Ovulatory Dysfunction

Definition - What does Ovulatory Dysfunction mean?

Ovulatory dysfunction is a problem involving the ovary where the egg fails to mature and release properly or the hormone estrogen or progesterone is abnormally low. Eggs cannot mature without the hormones that drive their maturation. Normally, a woman ovulates every 25 to 32 days (28 days on an average). Failure to release an egg may result in irregular menses or no menses at all and infertility. In fact, ovulatory difficulties account for about 20 to 30% of infertility cases.

FertilitySmarts explains Ovulatory Dysfunction

Conditions that can cause ovulatory dysfunction include:

  • Polycystic ovarian syndrome (PCOS): Various factors with PCOS can interfere with fertility including excess male hormone production, impaired follicle development, and elevated insulin levels.
  • Premature ovarian failure: A condition in which the ovaries of a woman stop functioning before she reaches 40 years.
  • Elevated prolactin levels in blood: Women with modestly elevated prolactin levels may ovulate regularly but lack the ability to produce the hormone progesterone. This is referred to as the luteal phase defect. A lack of progesterone after ovulation makes the uterine lining unsuitable for an implanting an embryo.
  • Having an underactive or overactive thyroid: Abnormal thyroid hormone levels disrupt the prolactin levels and impair the gonadotropin release, both of which can lead to ovulation problems
  • Disorders of the pituitary and adrenal glands
  • Extensive exercise: Impairs the gonadotropin release, and consequently, the release and maturation of the eggs
  • Breastfeeding: Because of elevated prolactin levels
  • Being extremely underweight or overweight
  • Idiopathic - no obvious cause found

In women suspected of having ovulatory dysfunction, the doctor performs hormonal blood tests and an ultrasound to determine the cause. The mainstay of treatment for ovulation problems is restoring the ovulation and fertility with medications like clomiphene (Clomid) and gonadotropins. Treating the cause also helps address the ovulatory dysfunction and irregular menstruation. If these options fail, the doctor may suggest proceeding on to other options such as in vitro fertilization (IVF) or intrauterine insemination (IUI).

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