'Chronic Anovulation': Causes, Symptoms, and Treatments to Increase Chances of Conception

Chronic anovulation is a condition where the ovaries do not ovulate or release eggs according to the normal menstrual cycle, causing irregular or absent menstruation, which is a major cause of infertility.

 

The main causes are hormonal imbalances (such as PCOS), stress, or abnormal body weight. Treatment can be done by lifestyle adjustment, using ovulation-inducing drugs, or assisted reproductive technology under the supervision of a specialist doctor.

 

What is chronic anovulation?

Anovulation is a condition where the ovulation process stops or becomes irregular. If it occurs consecutively, it directly affects fertility because there are no eggs available for fertilization with sperm.

 

Warning signs to watch for:

     ๐​ Irregular menstrual cycles Menstrual cycles longer than 35 days apart or irregular periods

     ๐ Amenorrhea Menstruation missing for several consecutive months

     ๐ No ovulation mucus No clear, stretchy cervical mucus in the middle of the cycle

     ๐ Stable body temperature Body temperature does not rise after mid-cycle

 

Causes and risk factors

Medically, the cause of anovulation is not only from the ovaries but also related to the brain’s regulatory system.

 

     ๐​ PCOS (Polycystic Ovary Syndrome) The most common cause, caused by excessive male hormones

     ๐ Pituitary gland disorders Causing abnormal secretion of FSH and LH hormones

     ๐​ Chronic stress (Hypothalamic Amenorrhea) Stress causes the brain to suppress ovulation

     ๐​ Abnormal BMI Being overweight or underweight affects estrogen production

     ๐ Thyroid disorders Both hyperthyroidism and hypothyroidism

     ๐ High prolactin hormone levels Affecting abnormal secretion of FSH and LH hormones

     ๐ Pituitary adenoma A benign tumor that disrupts the production of FSH and LH hormones

 

Medical diagnosis and treatment

Treatment should begin by identifying the true cause by a fertility medicine specialist.

 

Diagnostic steps

     1.​ Blood tests to check hormone levels of AMH, FSH, LH, Prolactin, and Thyroid

     2. Transvaginal ultrasound to check the number of antral follicles and ovarian characteristics

 

Treatment approaches

Treatment starts from the identified cause, such as using medication to adjust prolactin or thyroid levels. However, if anovulation persists due to PCOS, additional methods may be necessary.

     ๐ Use of ovulation-inducing drugs such as Clomiphene or Letrozole

     ๐ Hormone injections if oral medications are ineffective

     ๐ IUI or IVF if natural ovulation stimulation does not result in pregnancy

 

Self-care guidelines

Behavioral adjustments can increase success rates by 30-40%

     ๐ Diet control (PCOS Friendly Diet) focusing on low glycemic index foods to reduce insulin levels

     ๐ Exercise regularly but not excessively (Moderate Exercise)

     ๐ Vitamin supplements such as Inositol, Folic Acid, and Coenzyme Q10

 

FAQ: Frequently asked questions about anovulation

 

Q: If menstruation occurs every month, does it mean ovulation definitely happens?

A: Not always. In some cases, bleeding may come from the thickened uterine lining shedding without ovulation.

 

Q: Can chronic anovulation be cured?

A: It can be treated. Most cases can return to normal ovulation after hormone balance adjustment or medication under medical supervision.

 

Source : Phyathai Sriracha Hospital