Ovulatory Dysfunction

Ovulatory dysfunction describes an ovarian problem that interferes with the maturation or release of the egg. An estimated 20 percent or more of infertile women suffer from ovulatory dysfunction.

Causes of ovulatory dysfunction

There are many reasons why a woman might experience ovulatory dysfunction including the following:

• Polycystic Ovary Syndrome (PCOS) is a common cause of irregular periods. The ovaries are often enlarged due to the presence of multiple follicular cysts and the condition is associated with infrequent or prolonged menstrual periods, abnormal hair growth on the face or body, obesity, acne and insulin resistance
• Stress – physical or mental stress in the form of too much exercise, eating disorders or severe weight gain or loss can interfere with the pituitary gland’s production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) disrupting ovulation and leading to missed or irregular periods
• Hyperprolactinemia – excessive amounts of the hormone, prolactin are produced by the pituitary gland. This can suppress a woman’s natural hormone fluctuations and prevent ovulation
• Hypothyroidism –occurs when the thyroid gland produces less than normal amounts of the thyroid hormone. Low thyroid can prevent or decrease ovulation
• Premature Ovarian Failure (POF)– a rare condition where the ovaries stop functioning before age 40 affecting the production of both eggs and estrogen. Symptoms of POF are similar to those of menopause.

Diagnosis of ovulatory dysfunction

As with all infertility issues, a complete history and physical is needed to enable your reproductive endocrinologist to determine the cause of ovulatory dysfunction.

A woman with regular monthly menstrual period is likely ovulating, although uterine bleeding can occur without ovulation. It is possible to detect ovulation through use of ovulation prediction kits or by tracking basal body temperature.

Other tests your fertility specialist may utilize to detect ovulation are luteal phase serum progesterone levels measurements, ovarian follicle monitoring with serial transvaginal ultrasounds and endometrial biopsies.

Treatment of ovulatory dysfunction

Fertility specialists can successfully treat many ovulatory disorders. Fertility medications can trigger or regulate ovulation by mimicking FSH and LH. Commonly prescribed fertility drugs include:

• Clomiphene Citrate (Clomid®)
• Aromatase inhibitors (e.g. Letrozole)
• Metformin
• Follicle Stimulating Hormone (FSH)
• Luteinizing Hormone (LH)
• Human Chorionic Gonadotropin (hCG)
• Dopamine agonists