Ovulatory Dysfunction

Disorders of ovulation can cause infertility. Even though a woman gets a period every month, this does not prove that she is ovulating. The two most common causes of anovulation (no ovulation) or oligo-ovulation (irregular ovulation) are: 1) Polycystic ovarian disease (PCO) and 2) Hypothalamic dysfunction.

Polycystic ovarian disease was classically described in overweight women with irregular cycles with excess facial hair. It is now known that there is great variation in the disease, and some women that are quite thin, have no facial hair or irregular cycles, may still have PCO.

Women with PCO may have dysfunction of their insulin and blood sugar metabolism. Their egg quality may range from poor to excellent when retrieved for IVF cycles. Women with PCO have a higher chance of ovarian hyperstimulation syndrome (OHSS).

Treatment for women with PCO can range from ovulation inducing drugs, laparoscopy and ovarian drilling, or medical therapy to control insulin and blood sugar metabolism. Weight loss may be appropriate in over-weight individuals and may play a key role in increasing pregnancy rates in women with PCO.

Women with hypothalamic amenorrhea do not produce the correct hormones to cause monthly ovulation. It is corrected with ovulation inducing medications.