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Anovulation: A Very Treatable Cause of Women’s Infertility

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a blog by Jane Frederick, M.D., HRC Fertility, June 20, 2011

Many women come into my office frustrated after a year of trying to get pregnant, and are surprised to learn that they are not ovulating properly. "But doctor," they say, "I get my period every month."

Anovulation May Be the Problem

While you may still get your period, your ovary is not releasing a ripened egg. This affects pregnancy rates because an egg needs to ovulate in order to fertilize with sperm and implant in the uterus. In fact, about 40 percent of infertility in women is related to cycles that do not ovulate.

Anovulation can be caused by a number of things, including diet and exercise, obesity and advanced maternal age, but the most common cause is polycystic ovary syndrome (PCOS), a condition in which there is an imbalance of a woman's female sex hormones.

So how do you know if you are not ovulating? Usually, women who are not ovulating properly will have irregular periods. Is your period scant or very heavy? If your cycle is short (for example only 21 days), or long (more than 35 days), it may indicate ovulation dysfunction.  

How Is Anovulation Treated?

The good news is there are many successful treatments available for women of all ages. In a young patient, a hormonal imbalance can usually explain the reason for a cycle to not ovulate. The female hormones — estrogen and progesterone — are uniquely coordinated in the ovary to produce an egg for ovulation.  A synchrony exists between the brain and the ovary that allows the egg to develop normally and the uterus to be receptive to the fertilized egg for implantation. Hormones such as Clomid or FSH can be given to the patient to help her ovulate and produce a pregnancy. 

In an older patient, over 40, the reason for not ovulating may be related to the fact that she is undergoing an early menopause, and the eggs that remain are few. Ovulation medications like FSH can be given to maximize the pregnancy rate as well.

If you are experiencing difficulty trying to get pregnant and have irregular periods, you should immediately seek the help of fertility doctor (reproductive endocrinologist). Do not delay treatment. You may discover an easy fix for a common, yet frustrating problem.


Jane Frederick, M.D., has practiced in California since 1990. Dr. Frederick is board certified in both Reproductive Endrocrinology/Infertility and Obstetrics/Gynecology from the University of Southern California. At HRC Fertility in Orange County she developed a diverse clinical practice in reproductive surgery, IVF, and the genetic screening of embryos. She has also held many posts with organizations active in the advancement of reproductive medicine including the Pacific Coast Reproductive Society (Past President), and the American Society of Reproductive Medicine. In addition, Dr. Frederick has received a variety of honors for her outstanding work in the field including Distinguished Service to PCRS 2006, Castle Connolly Top Doctor 2009, Orange Coast Top Doctor 2009, and Top Doc Los Angeles 2011. Dr. Frederick provides state-of-the-art treatment with a great deal of personal attention and care to her patients. She has helped thousands of individuals worldwide achieve their dream of having children.

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Comments (2)

hi my name is farhana & i m trying for a baby from a year,bt no luck,in last year sep i got married & by the same month my periods start gtng irregular i thought 1st may b it z bcz of stress of marriage bt recently i went to gynaecologist & he gve me sum test to b done which showed i m suffering fromhyperprolactinaemia & hypothyrodism plz sugest what to do now???

i have tried fo r more than fifteen years in vain i went for a laproscopy as a newly wed nothing happ[ened and wend again but in vain my husband passed away now im 43 i went for a scan was told that my tubes are blocked now im having irregular periods i dont know what next.

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