The egg is a female reproductive cell that is produced by one side of the ovary each month. The egg must mature before it can be expelled from the ovary. The egg matures in a fluid-filled follicle, which is aptly described as a jellyfish. A woman expels about 400 eggs in her lifetime, with a maximum of 500 eggs. The average survival time of an egg is 12 – 24 hours, with some reports of eggs surviving up to 36 hours, which would be a relatively “strong” egg. Mature eggs can be up to 1 mm in diameter, and as the largest cell in the body, the egg is responsible for reproducing life. Before ovulation, the primary oocyte completes the first meiotic division, producing the secondary oocyte and the first polar body. The secondary oocyte then enters the second meiotic division and stops at mid-division. Ovulation usually occurs once every 28-35 d, with both ovaries taking turns to ovulate. The detailed mechanism and details of ovulation are not well understood. However, around the time of ovulation, a feedback regulatory response is formed between the hormones FSH, LH, estrogen and gonadotropin-releasing hormone (GnRH) secreted by the hypothalamus, resulting in regular and intense changes in hormone levels prior to ovulation, which is the trigger for the completion of ovulation and the formation of the corpus luteum after ovulation. Three hormonal peaks have been observed to play an important role in the production of ovulation: the first estrogen peak occurs and induces an increase in GnRH release, thus triggering an almost simultaneous peak of LH and FSH secretion. When LH alone is used to induce ovulation, all follicles already collected by the ovary will rupture, whereas when a certain ratio of FSH and LH is used to induce ovulation, only mature follicles will rupture and ovulate. The exact mechanism by which this phenomenon occurs is unknown. (1) Reduced follicular wall tone Prior to ovulation, the pituitary gland secretes elevated LH, which leads to increased progesterone secretion, the latter leading to the synthesis of various enzymes in the ovary that denature the proteoglycans that act as adhesions between the collagen fibers of the top tissue of the mature follicle and reduce follicular wall tone. (2) Enzymes dissolve the follicular wall It has been shown that follicular fluid contains protein hydrolase, amylase, collagenase, and hyaluronidase, etc. Therefore, ovulation is thought to be caused by the dissolution and rupture of the follicular wall by the above-mentioned enzymes. (3) Related to prostaglandins LH promotes prostaglandin synthesis by granulosa cells, and PG content in mature follicles increases progressively near ovulation. PG2α promotes smooth muscle fiber contraction in the interstitium around the follicle and follicle rupture for ovulation. Ovulation monitoring Ovulation can be monitored by indirect methods. (1) Basal body temperature monitoring: Basal body temperature is the temperature in the early morning when inactive. It remains low in the preovulatory period and increases significantly by about 0.2 to 0.5℃ after ovulation and continues until the onset of menstruation. Biphasic BBT: indicates ovulation, but not biphasic in menopausal women or women who have had their ovaries removed. Monophasic BBT: indicates possible anovulation. (2) Cervical mucus monitoring: In the first half of the menstrual cycle, the cervix does not secrete mucus and the vulva is very dry. Thereafter, the cervix secretes a small amount of thick and opaque mucus. By the time ovulation is about to occur, with the onset of the estrogen peak, the cervical mucus becomes thin, transparent, clear and the amount increases, which is called fertile mucus. (3) Ultrasonographic monitoring (ultrasound) is usually started on day 10 of the menstrual cycle to observe the change in follicle diameter. The follicle diameter increases by an average of about 3 mm per day in the 4 days before ovulation, and the follicle matures to about 17-25 mm before ovulation, and disappears after ovulation. Continuous monitoring shows that the follicle grows continuously before ovulation, and when the largest follicle disappears, it indicates the occurrence of ovulation. (This method is reliable, but requires continuous monitoring and is expensive). The mature ovarian follicle gradually approaches the surface and ruptures during each menstrual cycle, and the mature oocytes contained therein are discharged into the abdominal cavity together with their surrounding radiating crown, etc. This process is called ovulation. The first method of calculating the ovulation period is to measure the basal body temperature. The body temperature of a healthy person can change slightly at different times, and the body temperature of an adult woman can fluctuate with the menstrual cycle, especially on the day of ovulation, so ovulation can be calculated by measuring the basal body temperature. This is done by measuring your sublingual body temperature with a thermometer for several days in a row, just after waking up, and then recording it. Generally speaking, a woman’s body temperature fluctuates less before ovulation, and her basal body temperature will suddenly decrease on the day of ovulation, and then increase again after the day of ovulation, keeping it until the temperature drops again when her menstrual period comes. The second: Ovulation pain perception method Some women feel a slight pain in one side of the lower abdomen on a certain day in the middle of two periods, but it will pass after a period of time and there is no abnormality in the physical examination, which is most likely due to ovulation pain, which is mainly caused by the ovulation process, from which the date of ovulation can be accurately projected. The third type: menstrual cycle projection method Calculating ovulation through your own menstrual cycle is the easiest and simplest. The formula is: the first day of ovulation = the shortest menstrual cycle days minus 18 days, and the last day of ovulation = the longest menstrual cycle days minus 11 days. This is calculated by taking the first day of the current menstrual period as the base point and counting backwards in days. For example, if the longest menstrual cycle of a woman in the previous months was 30 days and the shortest was 28 days, then the first day of ovulation = 28 days – 18 days = 10 days and the last day of ovulation = 30 days – 11 days = 19 days, which means that she ovulates on the 10th day of her current menstrual cycle and the last day is the 19th day of her current menstrual cycle. . The fourth: cervical mucus observation method The hormonal changes in a woman’s body during ovulation affect her body in many ways. In order to create a better environment for the union of sperm and egg, a woman’s secretions will also change, mainly in the form of increased cervical mucus, which is clear and transparent and will be stretched when touched by a finger. Generally speaking, when this characteristic is most obvious, it is the ovulation period. The fifth: ovulation test paper test method Nowadays, apart from early pregnancy test paper, the most common test paper used by women is probably ovulation test paper. Because of its ease of operation, it gives hope to many women. The test paper will gradually show weak positive and strong positive characteristics. However, more than early pregnancy test strips, ovulation test strips need to be used in strict accordance with the instructions and it is best to be able to keep all the test strips in a cycle for color shade comparison to determine the exact time in order to project accurate results. It is also important to note that unlike early pregnancy test strips, morning urine should not be used. When is ovulation? Both menstruation and ovulation are affected by endocrine hormones from the pituitary gland and ovaries and show cyclical changes. The length of both cycles is the same, 1 cycle per month, and ovulation occurs in between periods. Women’s menstrual cycles vary in length, but the interval between the day of ovulation and the start of the next menstrual period is relatively constant, usually around 14 days. Based on this relationship between ovulation and menstruation, it is possible to calculate the ovulation period according to the menstrual cycle. This is done by counting down 14 days from the first day of the next menstrual period or subtracting 14 days from the day of ovulation. Among all the methods of ovulation measurement, the most accurate one is the vaginal ultrasound monitoring method, which can not only measure whether there are dominant follicles in both ovaries, but also the size of the dominant follicles and the thickness of the endometrium, etc. However, this method is usually used only when the patient really needs it, “for example, in some women with ectopic pregnancy, the left fallopian tube has been For example, in some women with ectopic pregnancy, the left fallopian tube has been cut, in which case, if her left ovary is ovulating, she cannot get pregnant, so she can observe which side of the ovary is ovulating by doing ultrasound”. “When a doctor observes a dominant follicle from a certain angle, it is better to monitor the development of that follicle from the same angle the next time. ” Although ultrasound monitoring of eggs is the most accurate method available, ovulation is only one of the factors that contribute to successful conception, and even if an egg is detected to be mature and about to be expelled, there is no guarantee that the seed will be sown at that time. “In addition to physical conditions, psychological factors may also affect the process of conception. It is common to find that ultrasound services are available for follicle monitoring, both vaginal and abdominal ultrasound. If an abdominal ultrasound is done, prior urine holding is required. Although ultrasound follicle monitoring usually takes only a few minutes, in some overcrowded hospitals, you may have to wait in line for more than an hour to have your follicles monitored as desired. “Although there are no side effects to having ultrasound to monitor your eggs, there is no particular need for normal women to have this test.” Ultrasound monitoring of eggs is not something that can be done once, it needs to be done several times a month, and each time you have to register and queue, and if you become irritable as a result, the quality of your eggs will be poor. “Pregnancy is a very natural process and deliberate human intervention is not scientific, often the more anxious you are the less likely you are to get pregnant.” He advises women who want to do ultrasound to monitor their eggs to go to a regular hospital and go under the guidance of a doctor. The causes of ovulation disorders are complex and can be divided into: polycystic ovary syndrome (PCOS), hyperprolactinemia (PRL), premature ovarian failure (or cryptogenic premature failure), and hypogonadotropic functional ovarian dysfunction. In addition, thyroid and adrenal disorders and abnormalities or systemic diseases can also lead to follicular development and ovulation disorders. PCOS is the most common, followed by hyper-PRLemia and premature ovarian failure. Most patients with PCOS have prolonged menstrual cycles, scanty menstruation (cycles >36 days), or even amenorrhea (no menstruation for more than 6 months); some patients are overweight, obese, hirsute, oily skin, acne, slight beard, acanthosis nigricans; severe hair loss, low voice, prominent laryngeal nodes, and enlarged clitoris are rare, but if they appear, they should be associated with follicular membrane cell proliferation disorder, androgen-secreting ovarian The most obvious signs of vaginal ultrasound are more than 8-10 small follicles (less than 10 mm in diameter), enlarged ovaries, and enhanced echogenicity of the envelope and interstitium; endocrine examination of androgen and estrone excess, and some other patients have hyperinsulinemia and insulin resistance; the examination of PCOS includes: attention to the examination of masculine signs; ultrasound The examination of reproductive endocrinology should pay attention to the increase of LH/FSH and androgens, and glucose tolerance and insulin release test can be performed to detect hyperinsulinemia, especially in obese patients. Ovulation 1. Cervical mucus method: In the gynecology department of the hospital, the cervical mucus is examined to determine whether the patient is in ovulation. 2.Basal body temperature method: Measure your body temperature every morning after waking up. Generally speaking, your body temperature is low during the first half of your menstrual period, and even lower when you reach ovulation, and will gradually rise after ovulation. 3, period projection method: many women do not know exactly which day their ovulation is, use the following formula, after a period of testing, it is easy to calculate. If your menstrual cycle is regular, ovulation is calculated by counting down 14 days or subtracting 14 days from the first day of your next menstrual period, the day of ovulation and the 5 days before and 4 days after it are called the ovulation period. If your period is abnormal, the formula for calculating ovulation is: first day of ovulation = days of the shortest menstrual cycle minus 18 days; last day of ovulation = days of the longest menstrual cycle minus 11 days. For example, if the shortest menstrual period is 28 days and the longest is 37 days, you need to subtract 18 (28-18=10) from the shortest regular period and 11 (37-11=26) from the longest regular period, so the 10th to 26th days after the menstrual flow belong to the ovulation period. It is important for young women to get ovulation right: for those who want to get pregnant, they should start having sex once every two days on the first day of ovulation and stick to it for a few months, and if there are no special circumstances, they will usually get pregnant. Women who do not want to get pregnant, on the other hand, need to miss these days to have sex, when ovulation is known by another term: the danger period. What is ovulation day A woman’s ovulation date is usually about 14 days before her next menstrual period. The day of ovulation and the 5 days before and 4 days after it are called the ovulation period. For example, if a woman has a 28-day menstrual cycle and the first day of her current period is on December 2, her next period will be on December 30 (December 2 plus 28 days), and then subtract 14 days from December 30, then December 16 will be the day of ovulation. The day of ovulation and the 5 days before and 4 days after it, i.e. December 11-20, are the ovulation period. Except for menstruation and ovulation, the rest of the time is considered safe. It is not necessary to use any contraceptive drugs or contraceptives to have intercourse during the safe period. A man’s sperm can survive in a woman’s body for 3 to 5 days, so avoid these days of ovulation, you really can’t help but use condoms. Safe period A woman’s ovulation date is usually about 14 days before her next menstrual period. The first day of the next menstrual period, count backwards 14 days or subtract 14 days to the day of ovulation, the day of ovulation and the 5 days before and 4 days after it are called the ovulation period. For example, if a woman has a 28-day menstrual cycle and the first day of her current period is on December 2, her next period will be on December 30 (December 2 plus 28 days), and then subtract 14 days from December 30, then December 16 will be the day of ovulation. The day of ovulation and the 5 days before and 4 days after it, i.e. December 11-20, are the ovulation period. Except for menstruation and ovulation, the rest of the time is considered safe. It is not necessary to use any contraceptive drugs or contraceptives to have intercourse during the safe period. Ovarian ovulation is a necessary condition for fertility. The causes of anovulation are mostly due to pathological disorders in any of the hypothalamic-pituitary-ovarian axis, but can also be influenced by other endocrine gland diseases. Therefore, the following questions should be clarified before treatment: ① whether the ovaries are ovulating, whether ovulation is normal and whether there is any regularity. (2) If ovulation is absent, which part of the hypothalamic-pituitary-ovarian axis is responsible for the anovulation. ③Whether there is any relationship between ovulation disorder and other endocrine gland function regulation or other systemic diseases, and whether it is related to psychological factors. ④Whether the endometrium responds normally to ovarian hormones. The woman’s immature follicles will ovulate In response to the question of immature follicles will ovulate, authoritative experts, in fact, under normal circumstances, the follicles reach more than 20MM will ovulate. The follicle ovarian cortex consists of an oocyte and many small follicle cells around it. According to the morphological and functional changes during follicular development, it can be divided into three stages: primordial follicle, growing follicle and mature follicle. Can immature follicles cause ovulation? Ultrasound can detect small follicles in the ovary on day 3-5 of the menstrual cycle, which will gradually grow and become the largest on day 14 on average, when ovulation can occur. Between day 5 of menstruation and ovulation, the primary follicle grows by an average of 1.5mm per day; by day 10 it grows by an average of 1.2mm per day, and 4 days before ovulation it grows by an average of 1.9mm until the follicle is developed and mature. What are the characteristics of mature follicles? Mature follicles generally have the following characteristics after maturation: 1. The follicles are round or oval in shape, with a diameter of 15-30 mm (21.2+-0.53 mm), with an echogenic area inside the follicle, clear and pure, with clear borders and thin walls. In 20% of mature follicles, the day before ovulation, the image of the cumulusoophorus is seen, with short strong echogenicity in the follicle near the wall. In summary, the above is the answer to the question of whether immature follicles will ovulate. We would like to remind you that normal ovulation is a prerequisite for pregnancy and there is no way to talk about conception if a woman does not have eggs to ovulate. Therefore, if you find the problem of ovulation disorder, you should promptly carry out the treatment of ovulation disorder, cure ovulation disorder is the prerequisite for infertility patients to become parents.