In order to become pregnant on their own, women must ovulate. That is, they must
mature and release an egg. There are a number of problems which can cause women not to ovulate
or to ovulate infrequently or irregularly. Some of these problems require treatment by a doctor.
Some of the problems that you can fix yourself.
Today on Infertility TV, I am going to discuss both types. At the end,
I will tell you what to do if all of these treatments fail and you still are not ovulating.
First some problems that you can fix yourself
Number 1. Being overweight is the most common cause for not ovulating
that I see in my practice in the USA. How does this happen? There are several
mechanisms that cause overweight women not to ovulate. Without getting too complicated,
being overweight can interfere with the hormonal control of the ovaries from the hypothalamus and
pituitary gland. The cure for this problem is easy! Weight loss. It doesn’t have to be a huge
amount either. Some studies found that losing only 5% of your total body weight can restore
ovulation and allow women to become pregnant without the use of fertility medications
Number 2. Being underweight. Although not as common, being underweight can also cause you to
stop ovulation. This is likely due to low levels of a hormone called leptin which is produced in
fat cells. If your percentage of body fat gets too low, your leptin levels drop and ovulation stops.
This fix here, of course, is weight gain which can be as difficult to accomplish as weight loss.
Number 3 Too much exercise. Even if you have a normal weight, too much exercise can cause your
ovulation to stop. This is due to the fact that your body needs energy to run properly.
That energy comes from the food you eat. Vigorous exercise can cause you to burn more energy than
you eat. This results in an energy deficit. Running, especially long distance running,
figure skating, aerobics, dancing, especially ballet dancing are all common causes for this
problem. It is less commonly seen in swimmers. The way to fix this problem is to correct the
imbalance. This can be done in two ways: Increasing the amount of calories you eat
or decreasing the amount of exercise you perform. Decreasing exercise can
mean decreasing the intensity of exercise or decreasing the length of time you are doing it.
Now for some problems that you need a doctor’s help to fix
Number 1 - Your prolactin levels are too high. Prolactin is a hormone produced from
your pituitary gland. Unless you are pregnant or nursing, your prolactin levels should be low.
If your levels are high, that will interfere with ovulation. You will need a blood test with
your doctor to measure your prolactin levels. If your levels are high, then you will need
medication to bring the levels down to normal. This is a very successful method for getting
ovulation to return. For more detailed information about prolactin, watch this excellent video.
Number 2 - Thyroid problems. The thyroid gland produces hormones that maintain
all of your body functions - including ovulation. However, if your thyroid starts producing too much
of those hormones or too little, your ovulation can be affected. Having an underactive thyroid,
which is called hypothyroidism is far more common in women but either problem
can interfere with ovulation. Like the problem with elevated prolactin,
a thyroid problem diagnosis requires a blood test called TSH. If your thyroid is underactive,
you need to take additional thyroid hormone which is given as a pill. If your thyroid is overactive,
it is sometimes treated with medication but occasionally other types of therapies are needed
Number 3 - Polycystic Ovary Syndrome - This problem, which is commonly referred to as PCOS,
is the most common cause for ovulation problems. Here are some important things to know about PCOS.
It can be difficult to diagnose. There isn’t a single blood test or symptom that all women
with PCOS are going to have. Doctors will look at a list of different blood tests,
ultrasounds, signs and symptoms that women with PCOS can have.
The more of these you have, the more likely it is that you have PCOS. There is no cure
for PCOS. There are treatments however that can help improve the chances for ovulation.
Many women with PCOS have a problem called insulin resistance. Taking a medication to reduce
insulin resistance called metformin can restore ovulation in many, but not all women with PCOS.
There are many causes for ovulation problems that I have not yet discussed.
What if your doctor has been unable to identify that cause for your ovulation problem?
What can you do if you are treated for an ovulation problem but you still are
not ovulating? Luckily, we have medications to help women to ovulate even when we dont
know the cause of the problem. We call these fertility medications and there are two types:
pills and injections. Fertility medications can be a very successful way to ovulate and get pregnant.
The biggest downside is that they will increase the chances for having a higher risk multiple
pregnancy so if you can ovulate by fixing your problem that is always the best course.
In addition to hosting InfertilityTV every week, I am a practicing physician. If you would like to
have a one on one consultation with me by video, check out my website at ivf1.com. Otherwise,
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