How to treat multifollicular ovaries to get pregnant?

Multifollicular ovaries are ovaries in which more follicles than what is considered normal mature simultaneously. Generally, their number varies between 5 and 7, but in the case of a multifollicular structure, there can be 8 to 10 or even more. This condition is often diagnosed incidentally during a routine gynecological ultrasound and does not always accompany pronounced symptoms or disorders.

According to statistics, multifollicular ovaries affect 8 to 15% of women of childbearing age, making this condition quite common: one in ten women may encounter it in practice.

Can you get pregnant with multifollicular ovaries?

It is possible to get pregnant with multifollicular ovaries, especially if ovulation is maintained in the woman. In the absence of hormonal imbalance and a regular menstrual cycle, the chances of natural conception are preserved. However, if multifollicular ovaries are a sign of polycystic ovary syndrome (PCOS), this condition can lead to an absence of ovulation and, consequently, difficulties in conceiving.

This pathology is most often detected as part of a comprehensive infertility examination, including an ultrasound and folliculometry. The ultrasound shows a characteristic image: a large number of follicles of the same size at the periphery of the ovary, without a dominant follicle.

Symptoms of multifollicular ovaries

In some cases, symptoms may be completely absent, but in the case of hormonal imbalance, women often complain of:

• menstrual cycle disturbances (shortened or prolonged cycles, amenorrhea);
• throbbing pain in the lower abdomen, especially during the presumed ovulation period;
• signs of hyperandrogenism: excessive male-type hair growth, acne, oily skin, male-pattern baldness;
• difficulties in conceiving, absence of ovulation;
• signs of metabolic disorders (insulin resistance, weight fluctuations, increased appetite).

Causes of multifollicular ovary development

The main causes are as follows:

• Polycystic ovary syndrome (PCOS) — a condition in which follicles form but do not ovulate due to hormonal imbalance;
• Hormonal disorders: imbalance between FSH and LH, high androgen levels;
• Chronic stress and psychological exhaustion, which influence the production of cortisol and gonadotropins;
• Hereditary predisposition, especially in cases of family history of PCOS.

Diagnosis of multifollicular ovaries

To make a diagnosis, it is necessary to:

• Consult a gynecologist-endocrinologist and provide detailed medical history;
• Perform a pelvic ultrasound with counting the number of antral follicles;
• Conduct ovulation monitoring to assess ovulatory function;
• Hormonal profile: LH, FSH, estradiol, prolactin, testosterone, DHEA-S, AMH, insulin, fasting glucose;
• In some cases, a brain MRI is performed if pituitary causes are suspected.

Treatment of multifollicular ovaries and preparation for pregnancy

If ovulation is regular and the hormonal profile is normal, no treatment is necessary, dynamic monitoring is sufficient. However, in the absence of ovulation for several cycles or in the presence of PCOS, a treatment aimed at restoring reproductive function is implemented:

• Hormone therapy: ovulation stimulation (clomiphene, letrozole), if necessary, combined oral contraceptives to normalize the cycle;
• Vitamin therapy and correction of deficiencies, particularly in vitamins D, B, and folic acid;
• Ovarian drilling by laparoscopy in cases of PCOS when drug treatment is ineffective;
• Dietary support in cases of insulin resistance and metabolic disorders.

If ovulation does not resume and the couple cannot conceive naturally, it is recommended to consider assisted reproductive technology programs.

Multifollicular ovaries and IVF programs

The "Natuvitro" clinic offers various in vitro fertilization (IVF) options suitable for women with multifollicular ovaries:

• IVF (in vitro fertilization) — performed in cases of absence of ovulation refractory to treatment or in cases of other complications preventing natural conception;
• IVF with donor eggs — recommended for women with low ovarian reserve or poor egg quality, which can be observed in cases of prolonged PCOS or age-related changes;
• IVF with double donation — used in cases of combined infertility factors in both partners, when it is necessary to resort to both donor eggs and sperm.

Each program is developed individually, based on medical history, age, hormonal status, and the reproductive goals of the patient.

When to see a doctor

To undergo a preventive examination or obtain qualified help in case of multifollicular ovaries, make an appointment with a gynecologist or specialist at the "Natuvitro" clinic. Experienced specialists will help you determine the best strategy and choose the path to the long-desired pregnancy, whether through natural means or with the help of modern reproductive technologies.