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Infertility due to ovulation problems
Anovulation - "Egg release" or ovulation disorders
Advanced Fertility Center of Chicago
IVF Specialist Clinic
Gurnee & Crystal Lake, Illinois
Our IVF Success Rates Our IVF Pricing Plans
Medication treatments for ovulation problems Polycystic ovary syndrom
Background on normal ovulation
An ovarian follicle is the home of the egg until it is released at the time of ovulation. As a follicle develops and grows in size through the menstrual cycle a fluid cavity enlarges within it. The egg is attached to the wall of the follicle. Ovulation is the process of rupture of the mature follicle and release of the egg. With follicle rupture, the egg detaches from the wall and is released with the fluid. The fallopian tube is then supposed to pick up the egg and, if all goes well (for those wanting to be pregnant), the sperm and egg have a productive date in the woman's fallopian tube - and baby arrives 81/2 months later.
Ultrasound picture of a polycystic ovary, circled in blue
Many small, immature follicles (black circles) are seen around periphery of ovary
Follicles here are less than 10mm in diameter - they are not growing to mature size
Ovary circled in blue
The black area inside the circle is the fluid of the mature
follicle
Follicle here is 20mm diameter - ready for ovulation
In an average 28 day menstrual cycle, ovulation usually occurs on day 14, with day 1 being the first day of menstrual bleeding. If a woman has cycle lengths that are shorter or longer than 28 days, then the day of ovulation will usually be 14 days before her next period. So if she has a 26 day cycle length, then her ovulation should be on about day 12 and if she has a 32 day cycle, the ovulation is about day 18. The length of time it takes a follicle to mature and ovulate is somewhat variable in different women (and in different cycles in the same woman), but the number of days from ovulation to the next period is much less variable and should be close to 14 days in everyone.
Developing follicle during a 28 day cycle with ovulation on day 14
Menstrual cycle days are shown at the bottom
Some women do not properly develop and release a mature egg every month - they do not ovulate regularly. We call this condition anovulation. Some women never develop and release an egg without medication - we say they are anovulatory. These women will have no menstrual periods for several months or years at a time. The medical term for this is amenorrhea - lack of menstrual periods. Often, when they do have a period it is quite heavy. In some cases, the woman may even require medical attention because of the degree of blood loss.
Some women will ovulate occasionally, for example once or twice a year and need medication to stimulate egg development and ovulation to occur more regularly in order to increase their chance for getting pregnant.
Diagnostic testing for ovulation disorders
Usually the doctor can tell from discussing the details regarding previous menstrual cycles whether there is likely to be an ovulation disorder. In addition, blood testing and ultrasound studies of the ovaries at various times of the menstrual cycle can clarify whether ovulation is occurring.
Polycystic ovarian syndrome is a very common cause of anovulation and infertility. When it is suspected, additional testing may be indicated.
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Laparoscopic image of an enlarged, polycystic ovary No mature follicle seen |
Picture of a normal ovary close to ovulation Mature follicle seen above the X (looks like a blister) U= uterus, T = tube |
Treatment of ovulation problems and polycystic ovaries
Treatment for ovulation disorders and / or polycystic ovaries using fertility medications, as well as pregnancy rates for women with ovulation disorders are discussed on the induction of ovulation page. In general, cumulative pregnancy success rates are high with treatment from a fertility specialist for couples where the only fertility problem is an ovulation problem. If the female age is under about 38, it is usually more a matter of which fertility medications and treatment regimens will end up being successful - rather than whether anything will ever work.
