Irregular periods are a common issue among menstruating women. It can interfere with a woman’s fertility and her attempts at pregnancy. Are you aware of ovulation disorders? These disorders can affect a woman’s ovulation in multiple ways and interfere with her fertility. It can lead to infertility too. Want to know more? Read on!
Ovulation is a time in a woman’s menstrual cycle when the ovaries release a mature egg for fertilisation. If the sperm enters this egg and fertilises it successfully, the egg will develop into an embryo and implant in the uterus, leading to pregnancy.
Ovulation usually occurs around the 12th – 14th day before the next period is to start. Once the egg is released, it will travel down the fallopian tube. If it meets a sperm, fertilisation can happen. If it doesn’t, the egg is reabsorbed into the body and the endometrial lining (uterine lining) is shed by the uterus, which is your period.
During ovulation, a woman’s cervical mucus changes. It becomes thinner, stretchy and slippery. This can help the sperm travel better and faster to reach the egg. The basal body temperature will also increase during ovulation and return to normal after ovulation.
Ovulation disorder refers to a group of issues with a woman’s ovulation. Ovulation disorder can cause irregular ovulation or total lack of ovulation – which means the ovaries do not release a mature egg.
The endocrine system in a woman’s body produces the hormones that control the ovulation process. When issues or factors affect this endocrine system, it can lead to hormonal imbalances which in turn can lead to irregular ovulation or anovulation (no ovulation). Medications, health issues and even products with endocrine disruptors can cause these issues.
Ovulation disorder is one of the most common reasons for irregular menstrual cycles. According to WHO, it contributes to 25% of fertility issues in couples.
During a woman’s menstrual cycle which is typically 28 days long, the endocrine system will secrete certain hormones at different stages to prepare the body for pregnancy. FSH (follicle-stimulating hormone) and GnRH (gonadotropin-releasing hormone) are mainly responsible for a woman’s egg to mature within her ovary. Once the egg matures, LH (luteinizing hormone) will stimulate the release of this egg into the fallopian tube.
After entering the fallopian tube, the egg will travel down. If it meets a sperm and allows it to enter it, fertilisation can happen, resulting in the formation of an embryo. If a sperm does not enter the egg, no fertilisation happens.
Now, when this ovulation (release of the mature egg) does not happen at the right time for various reasons, there is no mature egg for a sperm to fertilise. Sometimes, the ovulation can happen irregularly – meaning the egg may be released sooner or later than the date calculated, due to hormonal imbalances. This makes it difficult to know when to have unprotected sex so that the sperm can reach the egg. Sometimes, if the hormones are not enough, no egg is released, which is anovulation.
The most common symptoms of ovulation disorder are irregular or absent periods. The common conditions that interfere with a woman’s menstrual cycle are:
● POCS – Polycystic Ovarian Syndrome
● POF – Premature Ovarian Failure
● Early menopause (before the age of 40)
● Excess weight gain or loss
● Very high or low body weight
● Autoimmune disorders
● Cancer treatments
● Genetic disorders
● Hormonal imbalance
● Lifestyle factors
When a woman is suffering from infertility or irregular periods, the doctor will check various hormone levels to confirm if it could be an ovulation disorder. Some hormone levels they will check are:
● FSH Levels – FSH is an important hormone that regulates the reproductive process. This test will help understand if you are reaching menopause early or if your fertility is on a decline.
● AMH Test – This test will check the anti-Mullerian hormone levels in your blood. Low AMH levels indicate a declining ovarian reserve, which means the chances of getting pregnant are also lesser.
● Progesterone Levels – Progesterone prepares the uterus for implantation and also supports the pregnancy. Progesterone levels can indicate if ovulation has occurred.
● Ovaries Ultrasound – An ultrasound of the ovaries can help check the egg reserve and evaluate the functioning of the ovaries.
Ovulation disorder treatment will vary from case to case depending on the severity of the issue and its impact on the woman’s fertility. Some common treatment options include:
● Medications to treat underlying health issues that could be impacting the endocrine system or hormone secretion.
● Hormone Therapy to restore the hormonal imbalance that could be triggering the disorder.
● Ovulation stimulation drugs – oral or injections.
● Surgery to treat conditions like severe endometriosis or PCOS or to remove ovulation obstacles.
Ovulation disorder can be the total lack of ovulation or irregular ovulation, both of which can be very challenging when it comes to fertility. Timely diagnosis and starting appropriate treatment at the earliest can help improve one’s fertility and increase the chances of pregnancy.
Ovulation disorders can be broadly classified into two types – anovulation – no ovulation and oligo-ovulation – irregular ovulation.
Ovulation disorders can be diagnosed by checking various hormone levels through a blood test and by taking an ultrasound of the ovaries.
Yes. If the ovulation disorder is due to very high or low body weight or due to excess weight gain or loss, a few lifestyle changes can help. However, if it is due to hormonal imbalance or other underlying health issues, just lifestyle changes alone may not suffice.
When a woman experiences irregular or no periods, the doctor will take an ultrasound of the uterus and check various hormone levels to confirm a diagnosis.
