Every month during the female menstrual cycle, an egg is released from the ovaries into the fallopian tubes in a process called ovulation. Prior to being released, the follicles, containing immature eggs, in the ovaries must grow and develop into mature eggs. In order for conception to be achieved, ovulation must occur.

Ovulatory Disorders:

For many women, eggs may not develop properly or are not released from the ovaries. This absence of ovulation is called ‘anovulation.’

Ovulatory disorders are one of the most common causes of infertility, and account for infertility in 25% of couples.

Monthly menstruation typically occurs every 21-35 days, although it is possible that a woman can have a period but not ovulate. If you have irregular or absent periods, speak with a physician to investigate further.

Causes of anovulation:

  • Low BMI or body weight
  • Excessive exercise
  • Hormonal imbalances
  • Medical disorders
  • Polycystic Ovarian Syndrome (PCOS)
  • Unknown

Investigating ovulation:

It is possible to investigate personal ovulation at home. This can be done by using an ovulation prediction kit and/or charting basal body temperature.

Ovulation prediction kit (OPK): OPK’s measure the luteinizing hormone in urine, with a spike in LH signaling that ovulation will occur within the next 24-36 hours. If you do not experience a spike in LH, ovulation issues may be present.

Basal body temperature (BBT): Using a basal thermometer and carefully monitoring temperature daily, it is possible to determine when ovulation has occurred based on a consistent increase in temperature. Two or three days after ovulation, hormones cause a rise in BBT of 0.4 to 1 degree. During a pregnancy, the BBT remains elevated.

Diagnosing Ovulatory Disorders:

While it is unlikely that all of the below tests will be needed to diagnose anovulation, it is possible that a test will be necessary to confirm a diagnosis.

Follicle Stimulating Hormone (FSH) – A blood test will determine your Follicle Stimulating Hormone level. Low FSH results signal anovulation, while extremely high FSH levels can indicate the onset of menopause.

Progesterone Levels – Through a blood sample, the amount of progesterone in the blood is measured and it can be determined whether or not ovulation has happened. This test must be done on a specific day of the menstrual cycle, after ovulation has likely occurred.

Ultrasound – An ultrasound can assess whether follicles are developing, the amount of follicles present, and the size of the ovaries. Smaller ovaries with very few follicles can indicate a patient is approaching menopause or has diminished ovarian reserve (a diminished egg pool).