Female Infertility: I am not releasing my eggs. What could cause this?

What can cause anovulation - failure to release eggs)?

Failure of ovulation (anovulation) is the cause of infertility in 20 - 25% of couples referred to an infertility clinic. Anovulation may be associated with:

amenorrhoea (absent periods - amenorrhoea) - a successful outcome to treatment can be expected in 95% of patients with infertility.
oligomenorrhoea (infrequent periods - Q6.2). - a successful outcome to treatment can be expected in 75% of patients with infertility.
normal menstrual cycles - there may be evidence of ovulatory problems detectable on ultrasound or serum progesterone levels.
polycystic ovary syndrome (Q7.2) the most common reason for anovulation.
hyperprolactinaemia (high prolactin levels) - diagnosed when the prolactin level is inappropriately elevated (hyperprolactinaemia). Prolactin (hyperprolactinaemia) is the hormone responsible for milk production after childbirth. Breast feeding mothers tend not to see their periods quite as quickly as non-breast feeding mothers as a result of the increased prolactin levels. This is probably nature's way of providing some spacing between pregnancies. In mild hyperprolactinaemia there may be reduced Frequency of periods whereas in severe cases there may be amenorrhoea (Q6.4). Galactorrhoea (inappropriate lactation) is a symptom indicative of hyperprolactinaemia. Ovulatory disorders may be a manifestation of hyperprolactinaemia. Prolactin levels may be slightly elevated in patients with polycystic ovary syndrome and hypothyroidism. Higher levels may be found with pituitary adenomas (tumours) and radiological examination of the pituitary fossa is indicated. Routine prolactin measurement in women with normal menstrual cycles is probably of no value.
premature menopause (Q6.17 ;1) is indicated by cessation of menstruation and repeatedly elevated FSH levels (menstrual cycles- >30IU/L). In the years leading up to the menopause, FSH levels tend to gradually rise.
the 'inadequate luteal phase' is a loose term that has been the subject of an inconsistent definition and recognition. A shortened luteal phase (Q9.17), borderline progesterone estimations (Q9.17), and reduced hormonal effects on histological (microscopic) assessment of the endometrium have all been cited as diagnostic features.
Related Medical Abstracts - Click on the paper title:-
- Is glycosylated haemoglobin a marker of fertility? A follow-up study of first-pregnancy planners. (1999)
- The significance of FSH elevation in young women with disorders of ovulation (1980)
  Please click on the required question.
- 1 What is infertility?
- 2 How prevalent are infertility problems?
- 3 What are the main causes of infertility?
- 4 What are the objectives of our infertility investigations?
- 5 Have there been any noticeable changes in fertility requirements in recent years?
- 6 What is the effect of our age on fertility?
- 7 I smoke cigarettes. Can this have an effect on my fertility?
- 8 Does my weight influence fertility?
- 8A Obesity! How can I lose weight?
- 9 I have fibroids. Could these reduce my fertility?
- 10 I have been told that my womb has an abnormal shape and that was the way that I was born. Could this reduce my fertility?
- 11 I have endometriosis. Could this reduce my fertility?
- 12 I have been told that I have cervicitis or a cervical ectopy (erosion). Could this impair my fertility?
- 13 My doctor tells me that my womb is retroverted (tilts backwards). Could this reduce my fertility?
- 14 I have had an ectopic pregnancy. Does this affect my future fertility?
- 15 We are worried that we may have a fertility problem. What should we do?
- 16 How will our doctor be able to identify the cause of our infertility?
- 17 How can we tell if I am releasing my eggs (ovulating)?
- 18 Investigations have shown that I have a problem releasing my eggs (anovulation). What could be the cause of this?
- 19 How important are my Fallopian tubes in fertility?
- 20 How can we tell if my Fallopian tubes are functioning?
- 21 How can we assess male fertility?
- 22 What is the purpose of a post-coital test (PCT)?
- 23 We have had our infertility investigations and our problem remains unexplained. How can this be?
- 24 What are our chances of achieving a pregnancy?
- 25 Where can I obtain more information?
- 26 Could we have some recommended infertility support groups?
  
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  This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
  
  I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.