Causes of Ovulatory Disorders
Women are born with all the eggs they will have for a lifetime and one is usually ovulated during each monthly menstrual cycle. As women age, infertility increases as ovarian function begins to decline until menopause, where no more eggs are released and FSH levels are very high. Ovarian failure means that the ovaries cannot produce eggs that will normally fertilize and develop. Day 3 FSH levels are elevated in these patients and response to the clomiphene citrate challenge test is abnormal. Ovarian failure may occur early in some women. These women are often candidates for HRC's donor egg program.
Polycystic Ovarian Syndrome (PCOS)
PCOS is a common condition characterized by elevated androgens (male hormone), reduced insulin sensitivity, and numerous cysts on the ovary. Elevated androgens can lead to infrequent or irregular ovulation.
Abnormally high (hyperthyroidism) or low (hypothyroidism) levels of thyroid hormone can cause irregular ovulation thought to be due to the high levels of estrogen associated with these conditions.
Prolactin is responsible for breast milk production in pregnant women. Elevated levels of the hormone prolactin can lead to ovulatory disorders and infertility. Elevated levels in the absence of pregnancy cause irregular ovulation by reducing the levels of FSH and LH.
Androgens are produced by the adrenal glands and abnormally elevated levels lead to oligoovulation. Increased androgens are associated with elevated levels of prolactin, and/or tumors on the ovary, pituitary, or adrenal gland.
Excessive exercise, stress, and anorexia can also lead to irregular ovulation. Sometimes eggs will not fertilize and develop into health embryos for unexplained reasons. In many cases, these couples achieve pregnancy with donor egg in vitro fertilization (IVF).