How Ovulation Issues That Affect Fertility Are Treated at Cape Fertility
In this article, we outline the leading causes of ovulation issues and provides expert insights into what causes these ovulation problems, how they impact your fertility, and how they can be managed effectively.
When menstrual cycles are inconsistent or periods become unusually short or prolonged, it often signals an issue with ovulation. In some cases, women may experience only a few periods each year—a typical symptom of disrupted ovulation.
One of the easiest ways to identify if ovulation is occurring regularly is to observe the menstrual cycle. A regular cycle generally suggests ovulation is taking place, which happens around 14 days before the start of a woman’s next period.
If you are not ovulating regularly, your chance of falling pregnant is significantly reduced.
Key Causes of Ovulation Issues
There are several different reasons why ovulation may be affected. While polycystic ovarian syndrome (PCOS) is the most prevalent cause, other factors such as early menopause, pituitary gland dysfunction, thyroid disorders, and certain medications also play a role.
Polycystic Ovarian Syndrome (PCOS)
PCOS accounts for most ovulation disorders, being responsible for approximately 80% of such cases. Women with PCOS often have irregular cycles, and may also deal with weight gain, excess hair growth, acne, and an increased risk of high blood pressure and diabetes.
Fortunately, PCOS is manageable. For those trying to conceive, the goal is to restore ovulation. The process usually begins with weight loss, as even a modest reduction of two to three kilograms can significantly improve chances of pregnancy.
Following this, oral medication such as Clomid or Letrozole (Femara) is prescribed to encourage ovulation by stimulating the pituitary gland to release follicle stimulating hormone (FSH). In some cases, medications for insulin resistance and diabetes may also be required.
If oral treatments are not effective, hormone injections may be used. For most women with PCOS, medication alone is often enough to achieve pregnancy, and more intensive fertility treatments like IVF are not immediately necessary. In rare cases, surgical interventions on the ovaries may be considered.
Pituitary Gland and Hypothalamus Issues
Disorders involving the pituitary gland or the hypothalamus—the area above it—can also interfere with ovulation. These structures are responsible for producing FSH, which helps follicles in the ovaries grow. When the pituitary gland does not produce adequate FSH, follicle development and estrogen production decline, leading to irregular or absent periods and a higher risk of osteoporosis.
Causes include genetic factors and very low body fat, often due to eating disorders or extreme athletic training. In teenage girls, damage from eating disorders can sometimes be irreversible, while in athletes, reducing intense training can help restore normal function.
Treatment typically involves FSH and LH (luteinising hormone) injections to stimulate follicle development. With proper monitoring via ultrasound, ovulation can often be restored without the need for advanced assisted reproductive therapies.
Low Ovarian Reserve or Early Menopause
A reduced ovarian reserve—meaning a lower quantity of eggs—can also result in ovulation problems. This condition, also known as early menopause or premature ovarian failure, may be caused by genetic factors, prior cancer treatments, or ovarian surgery. Since women are born with all the eggs they’ll ever have, the supply gradually diminishes over time, typically ending at menopause around age 50.
Unfortunately, there is no way to reverse a low ovarian reserve. In such cases, donor egg IVF is often the only viable treatment. This involves fertilising a donated egg and transferring the resulting embryo into the uterus of the intended mother.
Elevated Prolactin Levels
Prolactin, a hormone released by the pituitary gland, can also influence ovulation by inhibiting the production of FSH and GnRH or Gonadotropin-releasing hormone. Elevated prolactin levels can disrupt menstrual cycles and impair fertility.
Two primary causes of high prolactin levels are pituitary tumours, detectable via MRI or CT scans, and certain medications, especially advanced antidepressants.
Thyroid Disorders
Thyroid dysfunction is another frequent contributor to ovulation difficulties, and women are up to five times more likely than men to experience thyroid-related problems.
Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can affect fertility. Hyperthyroidism can lead to weight loss, rapid heartbeat, and anxiety, whereas hypothyroidism may cause fatigue, weight gain, and heavy or irregular periods.
Thankfully, thyroid conditions are easily diagnosed with blood tests and are usually manageable with medication. In more complex cases, an endocrinologist may be consulted.
Comprehensive Treatment at Cape Fertility
If you’re experiencing challenges with ovulation, our team at Cape Fertility is here to help. We offer a full range of fertility services, including diagnosis and treatment of all ovulation-related conditions.
At Cape Fertility, we :
- Value each individual patient
- Deliver individualised and personalised care
- Always strive for higher success rates
Make quality fertility treatment affordable
Arranging your initial consultation with our team is as simple as contacting us here.