Ovulatory dysfunction refers to a condition where the ovaries do not release eggs regularly, making it difficult for women to conceive. This can be caused by hormonal imbalances, polycystic ovary syndrome (PCOS), or other medical issues. Women with ovulatory dysfunction may experience irregular or absent menstrual cycles. Ovulatory problems account for 20 to 30% of infertility cases.
Dr. Norbert Gleicher explains ovarian aging.
One of the most common causes of ovulatory dysfunction is aging ovaries. In the decade leading up to menopause, the number of eggs in a woman's ovaries declines significantly, and when egg reserves fall below a critical level, menstrual cycles often become irregular. The eggs that do mature during this period are less likely to lead to a successful pregnancy. Women with prematurely aging ovaries may require higher doses of fertility medications to stimulate ovulation. At the Center for Human Reproduction, we offer specialized programs to address this condition. Hormonal imbalances can also cause ovulatory dysfunction. Conditions such as polycystic ovary syndrome (PCOS) lead to irregular menstruation due to excess androgen production. Women with PCOS often experience weight gain, acne, and infertility. Treatment options include medications like metformin and clomiphene citrate (Clomid), which help regulate ovulation.
Other factors contributing to ovulatory dysfunction include stress, thyroid disorders, and high prolactin levels. Physical or emotional stress, such as extreme weight loss or intense exercise, can disrupt ovulation temporarily. Thyroid issues, whether an overactive or underactive thyroid, can also interfere with ovulation, but proper treatment of the thyroid condition often restores normal cycles. Elevated prolactin levels, typically associated with lactation, can cause irregular periods or the absence of menstruation altogether. This condition may require medical imaging to rule out pituitary abnormalities, and medication is often used to regulate prolactin levels. Lastly, some women are born with abnormal ovarian development, preventing them from producing eggs, leading to the absence of periods and a lack of puberty development.
The good news is that many ovulatory problems can be effectively treated, and once ovulation is restored, the chances of pregnancy return to normal. For women with ovarian aging or abnormal ovarian development, egg donors can offer an opportunity to achieve pregnancy. The medications used to treat ovulatory dysfunction vary depending on the cause and may include fertility drugs like clomiphene citrate, injectable medications such as recombinant FSH, and human chorionic gonadotrophins. In cases of hyperprolactinemia, medications like bromocriptine or cabergoline may be prescribed. If you’ve been trying to conceive for over a year and suspect ovulatory dysfunction, contact our center in New York City to schedule a consultation for our treatment program.
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