Ovarian follicle
Folliculus ovaricus
Also known as: Graafian follicle, primordial follicle, antral follicle, folliculogenesis, ovulation
The functional unit of the ovary: an oocyte surrounded by granulosa (and later theca) cells, which develops from the primordial stage to a mature (Graafian) follicle that ruptures at ovulation.
Overview
Folliculogenesis proceeds through recognisable stages. Primordial follicles (≈30–50 µm) — a primary oocyte arrested in prophase I surrounded by a single layer of flattened pregranulosa cells — form the resting reserve, laid down before birth. A few are activated each day. In primary follicles the granulosa cells become cuboidal and then multilayered, and the oocyte secretes the glycoprotein zona pellucida. In secondary (preantral) follicles, the granulosa is several layers thick and the surrounding stroma differentiates into a vascular, steroidogenic theca interna (LH receptors, androgen production) and a fibrous theca externa.
Fluid-filled spaces then coalesce into an antrum, forming the antral (tertiary) follicle. Antral follicles of ≈2–5 mm become FSH-dependent; each cycle a cohort is rescued from atresia by the intercycle rise in FSH. By days 5–7 one dominant follicle — the one with most FSH receptors and aromatase — is selected; its estradiol and inhibin B suppress FSH so the others undergo atresia (the fate of >99 % of follicles). The mature (Graafian, preovulatory) follicle reaches ≈18–25 mm; the oocyte sits on a hillock of granulosa cells, the cumulus oophorus, with an inner ring of cells, the corona radiata, attached to the zona pellucida.
Ovulation: the LH surge causes the oocyte to complete meiosis I, cumulus expansion, and prostaglandin- and protease-mediated breakdown of the follicle wall at the stigma; the secondary oocyte with its corona is released ≈24–36 h after surge onset. The remaining wall becomes the corpus luteum.
- Location
Cortex of the ovary; mature follicles bulge from the ovarian surface.
Parts & subdivisions
- Primordial follicleOocyte + single layer of flat pregranulosa cells; resting pool.
- Primary follicleCuboidal granulosa cells; zona pellucida appears.
- Secondary (preantral) follicleMultilayered granulosa; theca interna and externa form.
- Antral (tertiary) follicleFluid-filled antrum; FSH-dependent growth.
- Mature (Graafian) follicle≈18–25 mm; cumulus oophorus and corona radiata; ready to ovulate.
- Post-ovulatory endocrine body and its fibrous scar.
Function
- Nurtures and matures the oocyte (gap-junction coupling with granulosa cells).
- Produces estradiol (two-cell, two-gonadotropin system), inhibin B and AMH.
- Releases the oocyte at ovulation.
- Physiology
The journey from activation of a primordial follicle to ovulation takes several months; only the final ≈2 weeks (antral → preovulatory) depend on FSH and occur within a single cycle. Granulosa cells convert theca-derived androgens to estradiol via FSH-induced aromatase; the dominant follicle acquires LH receptors on its granulosa cells, allowing it to respond to the LH surge.
Clinical significance
Follicle monitoring and IVF
Transvaginal ultrasound tracks follicle growth; an antral follicle count (with AMH) estimates ovarian reserve. In IVF, exogenous FSH stimulates multiple follicles, and hCG or a GnRH agonist triggers final maturation before egg collection.
Mittelschmerz and follicular cysts
Mid-cycle pain at ovulation from follicular fluid or blood irritating the peritoneum; failure of a follicle to rupture can leave a follicular cyst.
Granulosa-cell tumour
Estrogen-secreting sex-cord tumour with Call–Exner bodies; causes precocious puberty in girls or postmenopausal bleeding and endometrial hyperplasia; inhibin is a marker.
Test yourself
A woman has oligomenorrhoea and hirsutism; ultrasound shows 25 follicles in each ovary. Which statement about PCOS is correct?
- Diagnosis requires all three Rotterdam criteria
- Chronic anovulation exposes the endometrium to unopposed estrogen, increasing endometrial cancer risk
- FSH is typically much higher than LH
- Insulin sensitivity is usually increased
Answer: Chronic anovulation exposes the endometrium to unopposed estrogen, increasing endometrial cancer risk
PCOS needs two of three criteria (anovulation, hyperandrogenism, polycystic morphology). Without ovulation there is no progesterone to oppose estrogen, so endometrial hyperplasia and carcinoma risk rises. LH is often high relative to FSH, and insulin resistance is typical.
Compiled from standard anatomy and physiology references — see the Reproductive System sources. For education only; not medical advice.