What is Ovulatory Dysfunction?

If you have ovaries and are experiencing infertility, you may receive a diagnosis of ovulatory dysfunction. Here’s what that means.

Each cycle the ovaries receive hormone signals which recruit a group of follicles (each containing a premature egg cell) and allow them to start growing. One follicle from this group will grow more than its peers and become the dominant follicle, which will grow the egg until it’s mature and ovulated. You need to ovulate a mature egg to give it the opportunity to fertilize, develop into a viable embryo and implant into the uterus. Ovulation is a prerequisite to getting pregnant without intervention.

Infertility or subfertility that is caused by ovulatory dysfunction means that there is an issue within ovaries that is preventing the egg from developing and being ovulated. The follicle cells can have problems nourishing the egg and therefore it can’t grow very well. There can also be issues with different hormones and this can affect the ability of the egg to mature and to prompt ovulation. 

What Are the Signs and Symptoms of Ovulation? →.

What are the causes of ovulatory dysfunction?

Causes of ovulatory dysfunction are generally hormonal in nature and can be grouped into three categories:

1. Hypo-hypo: The signalling from the pituatary to the ovaries is too weak. This can be due to breastfeeding, extreme stress, malnutrition or significant thyroid dysfunction.
2. Hyper-hypo: The signalling from the pituitary to the ovaries is fine, but the ovaries are unresponsive. This could be due to menopause or premature ovarian insufficiency.
3. Normo-normo: Commonly referred to as a hormonal imbalance, and the main culprit is PCOS.

One of the tests we use to assess ovarian function is a blood test for follicle stimulating hormone (FSH), typically done on cycle day three. This is a blood test that tells us how responsive the ovaries are. If FSH is too high, it means this hormone signal isn’t registering with the ovaries and therefore they’re not using FSH to recruit or grow the follicles. FSH levels will continue to rise during perimenopause and will be the highest during menopause.

What is the typical treatment for those with ovulatory dysfunction who wish to conceive?

There’s no standard treatment for those with ovulatory dysfunction; the treatment will largely depend on the cause.