Anovulation
A Menstrual Problem Which May Affect Your Fertility
What anovulation is, how it may affect your fertility and the types of treatment available to you.
What Is Anovulation?
In order to get pregnant, a woman should have a period between once every three weeks and once every six weeks. The average is every four weeks. The egg which is released is then lost in the menstrual flow, if not fertilized.
If ovulation doesn't take place, this usually means a woman will not menstruate, but in some cases regular periods will occur without ovulation. Sometimes ovulation will be sporadic and not occur during every cycle. This is known as anovulation.
It can make conception difficult because there will be fewer cycles in which it is possible to get pregnant.
What Causes Anovulation?
There are a variety of factors which can cause anovulation, including:
- Hormonal problems
- Thyroid problems
- Pituitary problems (a disorder with the central gland in the brain)
- Polycystic Ovarian Syndrome (PCOS)
- Eating disorders such as anorexia or being overweight
- Drug use - either prescription drugs or illegal drugs. If you are taking prescription drugs, please consult your doctor before attempting to get pregnant
- Stress, such as work pressures or a death in the family can disrupt your cycle
- Breast feeding. If you already have a baby and you are breast feeding, your periods may not return for many months. This is because you are producing the pro-lactin hormone (which is responsible for the production of milk) and this suppresses oestrogen which in turn stops ovulation and menstruation.
What Treatments Are Available?
If you have failed to get pregnant after at least one year of unprotected sex, you will be offered fertility testing, including blood tests to check your levels of follicle stimulating hormone (FSH). You may be offered ultrasound or a laparoscopy to rule out problems with your womb such as blockages of the tubes and your partner will be offered sperm tests and hormone tests to rule out male factor infertility.
If anovulation is suspected, a full history will be taken, including your diet and lifestyle. You may be advised to cut back on junk foods and relax more, or to stop smoking if you smoke. If you have a baby, your course of action may simply be to wait until your cycle regulates itself.
If you are taking medication, your doctor may be able to find you an alternative medication which is more compatible with your cycle.
Drug therapy is a possible treatment if your anovulation is not due to any lifestyle factors, for instance, Clomid to induce ovulation.
Pre-conceptual hormonal contraceptives may be used to regulate your periods, for example, the pill or depo provera injections. Once you are menstruating every month you can then start trying to get pregnant.
Sometimes a more radical treatment - surgery on the ovaries - is needed, but your fertility specialist will be able to discuss all your options with you.
