Can I get pregnant if my ovarian follicle ruptures and bleeds?

There are two possibilities for follicle rupture. One is the rupture itself. In this case, there will be bleeding, but it is one's own fault and will not lead to serious conditions. Generally, some blood will be secreted through the vagina. Follicular rupture and bleeding will not lead to pregnancy because the follicle is already damaged. The possibility of this kind of pregnancy is relatively small. We should also understand the several possibilities of follicle rupture and have relevant understanding and knowledge of the condition.

Pathological etiology

(1) Spontaneous rupture: that is, the follicular hematoma or corpus luteum hematoma continues to expand, and the internal pressure increases to a certain level and rupture occurs. There are several causes for its occurrence: ① It is closely related to ovarian congestion, such as ovarian torsion due to compression or uterine prolapse, long-term vaginal lavage and other mechanical factors or pelvic inflammation, acute and chronic appendicitis causing ovarian congestion; ② Changes in ovarian function, such as excessive cold or hot baths, long-term use of estrogen or progesterone can cause changes in ovarian function, or due to the influence of the autonomic nervous system, the function of the ovarian enzyme system is overactive, causing bleeding tendency or coagulation disorder; ③ Blood changes, before menstruation, due to infectious diseases, anemia and malnutrition or other conditions, partial damage to platelets and changes in blood components, leading to bleeding.

(ii) The ovary ruptures directly or indirectly due to external forces, such as sexual intercourse, increased intra-abdominal pressure (straining during bowel movements, nausea, vomiting, lifting heavy objects, etc.).

Disease diagnosis

(I) Acute appendicitis: Ovarian rupture occurs more often on the right side and can be easily misdiagnosed as acute appendicitis. The onset of acute appendicitis is often upper abdominal pain or full abdominal pain, which is gradually limited to the Malpighian point. Nausea and vomiting are more prominent. Tenderness, rebound pain and abdominal muscle rigidity are all obvious. Bimanual examination: cervical lifting tenderness and uterine movement pain are mild, while ovarian rupture is completely the opposite. The symptoms of mild ovarian rupture gradually subside. Acute appendicitis has symptoms and signs of internal bleeding, while appendicitis has none.

(ii) Ruptured tubal pregnancy or miscarriage: Ovarian rupture can be easily misdiagnosed as ruptured tubal pregnancy or miscarriage, but if the menstrual history is carefully inquired and attention is paid to the time when the lesion occurs in the menstrual cycle, it can generally be distinguished. Tubal pregnancy often has a history of short-term amenorrhea, a small amount of vaginal bleeding, recurrent abdominal pain, obvious pelvic tenderness, and a palpable mass. Other medical conditions such as a history of infertility are different from ovarian rupture.

Inspection method

Physical examination: In mild cases, there is only mild tenderness in the lower abdomen. In cases where the disease occurs on the right side, the tenderness point is located lower and inside the Mahalanobis point. In severe cases, there is obvious tenderness in the lower abdomen and rebound pain, but the abdominal muscle rigidity is not as good as in generalized peritonitis.

Bimanual examination: cervical lifting pain, tenderness in the fornix on both sides, uterus of normal size, pain when moving the uterus, fullness in the adnexal area or posterior fornix can be felt when internal bleeding is heavy, and enlarged ovaries can sometimes be palpated.

Complications such as shock.