Ovulation is the process by which the ovary releases an egg and is essential for pregnancy to occur naturally. Ovulation requires appropriate function and release of hormones from the hypothalamus (part of the brain) and the appropriate response of the ovary to these hormones. Ovulatory dysfunction refers to any condition which interrupts regular ovulation.
Testing for ovulatory dysfunction is done by a thorough medical history and laboratory evaluation. Ovulation can be expected in the presence of regular monthly menses and the presence of other monthly symptoms, such as breast tenderness, moodiness, and bloating. The absence of regular monthly menses and the above symptoms may be suggestive of ovulatory dysfunction. Testing for ovulatory dysfunction is performed by checking hormone levels on day 3 and day 21 of the menstrual cycle in addition to other hormonal blood tests. Your provider will evaluate for ovulatory dysfunction as part of your initial fertility evaluation.
Ovulatory dysfunction can occur as the result of many different medical conditions. Any condition which affects the normal cyclical release of hormones from the hypothalamus can cause ovulatory dysfunction. Such conditions include thyroid disease, pituitary disease, stress, malnutrition, eating disorders, and many other diseases. Other diseases associated with ovulatory dysfunction include polycystic ovarian syndrome and premature ovarian insufficiency.
Treatment of ovulatory dysfunction may involve several different medications. If thyroid or pituitary disease is the problem, treatment with medications to restore these hormones to normal levels may result in normal ovulation. Many medications are available which your fertility specialist can prescribe to increase the probability of ovulating. The most commonly used medication for this is clomid, which can result in ovulation about 80% of the time. Other medications your provider may use to help you ovulate include letrazole, metformin, dexamethasone, and gonadotropins. Gonadotropins are hormones given as shots that can also be used to increase the number of eggs that develop. These medications are used in our practice to stimulate the development of many eggs in preparation for IVF. Patients with ovulatory dysfunction typically respond well with gonadotropin usage in IVF.
In summary, ovulatory dysfunction is a common cause of infertility and is screened for in all our patients. Ovulatory dysfunction may be treated effectively by ovulation induction medication or IVF.