Akụkụ nke follicles na ụbọchị okirikiri. Gịnị kwesịrị ịbụ size nke follicle nkịtị

Female ahụ oge rearranged (eke cyclic mgbanwe) n'ihi mmetụta nke homonụ na ịchịkwa mgbagwoju usoro metụtara ya omumu usoro (nchịkọta ozu enye njikọta usoro). N'ihi na ime ga-hụrụ mkpa - uto na nkịtị mmepe nke ovarian follicles, projecting a ụdị "containers" maka ama ịmụpụta àkwá.

The nkọwa nke echiche nke "follicle"

Nke a obere size akpụpụta kwadoro nke nwere ụdị a gland ma ọ bụ obere akpa jupụtara intracavitary nzuzo. Ovarian follicles nọ ha cortical oyi akwa. Ha - isi esite maka gradual maturing nke egg.

Ná mmalite, follicles iru a quantitative n'ihe nke ma ovaries ịrịba ụkpụrụ (200 -. 500 igwe), onye ọ bụla nke nke n'aka nke mejupụtara a izizi cell. Otú ọ dị, n'ihi na oge nke mmalite oge uto, nwanyi (30-35 afọ) iru ntozu okè naanị 400-500 mbipụta.

Esịtidem Filiks evolushọn follicles

Ha n'ihu ha pouches na-ji a grainy amụba granulosa mkpụrụ ndụ, nke jupụta dum oghere.

Mgbe ahụ, granulosa mkpụrụ ndụ na-emepụta mmiri mmiri pushes na agabiga ha, n'otu oge na-eduzi n'ebe elu akụkụ ụfọdụ nke follicle (usoro nke na-ejuputa n'ime oghere nke follicular ọmụmụ).

Ma ihe ndị follicle, na ọ budata enwekwu na-aba na na olu (ka a dayameta nke 15-50 mm). A content - ọ bụ a mmiri mmiri na salts, ndi na-edozi na ndị ọzọ na bekee.

N'èzí, na ọ na-kpuchie site connective anụ ahụ n'ọbọ ya. Na nke ahụ bụ ala nke follicle a na-ewere tozuru okè, na-akpọ ya graafovym afụ (mgbe Dutch anatomist na physiologist Rene De Graaf, onye chọpụtara na 1672 bughi akụrụngwa nke ovary). Mfri eke "afụ" na-egbochi ndị maturation nke ndị ọrụ ibe ha.

Gịnị size kwesịrị follicle?

Na mmalite nke oge ịgba ajị (14-15 afọ), ọ enwezu ya mmepe. Weere nkịtị ma ọ bụrụ n'oge follicular adọ nke ịhụ nsọ okirikiri-amalite mgbe, ma tozuru okè ovarian follicles nke ọtụtụ, na otu onye nke esịmde a bukwanu size, nke mere na ọ na-ghọtara isi. Ndị fọdụrụ ihe na-doro atresia (reverse development). Ha metabolic ngwaahịa nke bụ estrogen - nne mmekọahụ hormone nke na-emetụta njikọta, ọmụmụ nke a nwa, nakwa dị ka calcium na metabolism.

The kasị follicle, akụkụ nke na-amụba site na nkezi nke 2-3 mm ụbọchị ọ bụla, na oge nke ovulation esịmde ya nkịtị n'obosara (18-24 mm).

Ịmụ ọmụmụ ọrụ dị ka a mkpa

Ke n'ime akụkụ nke a tozuru okè follicle agbakọta stratified epithelium, ọ nime ya (na a thickened òkè - na cumulus oophorus) bụ tozuru okè, ike ifatilaiza na egg. Dị ka e kwuru n'elu, nkịtị follicle size - 18-24 mm. Ná mmalite nke oge ịhụ okirikiri hụrụ ya protrusion (akpọ ụkwụ n'ihe-dị ka) n'elu nke ovary.

Ọzọkwa follicle budata thinner mgbidi, na-eme ya-agbawa. Ya mere, na ebe graafova afụ na-egosi odo ahu - otu ihe dị mkpa endocrine gland.

N'ihi a usoro nke mmiri ọgwụ ahaghị nhata a ọdịiche nwere ike ịhapụ, na njikọ na nke egg na-adịghị tọhapụrụ site ovary na ovulation emee. Oge a nwere ike ịbụ ihe kacha eme infertility, na dysfunctional eriri akpa nwa ọbara ọgbụgba.

Follikulometriya: definition, ohere

Nke a ultrasound-achọpụta ọrịa ọmụmụ, nke dị site na nsuso usoro nke follicle mmepe na ibu. Ọtụtụ mgbe na-eme ya ndị inyom na infertility ma ọ bụ ịhụ nsọ ụfọdụ. Weere na-enye ohere mkpachapụ site ultrasound soro na Ọnọdụ nke ovulation.

Ná mmalite nke oge ịhụ okirikiri, ọ bụ ike nyochaa usoro nke uto nke endometrium, mgbe a gasịrị ogbo - mmalite nke follicle. N'ihi ya, ọ bụ ike iji chọpụta kpọmkwem size of follicles na ụbọchị okirikiri.

Mgbe achọrọ follikulometriya?

Nke a na-achọpụta ọrịa ule-enye gị ohere:

• set of ovulation ruo a kpọmkwem ụbọchị;
• follicle size tupu ovulation;
• nyochaa arụmọrụ nke follicular unit;
• atụmatụ mmekọahụ nke nwa;
• guzosie ike n'ezi ịhụ nsọ okirikiri n'ụzọ;
• gbakọọ ezigbo ụbọchị maka tụụrụ ime nke nwa;
• na-eso na-enwe ọganihu nke multiple ime;
• ịchọpụta ịhụ nsọ ọrịa;
• na-amata onye ọrịa mmiri ọgwụ itule;
• akara nke eruba nke ọgwụgwọ kwesịrị ekwesị.

The uru nke larịị nke follicle mmepe na daa ọrịa

Na mmalite nke ya evolushọn ọnụego na "nkịtị" ọnọdụ - na follicle size n'obosara nke 15 mm. Ọzọkwa, dị ka na mbụ kwuru, ọ na-amụba site 2-3 mm kwa ụbọchị.

Ọtụtụ ndị inyom nwere mmasị na-ajụjụ a: "Gịnị bụ size nke follicle na ovulation?" Nọmalị atụle - banyere 18-24 mm. Mgbe ahụ corpus luteum egosi. Na nke a, ọbara bụchaghị ụba progesterone etoju.

A otu ultrasound napụ ikike iwu a zuru foto nke mmepe (maturation), na follicle, dị ka dị mkpa karịsịa na-elele onye ọ bụla nzọụkwụ.

Isi pathologies ndị na-emebi maturation nke follicles, bụ:

1. Atresia - involution neovulirovavshego follicle. Na-kpọmkwem, mgbe agụmakwụkwọ, ọ na-amalite na a n'otu isi ihe na mgbe ahụ na-akwụsị na regresses, si otú ovulation mesoghị.

2. Ịtachi - ichebe nke virus mgbe ọ ka bụ functionally ifịk ke cell ma ọ bụ anụ ahụ omenala nke ahu gabiga ihe e ji mara maka nnukwu ọrịa. Na nke a, follicles kpụrụ na mepụtara, na ya agbawa mesoghị, dapụtara na a luteinizing hormone na-adịghị ụba. Nke a na ụdị anatomical mmụta na-nọgidere na-enwe ruo mgbe ọgwụgwụ nke okirikiri.

3. Follicular ahu otutu - a ụdị ọtọ agụmakwụkwọ, na-metụtara nanị akụkụ ụfọdụ na ovary anụ ahụ. Ke idaha emi neovulirovavshiysya follicle na bụghị agbajikwa, ọ na-adị, na ọ bụ ihe kasị mgbe ọmụmụ accumulates na ekemende kpụrụ ahu otutu size n'elu 25 mm.

4. luteal - guzobe nke corpus luteum, nke na mgbe ụfọdụ a kpụrụ na-enweghị-agbawa nke follicle na ekemende na-emepe emepe. Ọnọdụ a bụ na o kwere omume ma ọ bụrụ na e nwere kemgbe a gara aga na-abawanye na uru nke LH ma ọ bụ ovarian lesion Ọdịdị.

Akụkụ follicles na okirikiri ụbọchị

Site nnọọ n'ụbọchị ndị mbụ nke ọzọ okirikiri na-enyemaka nke ultrasound nwere ike hụrụ na na ovaries e nwere ọtụtụ antral enyocha anatomical owuwu, nke ekemende ga-amụba. Ha na-abawanye bụ n'ihi na mmetụta nke pụrụ iche homonụ predominating otu nke bụ follicle-akpali akpali hormone (FGS) na estradiol. Ọ bụrụhaala na ha dị larịị nke nnabata ya na ụkpụrụ na ọdịnaya nke ndị a bekee na ọbara, a nwaanyị bụ Ọtụtụ ugbu anụ ovulation na anovulatory cycles ime ọ dịghị ihe karịrị ugboro abụọ n'afọ.

Antral follicles na ovaries, nke bụ obere size, ga-adị ugbu, dị ka ihe àmà nke iwu na ma gonads ke ichekwa ghara gafere itoolu iberibe. A, na dayameta ha adịghị karịa 8-9 mm. Ekemende ya antral follicles n'okpuru nduzi nke nwoke homonụ enye ịrị elu na ndị dị otú ahụ dị mkpa anatomical owuwu dị ka na-achị follicle, hà nke karịa ndị dayameta nke 2.5 ugboro.

The nkezi ịhụ nsọ okirikiri bụ ụbọchị 30. Ebe nke iri ụbọchị nke ozuzu oke nke antral follicles obụk achị.

Ọtụtụ mgbe ọrịa na-ewelite ajụjụ: "Olee nnukwu kwesịrị ịbụ follicle na a ogbo?" Ke akpa nnọkọ, ọ na o siri ike follikulometrii size dị iche iche site na ike (12-13 mm). Ọ bụ uru na-echeta na nke a na-achọpụta ọrịa ultrasound iji chọpụta size of follicles na ụbọchị okirikiri.

Ọzọkwa n'ala anata ọkachamara ga-enwe ike ikwu kpọmkwem ole nke kasị follicles kpụrụ. Ọtụtụ mgbe ọ bụ naanị otu onye (n'aka nri ma ọ bụ n'aka ekpe ovary). Otú ọ dị, mgbe onye ọrịa na-enwe pụrụ iche na-akpali akpali ovulation, ndị a follicles nwere ike mejupụtara ọtụtụ, n'ihi na a multiple afọ ime, ọ bụ ya, ọ bụrụhaala na abụọ ma ọ bụ karịa maturing kasị anatomical owuwu.

The abụọ nnọkọ ẹkenịmde mgbe ụbọchị atọ gasịrị. Na ya N'ezie dọkịta:

• Ọ na-egosi na ọnụnọ nke na-achị follicle;
• na-ekpebi size nke follicle ịhụ nsọ cycles;
• fixes (ma ọ bụrụ na nke a emee) nlaghachi azụ nke follicle.

Specialist eleru ma ovaries ndị inyom. Ọ bụrụ na ndị ileba anya follicle size site ụbọchị okirikiri, nke abụọ nnọkọ n'obosara ọ bụ 17-18 mm. Ọ nwere banyere 13 ụbọchị.

Na-atọ nnọkọ (transvaginal ultrasound) ọ ga-hụrụ na size nke follicle tupu ovulation (ya elu uru) natara uru nke 22-25 mm. Nke a na-egosi na n'oge na-adịghị (a awa ole na ole) nke ya agbawa, dapụtara na a tozuru okè egg abatakwa peritoneal oghere na mgbe ahụ ga-banye n'ime n'ime fallopian tube. Odika iri-na-anọ awa ọ bụ na-anabata njikọta, na ekemende anwụ. Kwesịrị iburu n'uche na ndị egg viability n'oge obere karịa nke spam.

E nwere otu mgbe na-achị follicle etolite na a dị iche iche ọnụego, dị ka a N'ihi ya nke ultrasound sessions nwere ike ịchọ ihe karịrị mmadụ atọ. Ọ bụrụ na onye ọrịa ugboro ugboro akwukwo ya nlaghachi azụ, mgbe ahụ, dị ka a na-achị, ndị dọkịta na-edepụta ya kwa ụbọchị follikulometriyu (9-10 ụbọchị okirikiri). Nke a ga-ekpughe mmalite nke nlaghachi azụ, wee chọpụta ihe kpatara nke a onu.

Ya mere, ọ dị mkpa na-echetara otu ugboro ọzọ na size nke follicle na cycles na o kwere omume n'oge na-achọpụta ọrịa ultrasound - follikulometrii. Ọ ga-bụghị naanị nyochaa N'ezie nke maturation nke na-achị echiche anatomical agụmakwụkwọ, kamakwa iji mata ndị na-akpata nke deviations, inhibiting ọmụmụnwa usoro (ma ọ bụrụ na ọ bụla).

mmetuta nke ovulation

Ndị ọzọ okwu, ya itinye n'ọkwa. Nke a mgbagwoju nke iche iche nke ọgwụgwọ na usoro, nzube nke nke - na ime. Ọ bụ na ina n'ime oge a ọrịa ụmụ nwanyị ùgwù nke nwanyi infertility n'ihi ọtụtụ ihe.

Ka malitere bụ ịkọwa echiche nke infertility - a ọnọdụ mgbe a nwaanyị n'okpuru afọ 35 afọ ike na-atụrụ ime maka ọnwa 12, n'okpuru ifịk mmekọahụ ndụ, nakwa dị ka a ụzọ (inyom n'elu 35 na ndị ikom - 40) onye ime adịghị ime acha ọcha ọnwa isii.

Egosi na contraindications maka mmalite

The itinye n'ọkwa a rụrụ na abụọ ikpe:

• anovulatory infertility;
• unexplained infertility.

Isi contraindications maka a usoro bụ:

• ọrịa nke Fallopian akpa;
• na-apụghị ime nke zuru nchoputa site ultrasound;
• nwoke infertility;
• follicular Mbelata nke ẹdude mee.

Mmetuta nke ovulation na-adịghị rụrụ ogologo oge ọgwụgwọ nke infertility nsogbu (karịrị afọ abụọ).

Ihe osise nke usoro

Ha gosipụtara abụọ ogbugba ndu:

• azụ kacha nta dose;
• ẹsụhọde elu doses.

Ke akpa idaha a nyere mbụ input mkpachapụ ọgwụ "Clomiphene" (ndị so ná ndị sịntetik estrogen), nke nkanka na estradiol anabata. The nkwadebe mgbe ahụ kagbuo na otú ịkpalite usoro inverse mmekọrịta: ụba njikọ nke gonadotropin-atọhapụ hormone na-arụsi ọrụ ntọhapụ luteinizing hormone. Ọgwụgwụ N'ihi nke a ga-eduga maturation nke follicles. Ya mere, anyị nwere ike ikwu na pụtara "Clomiphene" - egosi nke ovulation.

N'oge a mgbati nke naanị otu follicle maturation emee ekele ovulation itinye n'ọkwa, i.e. n'ụzọ na-ekwe ka ohere nke multiple ime na yiri nsogbu (atụ, ovarian hyperstimulation syndrome).

Mgbe dị n'oge dị ka size nke follicles n'oge mmalite nke mbụ circuit esịmde a dayameta nke 18 mm ( ọkpụrụkpụ nke endometrium nke 8 mm) mere ochichi triggers (ọgwụ ọjọọ na ndị tara LH anya). Mgbe ahụ, mgbe HCG ochichi, ovulation n'akparamagwa banyere ụbọchị abụọ.

The abụọ atụmatụ aghụghọ bụ na ọdabara isi ndị inyom nwere ala ovarian idobere na obere puru mmetụta nke obere doses nke FSH.

Manye egosi a aghụghọ:

• Women noo karịrị afọ 35;
• FSH uru karịrị 12ME / l (na ụbọchị 2-3 nke okirikiri);
• ovarian olu ka 8 cubic mita. cm;
• sekọndrị amenorrhea na oligomenorrhea;
• nnweta azụmahịa na ovaries, na-anara ọgwụ ma ọ bụ Radiotherapy.

Visible N'ihi kwesịrị egosi na n'ụbọchị nke isii. Ịrịba Ama mmetụta na-emetụta ndị ovaries, na nke a usoro nke itinye n'ọkwa nke ovulation - ize ndụ nke ha hyperstimulation syndrome. Ke edinam na na-esote ultrasound ga-ekpughe follicles na ovaries na-ebu ibu n'obosara karịa 10 mm, dọkịta na-ahụ nke a dị ka ihe mgbaàmà dịịrị ndị mgbochi agwọ ọrịa nke syndrome.

Control ultrasonography

Ọ dị mkpa iji gosi na ovulation site transvaginal ultrasound. Nke a bụ dị ka ihe dị mkpa dị ka ahụ n'ezie nlekota oru. Ọ na-ama e kwuru, a size nke follicle tupu ovulation (18-24 mm n'obosara), ma ọbụna mgbe chọrọ Capsule size nwere ike ghara imebi, na agaghị ripened ovum n'ime abdominal oghere. Control ultrasound a rụrụ 2-3 ụbọchị mgbe ọkọdọhọ ụbọchị ovulation.

Mgbe a na nnọkọ ahụ, dọkịta ga-elele ọnọdụ nke ovaries maka ihe ịrịba ama nke ovulation ẹkenịmde:

• akara ererimbot follicle anọghị;
• corpus luteum bụ ugbu;
• e nwere ụfọdụ na mmiri mmiri na ohere n'azụ akpanwa.

Ọ dị mkpa iburu n'obi na ọ bụrụ na ultrasound ẹkesikpede ga ịchịkwa na a gasịrị oge, ọ na-ịchọpụta ọ bụla mmiri mmiri ma ọ bụ odo ahu.

N'ikpeazụ, ọ bụ uru, ga-aza ajụjụ ahụ: "Gịnị bụ size nke follicle na ovulation?" Nke a kasị anatomical mmụta n'oge ovulation matures na a size nke banyere 18 - 24 mm n'obosara. Ọ bụ uru na-echeta na size nke follicles na endometrial mgbanwe dabere na ụbọchị nke ịhụ nsọ okirikiri.