Laga soo bilaabo qaan-gaarnimada ilaa dhalmo-joojinta, ugxan-yarigu waa goobta dhaqdhaqaaqa xilliyeedka ah. Marxaladda koowaad ee wareegga caadada, marxaladda follicular waxay u dhigantaa qaan-gaarnimada follicle-ka ugxan-sidaha, taas oo, wakhtiga ugxanta, soo deyn doonta oocyte diyaar u ah in la bacrimiyo. Laba hormoon, LH iyo FSH, ayaa lama huraan u ah wejigan follicular.

Gabadh kasta oo yar waxay ku dhalataa, ugxan-yari, kayd dhowr boqol oo kun oo loo yaqaanno follicles primordial, mid walbana ka kooban yahay oocyte. 28 maalmood kasta ama wax ka badan, laga bilaabo qaan-gaarnimada ilaa menopause, wareegga ugxan-sidaha ayaa dhacaya iyadoo la sii daayo oocyte - ugxan - by mid ka mid ah labada ugxan.

Wareegga caadadu waxa uu ka kooban yahay 3 waji oo kala duwan:

• wajiga follicular;
• l' ugxanta;
• marxaladda luteal, ama marxaladda ugxan-sidaha kadib.

Marxaladda follicular-ku waxay bilaabataa maalinta ugu horreysa ee caadadu waxayna dhammaanaysaa wakhtiga ugxan-sidaha, sidaas awgeed waxay socotaa celcelis ahaan 14 maalmood (ka badan 28-maalmood wareeg ah). Waxay u dhigantaa wajiga korriinka follicular, inta lagu jiro tiro cayiman oo follicles hore ah ayaa la hawlgelin doonaa oo bilaabi doona korriimadooda. Folliculogenesis Tani waxay ka kooban tahay laba marxaladood oo waaweyn:

• qoritaanka bilowga ah ee follicles: tiro go'an oo follicles asaasiga ah (qaar ka mid ah 25 kun oo millimitir dhexroorka ah) ayaa bislaan doona illaa heerka follicles jaamacadeed (ama kudka);
• korriinka antral follicle ilaa follicle pre-ovulatory: mid ka mid ah follicles antral ayaa ka go'i doona kooxda oo sii wadaan in ay koraan, halka kuwa kale waa la tirtiraa. Waxa loogu yeero follicle-ka ugu weyn waxay gaari doontaa heerka follicle-ka-hor-u-ugxaanta, ama De Graaf follicle kaas oo, inta lagu jiro ugxan-sidaha, soo deyn doona oocyte.

Inta lagu jiro marxaladda follicle-ka, haweeneydu ma dareemayso calaamado gaar ah, marka laga reebo bilawga caadada oo calaamad u ah bilawga wareegga cusub ee ugxan-sidaha iyo bilawga marxaladda follicular.

"Conductors" ee wareegga ugxan-sidaha waa hormoono kala duwan oo ay soo daayaan hypothalamus iyo qanjidhada pituitary, oo ah laba qanjir oo ku yaal saldhigga maskaxda.

• hypothalamus waxay soo saartaa neurohormone, GnRH (hormoonka sii deynta gonadotropin) oo sidoo kale loo yaqaan LH-RH, kaas oo kicin doona qanjirka pituitary;
• marka laga jawaabayo, qanjidhada pituitary waxay soo saartaa FSH, ama hoormoonka follicular stimulating hormone, kaas oo kicin doona tiro go'an oo follicles primordial ah ka dibna galaya koritaanka;
• Unugyadan ayaa iyaguna soo daaya estrogen taasoo adkeyn doonta xuubka ilmo-galeenka si loogu diyaariyo ilmo-galeenka si uu u helo ukun la bacrimiyey oo suurtogal ah;
• Marka la doorto follicle-ka hore ee ugxan-sidaha, dheecaanka estrogen-ka ayaa si aad ah u kordha, taasoo keenta kor u kaca LH (hormoonka luteining). Marka la eego saameynta LH, xiisadda dareeraha gudaha follicle ayaa kordha. Follicle-ku aakhirka wuu jabaa oo sii daayaa oocyte-kiisa. Waa ugxansidaha.

Marxalad follicular ah la'aanteed, xaqiiqdii ma jiro ugxan. Tan waxaa loo yaqaan anovulation (maqnaanshaha ugxansidaha) ama dysovulation (xannuunnada ugxanta), labaduba waxay keenaan maqnaanshaha wax soo saarka oocyte bacrin ah, oo sidaas darteed dhalmo la'aan. Sababo dhowr ah ayaa noqon kara asalka:

• dhibaato ka timaadda pituitary ama hypothalamus (hypogonadism of "sare" asalka ah), taas oo sabab u ah maqan ama maqan yahay dheecaan hormoon ah. Dheecaanka xad-dhaafka ah ee prolactin (hyperprolactinemia) ayaa ah sababta caadiga ah ee keenta cilladaan. Waxay u sabab noqon kartaa adenoma pituitary (buro aan fiicneyn oo qanjirka pituitary), qaadashada daawooyinka qaarkood (neuroleptics, antidepressants, morphine…) Cadaadiska muhiimka ah, shoogga shucuureed, miisaan lumis weyn ayaa sidoo kale faragelin kara shaqada saxda ah ee dhidibka hypathalamic-pituitary waxayna u horseedi kartaa anovulation ku meel gaar ah;
• Polycystic ovary syndrome (PCOS), ama dystrophy ugxan-sidaha, waa sababta caadiga ah ee cilladaha ugxan-sidaha. Sababtoo ah cillad la'aanta hoormoonka, tiro aan caadi ahayn oo follicles ah ayaa urura oo midkoodna ma yimaado qaangaar buuxa.
• cillad la'aanta ugxan-sidaha (ama hypogonadism asal ahaan "hooseeya") oo lagu dhasho (sababtoo ah cillad koromosoomyada, Turner syndrome tusaale ahaan) ama la helay (ka dib daawaynta kemotherabi ama qaliin);
• menopause hore, oo leh gabowga dhicis ee kaydka oocyte. Sababaha hidda-socodka ama difaaca waxay noqon karaan asalka dhacdadan.

Joogitaanka anovulation ama dysovulation, daaweynta kicinta ugxan-sidaha ayaa laga yaabaa in la siiyo bukaanka. Daaweyntani waxay ka kooban tahay kicinta korriinka hal ama ka badan oo follicles. Nidaamyo kala duwan ayaa jira. Qaar ka mid ah waxay u adeegsadaan clomiphene citrate, oo ah antiestrogen oo afka laga qaato kaas oo maskaxda ku siya in ay ku fekeraan heerka estradiol aad u hooseeya, taas oo keenaysa in ay qariso FSH si ay u kiciso follicles. Kuwo kale waxay isticmaalaan gonadotropins, diyaargarow la isku duro oo ay ku jiraan FSH iyo / ama LH kuwaas oo taageeri doona korriinka follicles. Labada xaaladoodba, inta lagu jiro borotokoolka, bukaanka si joogto ah ayaa loola socdaa iyadoo ay ku jiraan baaritaannada dhiigga si loo cabbiro heerarka hoormoonka iyo baarista ultrasound si loo xakameeyo tirada iyo koritaanka follicles. Marka xubnuhu diyaar garoobaan, ugxantu waxay kicisaa duritaanka HCG.