Ovulatory Dysfunction or Failure
Ovulation is the release of an egg from a follicle in the ovary. After ovulation, the egg is hopefully picked up by the fallopian tube where it can then be fertilized by the sperm. Ovulation usually happens approximately 12-16 days into the menstrual cycle. If pregnancy fails to result, ovulation is typically followed by a menstrual period 12-14 days later.
Ovulatory dysfunction includes any disorder in which ovulation fails to occur, or occurs on an irregular basis. Because many things can cause failure of ovulation, ovulatory dysfunction is one of the leading causes of infertility.
Ovulatory dysfunction can usually be diagnosed just by taking a medical history
When normal ovulation does not occur, there will typically either be no menses or irregular vaginal bleeding. In a normal menstrual cycle, a series of precise hormonal fluctuations causes the uterine lining to thicken. In the absence of pregnancy, hormone levels fall – which leads to shedding of the entire uterine lining. Therefore, unlike women who ovulate regularly, women with ovulatory dysfunction typically have irregular menstrual cycles. This irregularity can vary from simple prolongation of the cycle (35+ days vs. the normal 26-30 days) to occasional bleeding (every other month or every few months), to no bleeding at all. Women with ovulatory dysfunction can even have continual bleeding for weeks or months at a time.
Anovulation is the complete lack of ovulation. Women who have anovulation may never bleed, bleed occasionally, or have periods of continuous bleeding.
There are many possible causes for anovulation including rigorous exercise, eating disorders, abnormalities of the pituitary gland, and genetic problems.
Oligo-ovulation is a disorder in which ovulation happens occasionally. Menstrual cycles are typically longer than normal (once every 40 or 90 days for example).
Testing should be done to verify or determine the cause of irregular cycles and ovulatory dysfunction. The testing may include an FSH, a progesterone level, a vaginal ultrasound, thyroid testing, and a prolactin level.