Female infertility: abnormalities of ovulation

When ovulation is absent or irregular

That’s it, you’ve decided to have a baby. But ever since you stopped the pill, you have the feeling that something is wrong. Your period is not coming back. And after reflection, you remember that when you were younger already, you had little problems with your cycles. If these problems continue without becoming pregnant, it is possible that you have ovulation abnormality. This problem is the most common cause of infertility in women. This usually results in irregular, very long cycles, or no cycles at all. But no hasty conclusions! First thing, consult your gynecologist so that he makes an inventory. Your doctor will do an ultrasound to see the condition of your ovaries and, from there, can decide which additional tests to order. To detect whether there is ovulation, you will need to take hormonal measurements (blood tests) and also analyze your temperature curve.

Ovulation abnormalities: what are the causes?

  • The ovary is malfunctioning

Some anomalies are due to a ovarian dysfunction himself. This situation leads to irregular or short menstrual cycles, or no ovulation. Ovarian dysfunction can be total if the ovaries are absent or atrophied following heavy treatment (chemotherapy, radiotherapy). Sometimes it can be a chromosomal abnormality (Turner syndrome) or early menopause (when ovarian reserves are depleted before the age of 40). In these extreme situations, ovulation cannot be restored and the only solution to get pregnant is to turn to egg donation.

  • Thyroid dysfunction

Sometimes you have to look at the side of the thyroid or adrenal gland, when one fails to conceive. Thyroid dysfunction, which manifests as hyper or hypothyroidism, can disrupt hormonal balance and therefore ovulation. Thyroid problems are currently underestimated, while they are on the rise. Hence the importance of being prescribed a complete assessment including a thyroid assessment.

  • Hormonal imbalance

This is the most common situation: hormones are lacking or on the contrary are too abundant. Result: ovulation is impaired or non-existent and the rules, in the same way, are disturbed.

For this type of anomalies, we mainly observe hypothalamus and pituitary hormonal imbalances. These brain glands produce hormones that regulate a large part of our body. Sometimes they do not or insufficiently secrete the hormones essential for ovulation to take place. This is the case, for example, when there is insufficient production of FSH (stimulates the development of follicles) and LH (causes ovulation), or when LH levels are higher than FSH levels (when it is normally the other way around). In these cases, there is often a higher than normal production of male hormones (testosterone, DHA). This disorder can be manifested in particular by problems withhyperpilosité. This is often the case in the context of polycystic ovary syndrome, where the LH is too high.

Polycystic or multi-follicular ovaries.

This is both the cause and the consequence of the hormonal imbalances mentioned above. The woman presents a too many follicles (more than 10 to 15 at an advanced stage, on each ovary) compared to the average. There is none that matures during a menstrual cycle. This results in an absence of ovulation.

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