapy – relieves pain, has anti-inflammatory, calming and improves blood supply to the reproductive organs. Sodium chloride, sea or pine baths, Charcot or circular showers are used for treatment.

Contraindications to physiotherapy:

• Exacerbation of chronic diseases.
• Pathologies in acute form.
• General grave condition.
• Uterine bleeding.
• Infectious processes in the body.
• Oncological pathologies of any localization.
• Early postoperative period.
• Psychoneurological disorders.
• Diseases of the genital organs: vaginal condylomas, dysplasia, polyps in the uterus.

Physiotherapy begins on the 5th-7th day of the menstrual cycle. Treatment is not performed during menstruation, as there is a risk of heavy bleeding. Before the procedures, you should empty your bladder and not go to the toilet for 30 minutes after. The therapeutic effect lasts for 6-12 months.

Folk remedies

To restore hormonal balance, many women resort to using non-traditional methods. Let's consider the most popular recipes for folk treatment of MFI:

1. Take equal parts of nettle and yarrow. Pour 250 ml of boiling water over the herbal raw material and let it brew for 10-12 hours. Strain and take in small portions throughout the day. The course of treatment is 30 days with a week's break and repeated intake of the infusion. To normalize the functioning of the ovaries, the therapy should last at least 6 months.
2. Take 100-80 g of red brush herb and pour 500 ml of alcohol or vodka. Pour the resulting solution into a container with a tight lid and put it in a dark place for 7 days. After a week, strain and take ½ teaspoon 3 times a day before meals.
3. Take the following ingredients in equal proportions: buckthorn bark, birch leaves, peppermint, yarrow herbs and valerian root. Mix all the ingredients and grind. Pour 300 ml of boiling water over a tablespoon of the mixture. Strain after 6 hours and take it in small sips throughout the day. The infusion normalizes the hypothalamic-pituitary system.
4. Mix 1 kg of ripe viburnum berries with a liter of liquid honey and the same amount of 70% medical alcohol. Mix everything thoroughly and leave in a closed container to infuse for a week in a dark place. After a week, mix everything again and take 1 tablespoon morning and evening.
5. Quench a tablespoon of soda with vinegar, add 100 ml of alcohol and 20 ml of water. Mix everything thoroughly and soak a gauze bandage in the resulting liquid. Apply the compress to the groin area at night. The procedure is recommended to be carried out daily for 14 days. After a month's break, the treatment should be continued.

The use of the above recipes is possible only with the permission of the attending physician.

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Herbal treatment

Medicinal plants are popular in the treatment of many diseases, including multifollicular ovaries. Herbal decoctions and infusions have a gentle effect on the female body, normalize hormonal levels and restore ovulation.

Herbal treatment can be carried out using the following recipes:

1. Pour 500 ml of vodka or 70% alcohol over 50 g of crushed peony roots. Place the infusion in a container with a lid and leave in a dark, cool place for 10 days, shaking daily. After that, strain the medicine and take 30 drops 3 times a day 30 minutes before meals. The course of treatment is 2 months.
2. Pour 250 ml of boiling water over a tablespoon of chopped birthwort and simmer for 5 minutes over low heat. Remove from heat, wrap and let steep for 2-3 hours. Strain and take 1 tablespoon 4-5 times a day.
3. Mix equal parts of horsetail, nettle, rose hips, dandelion and mint root. Grind everything thoroughly and brew a spoonful of the mixture in a glass of boiling water. Strain and take ½ glass 2 times a day. The duration of treatment with this recipe should be no less than 6 months.
4. Take equal proportions of birthwort, knotweed and common heather. Pour 250 ml of boiling water over a tablespoon of the mixture and simmer for 10-15 minutes. Strain and use for douching from day 3 to day 15 of the menstrual cycle for 2-3 cycles.
5. Take 100 g of crushed root of Leuzea carthamoides and pour 500 ml of vodka. The medicine should be infused for 30 days in a closed container at room temperature. The finished infusion is filtered and taken 20 drops 3 times a day 30 minutes before meals. The course of treatment is 2 months.

Before using the above recipes, you should consult with your doctor. It should be noted that herbal treatment is contraindicated in case of allergic reactions to plant components, severe kidney and liver dysfunction.

Orthilia secunda

Ortilia secunda belongs to the heather family. The plant is popularly called the herb for forty diseases or the orthilia secunda. Its medicinal properties are confirmed by official medicine, and medicines are made from it.

The plant contains phytohormones necessary for the female body - phytoestrogen and phytoprogesterone, as well as glycosides, coumarins, arbutin, acids, saponins, tannins, vitamins and microelements. The rich composition has the following effect on the body:

• Strengthens the cardiovascular system.
• Normalizes blood pressure.
• Prevents the growth of malignant cells.
• Prevents ischemic heart disease.
• Antimicrobial and anti-inflammatory action.
• Immunostimulating.
• Anesthetic.
• Diuretic.

The orthilia secunda has a wide range of applications:

• Infertility.
• Hormonal imbalances.
• Menstrual cycle disorders.
• Inflammatory processes.
• Endometriosis.
• Mastopathy.
• Fibroma.
• Polycystic ovary syndrome.
• Adhesions in the pelvic organs.

The herb is prescribed for diseases of the gastrointestinal tract, musculoskeletal system, and endocrine pathologies. The orthilia secunda normalizes hormonal levels in MFI and helps restore the menstrual cycle and ovulation. The plant also reduces painful symptoms during menopause.

For women with low estrogen levels, ortilia secunda should be taken in the second phase of the menstrual cycle. For the treatment of anovulatory cycles and infertility caused by MFY, the following recipes are used:

• Pour 250 ml of boiling water over 10 g of dry herb and let it brew for an hour. Strain and take 1 tablespoon 3 times a day after meals.
• Pour 20 g of the plant into 400 ml of cooled water and place in a water bath for 5-10 minutes. After cooling, strain through cheesecloth and take 1 spoon 3-4 times a day.
• Take 50 g of the herb and 500 ml of vodka. Mix the ingredients in a glass container with a tight lid. The medicine is infused for 30 days, then filtered. The alcohol tincture is taken 15 drops 3 times a day before meals.
• Pour 200 ml of vegetable oil over 50 g of fresh grass and let it brew for 1-1.5 months. The finished mixture is used for compresses or internal use.

The use of the orthilia secunda is only possible with a doctor's prescription. The plant contains potent substances that, if dosed incorrectly, have a negative effect on the body.

The plant also has a number of contraindications for use: patients under 14 years of age, pregnancy and lactation, individual intolerance to the components of the herb, menstruation, taking hormonal drugs, peptic ulcer, liver failure, tumors of the genital organs, tendency to bleeding.

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Sage

A plant popular in folk medicine, in the inflorescences and leaves of which contain essential oils, linalool, aromatic resins, acids (formic, acetic) and tannins - this is sage. Its seeds contain 30% fatty oil and 20% protein, the roots contain coumarin.

Medicinal properties of sage:

• Anti-inflammatory.
• Antimicrobial.
• Hemostatic.
• General tonic.
• Increases the secretory activity of the digestive tract.
• Increases the secretion of bile juice.
• Reduces sweating.

Sage has gained particular popularity in the treatment of gynecological diseases. The plant contains hormones that stimulate the ovulation process, that is, the maturation of follicles and the formation of an egg.

The effect of the plant on the reproductive system:

• Normalizes hormonal levels.
• Increases estrogen levels in the blood.
• Prevents and treats endometriosis.
• Regulates and restores the menstrual cycle.
• Relieves symptoms of PMS and menopause.

For multifollicular ovaries and their complications, an infusion is prepared from sage. A finely chopped tablespoon of the herb is poured with 200 ml of boiling water. The remedy should be infused in a tightly closed container for 15 minutes. Then it is filtered and taken 1/3 cup 3-4 times a day before meals.

For conception, the infusion is taken from the 4th day of the menstrual cycle until the expected ovulation. In anovulatory cycles, the infusion is taken on any day of the cycle, counting it as the 5th day from the onset of menstruation. If pregnancy occurs, sage should be stopped. Infusions and decoctions from the plant are contraindicated in case of hypersensitivity to its components, as well as during lactation.

Homeopathy

An alternative method used to treat many diseases is homeopathy. In the case of MFY syndrome, homeopathic remedies are selected based on the patient's constitutional type. That is, not only the causes and symptoms of the pathology are taken into account, but also the functional characteristics of the body, caused by various factors.

Homeopathic remedies:

• Apis – normalizes the functioning of the ovaries, treats and prevents the development of endocrine disorders in the early stages of pregnancy.
• Aurum Iodine – multifolliculosis, adnexal cysts, uterine fibroids.
• Berberis - stabbing and burning pains in the lower abdomen.
• Aurum Metallicum – hormonal disorders, atherosclerosis, hypertension.
• Iodium - ovarian hypofunction, mastopathy, pain in the lower abdomen.

Homeopathic medicines can be used only after consultation with the attending physician. All medicines and their application scheme are selected by the homeopath, individually for each patient.

Surgical treatment

If conservative treatment methods do not give the expected result, then surgical intervention may be indicated. The main indication for surgery is hyperplastic changes in the tissues of the ovary and endometrium.

Surgical treatment is performed using a minimally invasive method - laparoscopy. This is due to the fact that the traditional laparotomy operation leaves behind many complications, one of which is adhesions in the pelvic organs and abdominal cavity.

Another effective surgical method is cauterization. The operation is aimed at removing underdeveloped capsules and excess dominant follicles. Timely treatment allows for full restoration of the functional capabilities of the ovaries and ovulation, and avoiding the problem of infertility.

Laparoscopy of multifollicular ovaries

A popular minimally invasive surgical treatment method is laparoscopy. It is used for both therapeutic and diagnostic purposes. The main indications for its implementation in case of multifollicular ovaries are:

• Unsuccessful conservative therapy.
• Infertility due to lack of ovulation.
• Tumor neoplasms.
• Severe intermenstrual pain.
• Removal of underdeveloped follicles.
• Polycystic ovarian changes.

Before the operation, the patient is prescribed a set of preparatory measures: general clinical tests, blood tests for syphilis, HIV and hepatitis, ultrasound of the pelvic organs, chest X-ray, smear of flora from the genitals.

12 hours before the planned procedure, the patient must abstain from food and minimize fluid intake. This is necessary to prevent vomiting in the postoperative period. Also, the day before the operation, the intestines are cleansed using an enema or laxatives.

If both ovaries are preserved after laparoscopy, the chances of successful conception increase significantly. It is recommended to plan pregnancy in the next cycle or after complete recovery. The rehabilitation period lasts for a month. Ovulation occurs on the 10th-14th day. In rare cases, minor delays in menstruation occur. Also, many patients note the appearance of intermenstrual spotting for 7-14 days, which passes as recovery progresses.

Diet and nutrition for multifollicular ovaries

For the ovaries to function properly, a balanced diet is necessary. That is, a diet for MFY is an obligatory component of complex treatment. A healthy diet increases the production of necessary hormones, helps normalize body weight and speeds up the recovery process.

Rules of diet therapy:

• The basis of the diet should be products with a low glycemic index. The minimum amount of carbohydrates facilitates the work of the pancreas and normalizes insulin production.
• Balance of proteins, fats and carbohydrates. It is necessary to limit the consumption of animal fats, which are rich in cholesterol.
• Fractional nutrition – 5-6 meals a day in small portions. The daily diet should be within 1500-1800 kcal.

Useful products:

• Liver and lean meat.
• Egg yolks.
• Beekeeping products.
• Dark bread and bran.
• Carrots, sea buckthorn, red bell pepper, pumpkin.
• Vegetable oils.
• Beans, cereals, nuts.
• Citrus.
• Seafood.
• Fermented milk products.

During the diet, you should avoid eating foods that are harmful to the female reproductive system: fast food, bakery products, potatoes, sweets, instant foods and foods with various chemical additives (flavorings, dyes, flavors). Alcohol is prohibited, as it triggers destructive processes in the ovaries and disrupts their functioning.

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