When a woman becomes pregnant, she often has no idea about the process her body went through for this natural phenomenon to happen. Many times the body is so mysterious and unknown that we can’t even imagine there is a natural occurrence like the dominant follicle in the ovary. But, after all, what is that? What causes it, and is there any risk for women? What is a follicle?
Follicles are small fluid-filled sacs that contain inside the female reproductive cell, known as the oocyte, which stores the future eggs. However, there’s another detail to this matter, which is the dominant follicle in the ovary. It is simply a follicle that stands out among the others that started the stimulation and maturation process1. In fact, women are born with their ovarian reserve ready: about 250,000 in each ovary. Cycle after cycle after the first menstruation, this reserve starts to be activated as hormonal stimulation occurs. GnRh plays the initial role in the ovulation journey. Stimulation begins with a few follicles, about 8 in each ovary, but not all will grow large enough to be noticed. Among these initial follicles, some—or one—will become more likely to be released. This larger follicle is called the dominant follicle.
A good dominant follicle in the ovary is one that measures about 14mm up to 30mm. It is a strong candidate to be released for ovulation and be fertilized to result in a baby. After reaching the ideal size, from 19 to 30mm, it receives LH stimulation which causes the follicle to rupture and then releases the egg. The growth of more than one follicle depends on certain factors, but it is possible to have several dominant follicles at the same time. In these cases, there is a risk of twin pregnancy2. Naturally, it is less likely, but it is possible for women with a genetic tendency for multiple pregnancies. Instances of twins in the family, for example.
Ultrasound showing a clearly visible dominant follicle in the right ovary.
How to Help Nature for More Dominant Follicles in the Ovaries?
Other cases that could increase the likelihood of multiple pregnancies with several dominant follicles in the ovaries include induction by medication. Indux, Clomid, Serophene, and injectables like Menopur, for example, are major aids. However, they are not always effective—there is a higher risk of twin pregnancy, but never an absolute certainty of 100%. Moreover, these medications bring significant risks to the ovaries. Since they are extremely invasive, they can actually be much more aggressive to the body than one may think3. Therefore, the best solution is to use these medications only in cases indicated by a doctor and with strict monitoring to avoid problems.
Ovarian hyperstimulation is a reality among women who undergo induction with medication. Sometimes they can stimulate so much that several follicles become dominant, and then the ovary cannot handle the load and may temporarily shut down, causing severe pain. However, there is a great natural alternative for women who want to stimulate their follicles until they become dominant. Foods based on yam—for example, the elixir, tea, or other preparations of the vegetable—act as a very effective inducer in almost all bodies. Another food also rich in estrogen is soy. Women who want to become pregnant should consume it regularly, especially during the ovulation stimulation phase.
To actually detect the dominant follicle, it is recommended to perform tests like serial ultrasounds during the fertile period to really determine when the dominant follicle will rupture. Ovulation tests are quite effective, so it is recommended to use them during the fertile period to detect the LH peak in the body. This way, the chances of getting pregnant with sexual intercourse at the right time increase considerably. There are also cases where the dominant follicle does not rupture and may cause a phenomenon called LUF. Women diagnosed with anovulation may need medications based on HCG that help ovulation occur, regardless of whether they have LUF or not. Don’t forget: any and all medications must be prescribed by the physician responsible for your treatment.
