Anovulation, a condition in which the ovaries do not release an egg during a menstrual cycle, can make it extremely difficult to become pregnant. At Pacific Fertility Center in Los Angeles, CA, Dr. Vicken Sahakian can work with you to determine the cause of anovulation and design a personalized treatment plan to help you grow your family.
Signs of Anovulation
Anovulation is one of the top causes of infertility. It causes menstrual cycle irregularities such as extended or shortened cycles, or no menstrual cycle at all.
Ovulation typically occurs about halfway through a menstrual cycle. The average menstrual cycle of 28 days would experience ovulation around day 14. Your ovulation day can fluctuate, and a normal menstrual cycle can vary in length, lasting anywhere from 21 to 35 days.
If you do not ovulate, you cannot become pregnant (unless you have frozen eggs or use an egg donor). Becoming aware of the signs of ovulation (and monitoring your menstrual and ovulation cycles accordingly) can alert you to symptoms of ovulation dysfunction, which include:
- Irregular menstruation
- Excessive or light menstruation
- Lack of menstruation
- Lack of cervical mucus
- Irregular basal body temperature (BBT)
Experiencing menstruation does not necessarily mean a woman is ovulating normally.
Causes of Anovulation
Polycystic ovarian syndrome (PCOS) is the most common cause of anovulation. Other potential causes of ovulation dysfunction include:
- Being overweight or underweight
- Exercising to an extreme degree
- Low ovarian reserves
- Thyroid dysfunction
- Abnormally high stress levels
- Premature ovarian failure
The team at Pacific Fertility Center will use a variety of methods to diagnose anovulation, including:
Reviewing the patient's medical history to determine if the woman menstruates on a normal cycle.
Blood tests for levels for progesterone in the second half of a cycle. This is when the hormone surges to levels of 5 to 20 ng/ml.
Performing a postcoital test, which involves taking a sample of cervical mucus soon after intercourse.
Performing an ultrasonography, typically intravaginal, to have a clear image of the reproductive tract and detect potential abnormalities. This tool is also used to monitor follicular development before ovulation.
Having an endometrial biopsy, or a tissue sample, taken from the endometrium (uterine lining). By studying the thickness and other qualities of this tissue, it can be determined if ovulation has occurred and if the endometrium is healthy enough to support egg implantation and fetal growth.
Treatment for Anovulation
Because many factors influence a woman's hormones and menstrual cycle, there is no single solution for treating anovulation. Often, the underlying cause of anovulation is addressed. For example, lifestyle changes, such as weight loss or stress management, may be advocated by your physician. In many cases, fertility drugs are prescribed to balance hormone cycles and trigger ovulation. The first recommendation is usually Clomid, which initiates ovulation in up to 80 percent of women with anovulatory.