Ovulation is the process that leads to fertility and is very intricate. It depends on the healthy interaction of the reproductive organs and hormone systems of both the male and the female. However, most women find themselves cursing the ovulation process at some point in their lives. At best, we’ve tolerated or perhaps overlooked them. It isn’t until we want to conceive and try to induce a pregnancy that almost all women focus intently on our menstrual cycles. Then, suddenly, we’re perceptive about each little detail and become ovulation professionals. We start charts, track numbers, create calendars with check marks and smiley faces, use ovulation prediction apps and have an array of pee sticks we never knew existed until we want to get pregnant.
For most women, the underlying cause reveals to them something they may have suspected but never focused on – their menstrual cycles are irregular. Many women have irregular periods resulting in irregular ovulation. Some women may ovulate sporadically and others menstruate, but don’t ovulate, and some don’t ovulate or menstruate. Many medical conditions can also contribute to a woman’s infertility. In fact, most cases of infertility are due to underlying medical problems and health-related issues.
Dr. Allon understands the importance of ovulation and the different medical treatments available for women just like you. He understands that most of the ovulation inefficiencies a woman experiences can be easily treated. He finds and pinpoints the root cause of irregular or not ovulating and designs a treatment plan tailored to each patient outlining the keys to success. Here are a few things to consider about specific types of ovulation irregularities.
What is the cause of not being able to ovulate regularly?
The root cause for women who are not ovulating regularly is the female reproductive system. Usually, the ovary is not receiving the necessary timed signals to mature and release an egg. The base of the brain is where you will find the pituitary gland which produces the hormones that control the ovaries. Also called the follicle stimulating hormone (FSH) and luteinizing hormone (LH), this release does not occur regularly and in a timely fashion causing the communication between the ovaries and pituitary gland to not be in sync.
Often hormonal irregularities sometimes lead to other issues, like…
- Lack of fertile cervical mucus
- Thinner or over-thickening of the endometrium
- Abnormally low levels of progesterone
Advanced Fertility Center of Texas breaks ovulation problems down into two groups. Anovulation and oligo-ovulation. Anovulation is when no ovulation at all occurs, and oligo-ovulation occurs infrequently or irregularly.
What Causes Anovulation or oligo-ovulation?
We have found that Polycystic Ovarian Syndrome, otherwise known as PCOS is and always has been the most common cause of anovulation and oligo-ovulation. PCOS can cause several symptoms which can cause a woman to not ovulate. Additional symptoms can include small cysts in the ovaries, obesity and unwanted facial hair. Advanced Fertility Center of Texas believes that any woman experiencing ovulatory problems, regardless of the type, should seek treatment if she wants to increase her chances to become pregnant and have a child. Here is a list of the common causes of Anovulation.
- Extremely low body weight
- Extreme exercise
- Premature ovarian failure
- Perimenopause, or low ovarian reserves
- Thyroid dysfunction (hyperthyroidism)
- Extremely elevated levels of stress
How does Advanced Fertility Center of Texas Diagnose Ovulation problems like Anovulation and oligo-ovulation?
Our doctors, such as Dr. Allon, will ask you about your menstrual cycle. If you tell him that you are having irregular or absent cycles, ovulatory problems will be suspected. The doctor might also ask you to track your basal body temperature at home for a few months. We will order blood work to check hormone levels. One of these tests may include the 21-day progesterone blood test. After ovulation, progesterone levels rise. If they do not rise, you are probably not ovulating. The doctor will then take an ultrasound to check out the shape, size of the uterus and look at the ovaries. The doctor will also look to see if your ovaries are polycystic, a common symptom of PCOS.
An ultrasound can also be used to track follicle development and ovulation, although this is not commonly done. In this case, you may have several ultrasounds over a 1-2-week period.
What are the potential treatments for Ovulation problems?
The treatment will always depend on the cause of the anovulation or oligo-ovulation. Some cases can be treated by a simple change in diet and/or lifestyle. If low body weight or extreme exercise is the cause, gaining weight or lessening your exercise routine may be enough to restart ovulation.
The same goes for obesity. If being overweight is the root cause of ovulation problems, then simply losing a few pounds and exercising may help the ovulation process.
The most common treatment to help women who are experiencing ovulation and menstrual problems will be fertility drugs. Usually, Clomid is the first fertility drug tried. Clomid can trigger ovulation in 80% of women who are having problems. It is known to help about 45% of women trying to get pregnant in the first six months.
For women who have PCOS, insulin-sensitizing drugs might be the answer. Metformin may help a woman start ovulating again. Six months of treatment is commonly required before you will know if Metformin will work. Afterwards, the doctor will ask you to take a pregnancy test to see if you conceived. If it did not help, the doctor may use a combination of fertility drugs to help with the ovulation issues. This will tremendously help the success in women who didn’t ovulate on Metformin alone.
If the cause is related to premature ovarian failure or low ovarian reserves, then fertility drugs are less likely to work. However, that does not single you out from getting pregnant with your own eggs. Some women will be unable to conceive with their own eggs and may require IVF treatments with an egg donor. Advanced Fertility Center of Texas is here to help. If you are experiencing any of the ovulation issues discussed above or just have questions about the ovulation and menstrual cycle, please, give us a call at 713.467.4488. We are happy to assist and get you on the road to fulfilling your dreams of becoming pregnant.