Los ntawm kev pub niam txiv mus txog lub cev ntas, zes qe menyuam yog qhov chaw ua haujlwm ib ntus. Thawj theem ntawm qhov kev coj khaub ncaws no, lub hauv paus theem sib xws rau qhov loj hlob ntawm cov hauv paus zes qe menyuam uas, thaum lub sijhawm ovulation, yuav tso cov oocyte npaj los ua chiv. Ob yam tshuaj hormones, LH thiab FSH, yog qhov tseem ceeb rau theem hauv qab no.

Txhua tus menyuam ntxhais yug los, hauv lub zes qe menyuam, muaj ntau pua txhiab lub npe hu ua cov hauv paus hauv paus, txhua tus muaj oocyte. Txhua txhua 28 hnub los yog li ntawd, txij thaum pub dawb mus txog rau lub cev ntas, lub zes qe menyuam hloov pauv nrog qhov tso tawm ntawm oocyte - ovulation - los ntawm ib ntawm ob lub zes qe menyuam.

Lub caij coj khaub ncaws no yog ua los ntawm 3 ntu sib txawv:

• theem follicular;
• kev cai;
• theem luteal, lossis theem tom qab ovulatory.

Cov theem hauv qab pib hauv thawj hnub ntawm kev coj khaub ncaws thiab xaus rau thaum lub sijhawm ntawm ovulation, thiab yog li ntawd kav ntev li ntawm 14 hnub (dhau 28-hnub voj voog). Nws sib raug mus rau theem kev loj hlob ntawm lub hauv paus, thaum lub sijhawm uas muaj qee tus lej ntawm cov hauv paus hauv paus yuav tau qhib thiab pib ua kom tiav. Cov folliculogenesis no suav nrog ob theem tseem ceeb:

• thawj qhov kev nrhiav neeg ua haujlwm hauv qab: qee tus naj npawb ntawm cov hauv paus hauv paus (qee qhov 25 txhiabths ntawm ib lub hli hauv txoj kab uas hla) yuav paub tab kom txog rau theem ntawm cov hauv paus plaub hau (lossis anthrax);
• kev loj hlob ntawm cov hauv paus antral mus rau lub hauv paus ua ntej ovulatory: ib qho ntawm cov hauv paus antral yuav cais tawm ntawm cov pab pawg thiab txuas ntxiv mus rau kev paub tab, thaum lwm tus raug tshem tawm. Qhov no thiaj li hu ua cov hauv paus tseem ceeb yuav mus txog theem ua ntej ovulatory follicle, lossis De Graaf follicle uas, thaum lub sijhawm ovulation, yuav tso tawm oocyte.

Thaum lub hauv paus theem, tus poj niam tsis xav tias muaj cov tsos mob tshwj xeeb, sib nrug los ntawm qhov pib ntawm kev coj khaub ncaws uas qhia txog qhov pib ntawm lub voj voog tshiab ntawm zes qe menyuam thiab yog li ntawd pib ntawm theem hauv qab.

"Tus coj" ntawm lub voj voog ntawm zes qe menyuam no yog cov tshuaj sib txawv uas zais los ntawm hypothalamus thiab pituitary caj pas, ob lub qog nyob ntawm lub hauv paus ntawm lub hlwb.

• cov hypothalamus zais cov tshuaj neurohormone, GnRH (gonadotropin tso cov tshuaj hormone) tseem hu ua LH-RH, uas yuav ua rau lub caj pas pituitary;
• nyob rau hauv cov lus teb, lub caj pas pituitary zais FSH, lossis cov tshuaj tiv thaiv follicular, uas yuav qhib qee qhov ntawm cov hauv paus hauv paus uas tom qab ntawd nkag mus rau hauv kev loj hlob;
• cov hauv paus no tig los tso cov tshuaj estrogen uas yuav ua rau lub tsev menyuam sib sib zog hauv lub cev txhawm rau txhawm rau npaj lub tsev menyuam kom tau txais lub qe fertilized.
• thaum qhov tseem ceeb ua ntej ovulatory follicle tau xaiv, cov tshuaj estrogen secretion nce ntxiv, ua rau muaj kev nce hauv LH (luteinizing hormone). Raws li cov txiaj ntsig ntawm LH, qhov nro ntawm cov kua hauv lub hauv paus nce. Lub hauv paus nws thiaj li tawg thiab tso nws cov oocyte. Nws yog ovulation.

Yog tsis muaj theem follicular, muaj tseeb tsis muaj ovulation. Qhov no hu ua anovulation (tsis muaj ovulation) lossis dysovulation (ovulation teeb meem), ob qho tib si uas ua rau tsis tuaj yeem tsim cov tshuaj oocyte uas tuaj yeem tsim tau, thiab yog li ntawd ntxiv lawm ntxiv. Ntau qhov laj thawj tuaj yeem yog ntawm keeb kwm:

• teeb meem nrog pituitary lossis hypothalamus (hypogonadism ntawm "siab" keeb kwm), uas ua rau tsis tuaj lossis tsis txaus cov tshuaj hormones tso tawm. Kev tso zis ntau dhau ntawm prolactin (hyperprolactinemia) yog qhov ua rau qhov ua haujlwm tsis zoo. Nws tuaj yeem yog vim muaj cov qog adenoma (qog qog ntawm cov qog pituitary), rau kev noj qee yam tshuaj (neuroleptics, antidepressants, morphine ...) lossis qee yam kab mob (mob raum tsis ua haujlwm, hyperthyroidism, ...). Qhov kev nyuab siab tseem ceeb, kev xav poob siab, poob phaus tseem ceeb tuaj yeem cuam tshuam nrog kev ua haujlwm zoo ntawm no hypathalamic-pituitary axis thiab ua rau kev hloov pauv ib ntus;
• Polycystic ovary syndrome (PCOS), los yog zes qe menyuam dystrophy, yog ib qho ua rau muaj teeb meem ntawm zes qe menyuam. Vim yog kev ua haujlwm tsis txaus ntawm cov tshuaj hauv lub cev, cov naj npawb ntawm cov hauv paus tsis sib xws thiab tsis muaj leej twg tuaj txog rau qhov loj hlob.
• tsis ua haujlwm ntawm zes qe menyuam (lossis hypogonadism ntawm "qis" keeb kwm) congenital (vim yog chromosomal txawv txav, Turner syndrome piv txwv) lossis tau txais (tom qab kho tshuaj lossis phais);
• menopause thaum ntxov, nrog rau hnub nyoog ntxov ua ntej ntawm oocyte cia. Kev ua caj ces lossis kev tiv thaiv kab mob tuaj yeem yog qhov pib ntawm qhov tshwm sim no.

Thaum muaj qhov anovulation lossis dysovulation, kev kho mob rau zes qe menyuam tuaj yeem ua rau tus neeg mob. Qhov kev kho mob no suav nrog txhawb kev loj hlob ntawm ib lossis ntau qhov hauv paus. Cov txheej txheem sib txawv muaj nyob. Qee qhov chaw siv clomiphene citrate, tshuaj antiestrogen los ntawm lub qhov ncauj uas ua rau lub paj hlwb xav hauv qib estradiol qis dhau, ua rau nws zais FSH txhawm rau txhawm rau txhawb cov hauv paus. Lwm tus siv gonadotropins, txhaj tshuaj npaj muaj FSH thiab / lossis LH uas yuav pab txhawb kev loj hlob ntawm cov hauv paus hniav. Hauv ob qho xwm txheej no, thoob plaws cov txheej txheem, tus neeg mob tau ua ntu zus nrog saib xyuas nrog rau kev kuaj ntshav txhawm rau ntsuas qib cov tshuaj hormones thiab kuaj ultrasound txhawm rau tswj tus lej thiab kev loj hlob ntawm cov hauv paus. Thaum cov hauv paus no tau npaj tiav, ovulation tau tshwm sim los ntawm kev txhaj tshuaj HCG.