Ovulation Disorders and infertilityDr Chaithra S.K
Ovulatory disorders are one of the leading causes of infertility in women and can occur when ovulation is disrupted or absent. Such women experience irregular or absent periods. The foremost common causes of ovulatory problems are hormone imbalance within the body.
There are several causes of ovulation disorders. Some are caused by hormonal problems when the pituitary gland in the brain doesn’t release the proper hormones. It could also be due to an imbalance in the hormone levels due to stress, diet, exercise, radiation, or a condition called polycystic ovarian syndrome (PCOS), which causes eggs to be released at irregular intervals or stop releasing eggs. Issues with the ovaries may cause other ovulation disorders. For example, some women are born with no ovaries or have ovaries that fail prematurely (premature ovarian failure). Others have ovaries that are immune to the consequences of hormones, and thus, the eggs don’t develop (ovary syndrome) or ovaries that are damaged by medication, radiation, or surgery.
How do Ovulatory disorders affect fertility and the ability to conceive naturally?
Infertility problems happen when you stop ovulating or if the ovulation process is disrupted. This makes it difficult, if not impossible, for you to conceive. The body prepares for pregnancy by secreting hormones during a normal cycle. Some of them are
• Gonadotropin-releasing hormone (GnRH)
• (FSH) Follicular Stimulating Hormone
• (LH) Luteinizing Hormone
GnRH and FSH are the hormones liable for causing an egg to mature within a woman’s ovary. LH spurs the eventual release of the mature egg (ovum) into the Fallopian tube, where a man’s sperm fertilizes it.
Though cycle lengths vary, women who ovulate regularly tend to possess a cycle that’s 28 days long and ovulate once during these 28 days. Women with hormone imbalance or hormone deficiencies experience infrequent or absent ovulation (anovulation) and infertility as a result. Ovulation disorders are a spectrum of conditions that affect a woman’s body. The endocrine system controls the woman’s hormones and ovulation patterns, which is how the ovary releases the egg during the cycle. Ovulation disorders can cause infrequent and irregular ovulation, also anovulation or the absence of ovulation, which can be a standard explanation for irregular menstrual cycles. Some lifestyle factors, medications, conditions can affect hormone levels and cause an ovulation disorder. As per the WHO, 25% of infertility cases in couples are due to disordered ovulation.
Ovulation disorder symptoms & diagnosis
Abnormal menstrual cycles are usually frequent or infrequent periods, or irregular cycle lengths are generally the most unambiguous indication of an ovulation disorder being present. Or there could even be regular menstrual cycles and still not be ovulating. A doctor diagnoses ovulation disorders by discussing the patient’s previous menstrual cycles. Blood tests and ultrasound studies of the ovaries will clarify whether ovulation occurs.
Different types of ovulation Disorders
Some medical issues which cause ovulatory disorders are
Polycystic Ovarian Syndrome (PCOS): The precise explanation for PCOS is probably the hormone imbalances affecting a woman’s androgen (testosterone) levels and insulin receptivity. Low levels of insulin receptivity can cause an increase in blood glucose levels and lead to a rise in testosterone. Testosterone is produced naturally in women. In women with PCOS, there will be elevated testosterone levels. They can experience irregular or absent periods, anovulation, and have ovarian cysts – the production of multiple cysts that block ovarian follicles from producing mature eggs. Testosterone excess can disrupt ovulation and cause infertility. Other symptoms of PCOS include excessive hair on the face, chest, stomach, and upper thigh, weight gain, severe acne and oily skin, male pattern baldness, irregular periods, amenorrhea or no period, and severe pelvic pain.
Hypothalamic amenorrhea: FSH and LH are the key hormones essential to obtaining pregnancy. During the cycle, the pituitary releases FSH to signal to the ovaries that a follicle must mature into an ovum. Women with hypothalamic amenorrhea have irregular or absent ovulation because their bodies don’t have the nutrients or fat content, which helps send hormone impulses to the ovaries. Excess stress, high or low weight, and excessive weight gain or weight loss can contribute. Hypothalamic amenorrhea is common in professional athletes, dancers, and ladies with anorexia nervosa.
Hypothyroidism/Hyperthyroidism: High or low hormone levels can cause ovulatory disorders, and a simple biopsy can help diagnose.
Hyperprolactinemia: Prolactin is a hormone produced by the pituitary gland, and an excess of prolactin may cause hyperprolactinemia. Elevated levels of prolactin hormone can cause ovulatory disorders. A lot of prolactin reduces estrogen levels, causing infertility. Prolactin hormone is responsible for the production of breast milk. The body is deceived with high levels of this hormone in women who aren’t pregnant and stops ovulating, assuming the occurrence of childbirth.
Adrenal dysfunctions: Androgens produced by the adrenal glands and abnormal levels of androgens can cause irregular ovulation. High levels of androgens can, in turn, cause infertility.
Premature ovarian failure & menopause: Premature ovarian failure (POF), also called primary ovarian insufficiency (POI), is the onset of menopause before 40. In premature ovarian failure and menopause, the ovaries stop producing Estrogen. Premature ovarian failure typically occurs because the body has “run out” of functioning ovarian follicles (the sacs that grow to be eggs) early or the ovarian follicles are working improperly. A woman’s body produces less estrogen as she grows old, but the cause of premature ovarian failure is still not known. Women with autoimmune disorders who received chemotherapy or radiation or have certain genetic diseases are more likely to experience premature ovarian failure.
Some women may experience ovulatory problems even if they do not have medical issues. Excess stress, high or low body weight, and excessive weight gain or weight loss can contribute to. Certain factors such as being overweight, a woman’s level of activity, and medication use can affect hormone levels and cause infertility—women who are overweight or obese experience hormone imbalances that impact their ability to conceive.
Side Effects of Medication
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can affect ovulation when taken for extended periods. Steroids, even prescribed by a doctor for medical use, interfere with ovulation hormones, as do some epilepsy medications. Many contraception methods use hormones that interfere with the ovaries’ ability to form and release eggs.
Eating disorders, severe stress, excessive weight loss, weight gain, and excessive exercise can affect ovulation. Eating healthy and regular exercise is essential. Avoiding too much or too little activity can affect ovulation.
Diagnosing and treating ovulation disorders
Ovulation disorders are diagnosed with a detailed case history, menstrual history, and physical examination. But other diseases require laboratory blood testing for further diagnosis. Based on the symptoms, doctors will test for different hormone levels. For instance, if a lady has PCOS symptoms, the doctor will likely push her testosterone and insulin levels.
Once diagnosed, it is essential to make lifestyle changes if ovulation has been affected by one of the factors related to lifestyle; most ovulation disorders are often treated with lifestyle changes or medication. Eating healthy and regular exercise is essential, and too much or too little exercise can affect ovulation. Some prescription medications can alter ovulation. It is necessary to eliminate medications with the prescribing physician before destroying them. A doctor may advise adjustments in the diet and nutrition, and fertility induction may be done that supplements are missing hormones and stress reduction.
A woman with irregular or no menstruation should regularly see a fertility specialist if she cannot become pregnant within 12 months of unprotected sex (six months if she is over 35 years).
At GarbhaGudi, we treat ovulation disorders using a wholesome approach that addresses both mind and body. Medication can be advised to regulate the menstrual cycle or IVF treatment and programs for managing weight, lifestyle, stress, nutrition, exercise, hydration, and other factors. The treatment will depend on the exact nature of the disorder. Clinicians will advise a tailor-made treatment plan.
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