Women with ovulatory dysfunction may fail to ovulate (anovulation) or have disordered/sporadic ovulation (oligo-ovulation). When an egg is not released from the ovary, natural fertilization and conception is not possible. If ovulation is reduced or irregular, opportunities for conception are also diminished, resulting in infertility.
When menstrual cycles are irregular (shorter than 21 days, or longer than 35 days), or if menses are skipped or absent, ovulatory dysfunction is diagnosed. Occasionally, women with regular monthly menses may also fail to ovulate, which can be confirmed using ultrasound examinations, ovulation prediction kits, and blood testing.
Establishing the exact cause for ovulatory dysfunction may prove to be a difficult task. There are many different factors which can lead to anovulation or disordered ovulation. Such factors may include generalized stress/anxiety, hormonal imbalance, eating disorders (anorexia/bulimia), excessive exercise, central nervous system abnormalities, cancer therapy, genetic disorders, polycystic ovary syndrome (PCOS), obesity, and unexplained factors, among others. A careful history and physical examination can often establish the diagnosis and suggest a specific cause, which often requires additional testing for confirmation (blood work, imaging studies…).
Establishing a specific cause for ovulatory dysfunction is important in order to determine a customized treatment protocol. Occasionally, simple interventions such as behavioral changes or the correction of a specific hormonal imbalance can lead to resumption in normal ovulatory cycles. Sometimes, specific diagnoses require ovulation induction with various orally ingested medications (Clomiphene citrate, Tamoxifen, aromatase inhibitors, Metformin…) or, if needed, injectable hormones, often with excellent results.
The California Center for Reproductive Health specializes in diagnosing and treating anovulation/oligo-ovulation. After a comprehensive work-up, simple treatments are initially employed to achieve ovulation and pregnancy.
