Multifollicular ovary (MFO) is a condition characterized by the presence of multiple follicles (usually 6 to 10) in the ovaries that are larger than normal (up to 10 mm in diameter). It is also called multicystic ovary disease. Multicystic ovary disease is mostly asymptomatic and can be detected during a routine gynecological examination.
Multicystic and polycystic ovary syndrome: what is the difference?
Multifollicular ovaries are often mistakenly confused with polycystic ovary syndrome (PCOS), but they are actually two different clinical conditions.
Polycystic ovary syndrome is part of a complex endocrine-metabolic syndrome caused by hormonal imbalance that affects the reproductive system and includes many more or less pronounced symptoms. This clinical form is often associated with metabolic changes (including insulin resistance ), irregular and very long cycles, and hyperandrogenism . In PCOS, there is a greater number of cysts (usually more than 10), with a diameter of 3 to 9 millimeters, but they do not exceed 10 mm, unlike in a multifollicular ovary. Throughout reproductive life, polycystic ovary syndrome maintains its appearance regardless of the rhythm of the menstrual cycle, pregnancy or drug treatment.
Polycystic ovary syndrome is not associated with hyperandrogenism or metabolic changes. In a multifollicular ovary, the follicles are distributed throughout the ovary, not just in the cortical (peripheral) region. There is no stromal hypertrophy, meaning the ovaries remain normal or only slightly enlarged in size.
Who is at highest risk for polycystic ovary syndrome?
Multifollicular ovary is usually found in young girls, affecting about 10 out of 100 women. The condition is more common during puberty, at the end of which it tends to resolve spontaneously. However, sometimes multifollicular ovary can persist or occur even in adulthood.
What are the causes of multifollicular ovary?
The growth of excess follicles is associated with inadequate hypothalamic-pituitary signaling during puberty and is associated with an increase in the amplitude of nocturnal fluctuations in gonadotropin levels. This explains why this disease mainly affects young women.
Factors that may predispose to the development of multifollicular ovaries include: hyperprolactinemia ; anovulation ; secondary amenorrhea due to low weight or weight loss (e.g., in the case of a restrictive diet, stress, or excessive physical activity); ovarian hyperstimulation (e.g., after assisted reproductive therapy); discontinuation of hormonal contraceptives ; use of an intrauterine device.
What are the signs of multicystic ovary syndrome?
Multicystic ovary syndrome often causes no symptoms. However, the following may sometimes occur: absence or decreased ovulation; menstrual irregularities, sometimes associated with oily skin and acne; excess hair growth . In some cases, multifollicular ovary syndrome may evolve into polycystic ovary syndrome.
Multicystic ovary syndrome can make it difficult to conceive if there is an accompanying condition anovulation . If a mature oocyte is not available each month, the difficulty of conceiving certainly increases.
How to treat multifollicular ovaries?
A gynecologist will determine, based on a clinical examination, whether hormonal therapy is appropriate in a particular case. In addition, interventions for specific reasons are possible: for example, the ovaries may return to normal after weight gain or treatment with gonadotropins to stimulate or improve ovulation. In many cases, the ovaries themselves resume normal function before adulthood, as the follicles gradually degenerate.
