Does the largest follicle always release an egg?

Not always. A larger follicle may be closer to maturity, but it still needs to rupture to release the egg.

Can a follicle grow after another follicle has ruptured?

Sometimes. A second follicle may still be visible or continue changing, depending on its stage of development.

Does having multiple follicles mean you have PCOS?

No. Multiple growing follicles on one scan do not automatically mean you have PCOS. A diagnosis depends on other findings and symptoms.

Two or More Follicles on a Follicular Scan: What Happens Next?

When two or more follicles appear on your follicular scan, it simply means your ovaries have more than one follicle developing during that cycle. These follicles may not behave in the same way or reach maturity at the same time.

Why Do Two or More Follicles Develop in the Same Cycle?

At the start of your cycle, a hormone called follicle-stimulating hormone (FSH) helps several small follicles in your ovaries begin to grow. Usually, one follicle grows faster and becomes the dominant follicle. As it grows, changes in your hormone levels cause the other follicles to slow down.

Two or more follicles may keep growing in two situations:

Naturally: Sometimes, more than one follicle responds well to FSH, so they continue growing together.
During fertility treatment: Medicines used for IVF or other fertility treatments encourage your ovaries to develop several follicles at the same time.

Why Do Some Follicles Grow Faster Than Others?

Follicles can grow at different speeds because each one responds in its own way to your body's hormones.

This may happen because:

One follicle may respond better to FSH and grow faster than the others
Some follicles may receive better blood flow, which supports their growth
A few follicles may simply slow down or stop growing as your cycle continues

Which Follicle Is Likely to Become Dominant?

When several follicles are growing, the one that continues to develop and becomes larger than the others is usually called the dominant follicle. As ovulation approaches, it may reach 18-22 mm. Your follow-up scans can show whether this follicle is still growing and moving towards maturity. If two follicles reach a similar stage, both may have the potential to release an egg.

Can Two Follicles Mature in the Same Cycle?

Yes, two follicles can reach maturity during the same menstrual cycle. They may grow in the same ovary or one in each ovary.

If both follicles rupture, each may release an egg. This means two eggs could be available for fertilisation. However, a mature follicle may sometimes fail to rupture, so the egg remains inside. This is why two mature follicles do not always mean that two eggs will be released

Follicle Growth in Natural and Fertility-Treatment Cycles

The table below shows how follicle development may differ between a natural cycle and a fertility-treatment cycle:


Egg development	Your body usually prepares one egg for ovulation	Treatment may encourage several eggs to mature
Follicle growth	Follicles grow with your body's natural hormonal changes	Medicines stimulate your ovaries and support the growth of several follicles
Average growth rate	Around 1.4 mm per day	Around 1.7 mm per day with ovarian stimulation
Developing follicles	Usually, one follicle becomes the main follicle and continues to develop	More than one follicle may continue to grow and develop

Do Multiple Follicles Increase Your Chance of Twins?

Seeing two follicles on your scan may make you think about twins, but it does not always lead to a twin pregnancy. Both follicles need to release an egg, and both eggs must be fertilised and implant in your uterus.

Twin pregnancies are more common with some fertility treatments. One study found twin pregnancies in about 1.5% of non-IVF pregnancies and 32.1% of IVF pregnancies. However, these figures do not mean that two follicles give you a 32.1% chance of twins. Your individual chance can vary depending on your treatment and other fertility factors.

What Happens to Follicles That Do Not Release an Egg?

Not every follicle seen on your scan will release an egg. If a follicle stops developing, your body may gradually break it down and absorb it.

Sometimes, a mature follicle may remain without rupturing and releasing the egg. This is known as a luteinised unruptured follicle (LUF). In some cases, the follicle may remain as a temporary functional ovarian cyst, which often resolves on its own.

How Your Follicles Change as the Cycle Progresses

After multiple follicles are seen on your scan, you may notice different changes over the next few days.

Your follow-up scan may show that:

One of your follicles has moved closer to maturity
Two or more follicles are still developing
One or more mature follicles have released an egg
A follicle has stopped growing or has not ruptured

Multiple follicles can make you curious about what they mean for your cycle and pregnancy chances. Their number alone does not predict the outcome. Watching how your follicles change over time gives a clearer understanding of ovulation and what may happen during your cycle.

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FAQs on Two or More Follicles on a Follicular Scan: What Happens Next?

Does the largest follicle always release an egg?
Not always. A larger follicle may be closer to maturity, but it still needs to rupture to release the egg.
Can a follicle grow after another follicle has ruptured?
Sometimes. A second follicle may still be visible or continue changing, depending on its stage of development.
Does having multiple follicles mean you have PCOS?
No. Multiple growing follicles on one scan do not automatically mean you have PCOS. A diagnosis depends on other findings and symptoms.