Diagnosing Infertility
Ovulatory Disorders
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Ovulatory disorders are the most common form of infertility in women. Affecting nearly 40% of women in child-bearing age, ovulatory disorders directly affect the ovaries' ability to release the egg. Symptoms may include the absence of regular periods, called anovulation, or irregular menses due to a hormonal imbalance, severe stress, high endurance or excessive exercising, extreme weight (both over and under), thyroid dysfunction, insulin resistance and eating disorders.
Anovulation is a condition in which a woman's eggs fail to develop properly, and/or are not released from the follicles of the ovaries. Women who have this disorder may not menstruate for several months. Others may menstruate, but not ovulate.
How is an Ovulatory Disorder Diagnosed?
To diagnose an ovulatory disorder, Dr. Zoneraich and Dr. Larsen will start with a full evaluation of your medical and menstrual history. They will also use one or more of the following tests:
- Hormonal Blood Tests – to measure the levels of your key hormones, including FSH (follicle stimulating hormone), LH (luteinizing hormone), E2 (estradiol), and progesterone. Often time male hormone levels (androgens) will also be measured.
- Transvaginal Ultrasound – a scan that uses echoes from high frequency sound waves to see follicles and or cysts in your ovaries. The ultrasound can also be used to evaluate ovarian function.
What Are The Different Types of Ovulatory Disorders?
Ovulation is controlled by complex interactions between numerous endocrine hormones including FSH (follicle stimulating hormone), LH (luteinizing hormone), E2 (estradiol), progesterone and others. The pituitary gland sits at the base of the brain and it produces hormones that control the ovary, the thyroid gland and the adrenal gland. If ovulation is not occurring in a regular, timed fashion, it is likely that the pituitary and the ovary are not communicating correctly.
For women with normal thyroid, prolactin and adrenal hormones that have irregular ovulation may still be diagnosed with polycystic ovary syndrome (PCOS). Read more about polycystic ovary syndrome (PCOS).
A less common ovulatory disorder is hypothalamic amenorrhea. Hypothalamic amenorrhea can develop spontaneously, however, it usually develops when poor nutrition, excessive exercise, or stress alters your signaling to the brain to regulate the menstrual cycle. Read more about hypothalamic amenorrhea.
How are Ovulatory Disorders Treated?
If you are trying to get pregnant and you are having trouble ovulating, Dr. Larsen and Dr. Zoneraich have many options available for you. Common treatments for ovulatory disorders include fertility medications to help induce ovulation. These medications can be either oral medications or injectable medications. Dr. Zoneraich or Dr. Larsen will need to monitor you carefully while you are taking these medications through ultrasound and blood work to see if and when you are ovulating.