Thorough Evaluation for Ovulatory Dysfunction
Every fertility evaluation performed by an Ovation partner physician consists of a thorough evaluation for ovulatory dysfunction. This includes a complete medical history, a physical examination, and frequently, a transvaginal ultrasound examination – plus blood work to evaluate the specific hormones involved with ovulation.
Diagnosis and Treatment for Ovulatory Dysfunction
Ovulatory dysfunction isn’t just one condition. The term refers to a variety of different conditions that cause irregular, rare, or even no ovulation. Fortunately, it is one of the easiest conditions to treat, and the vast majority of patients who receive treatment eventually conceive successfully.
Irregular Periods May Indicate Ovulatory Dysfunction
Most women have regular, ovulatory menstrual cycles that occur about every 26-32 days and may be accompanied by symptoms such as cramping and occasional mid-cycle discomfort.
Women with ovulatory dysfunction do not usually have regular cycles. More commonly, their cycles range from 30-90 days or more, their menstrual cramping is more variable, and they may or may not experience mid-cycle discomfort. Some may experience a milky breast discharge and/or increased hair growth on their face and body.
Important to Know the Cause
When you come to an Ovation partner physician with symptoms suggestive of ovulatory dysfunction, your physician will use your medical history, physical examination and lab results to determine the cause of the problem.
Some of the causes of ovulatory dysfunction include:
- Hyperprolactinemia (increased production of the hormone prolactin from your pituitary gland)
- Hypothyroidism (underproduction of thyroid hormone)
- Hypothalamic dysfunction (underproduction of the pituitary hormones that stimulate egg development within the ovaries)
- Polycystic ovarian syndrome, or PCOS (a complex metabolic syndrome that can be accompanied by resistance to insulin, impaired metabolism of glucose, and overproduction of androgenic, male, hormones)
Treatment Targeted to Cause
An elevated prolactin level may mean a condition known as hyperprolactinemia and a thorough evaluation of your pituitary gland to rule out a tumor as the cause. If a tumor is the cause, it is most likely benign, and it can be treated with medication.
If your blood work reveals a thyroid disorder, such as hypothyroidism, your physician will likely treat you with thyroid replacement therapy.
Your fertility doctor will make a diagnosis of PCOS if you have a chronic failure to ovulate and display excessive androgen production or have evidence of insulin resistance. Treating ovulatory dysfunction caused by PCOS involves the use of clomiphene citrate or gonadotropins, as well as metformin in patients with insulin resistance.
The less common cause of hypothalamic dysfunction is often seen in women with a low percentage of body fat or excessive stress. The most common course of treatment includes clomiphene citrate and/or gonadotropins to induce ovulation.
The causes of ovulatory dysfunction are highly treatable, and the vast majority of patients are able to successfully conceive after treatment. If you would like more information about treatments for ovulatory dysfunction, please contact your physician. We are happy to connect you to an Ovation partner physician fertility center.