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Failure To Ovulate

Ovulatory disorders are one of the most common reasons why women are unable
to conceive, and account for 30% of women's infertility.  Fortunately, approximately 70% of these cases can be successfully treated by the use of drugs such as Clomiphene and Menogan/Repronex. The causes of failed ovulation can be categorized as follows:

(1)
Hormonal Problems
      These are the most common causes of anovulation.  The process of ovulation depends upon a complex balance of
      hormones and their interactions to be successful, and any disruption in this process can hinder ovulation.  There are three
      main sources causing this problem:

  
Failure to produce mature eggs

    In approximately 50% of the cases of anovulation, the ovaries do not produce normal follicles inwhich the eggs can mature.  Ovulation is rare if the eggs are immature and the chance of fertilization becomes almost nonexistent.  Polycystic ovary syndrome, the most common disorder responsible for this problem, includes symptoms such as amenorrhoea, hirsutism, anovulation and infertility.  This syndrome is characterized by a reduced production of FSH, and normal or increased levels of LH, oestrogen and testosterone.  The current hypothesis is that the suppression of FSH associated with this condition causes only partial development of ovarian follicles, and follicular cysts can be detected in an ultrasound scan.  The affected ovary often becomes surrounded with a smooth white capsule and is double its normal size.  The increased level of oestrogen raises the risk of breast cancer.
    
    Malfunction of the hypothalamus


    The hypothalamus is the portion of the brain responsible for sending signals to the pituitary gland, which, in turn, sends hormonal stimuli to the ovaries in the form of FSH and LH to initiate egg maturation.  If the hypothalamus fails to trigger and control this process, immature eggs will result.  This is the cause of ovarian failure in 20% of cases.
    
    Malfunction of the pituitary gland

    The pituitary's responsibility lies in producing and secreting FSH and LH.  The ovaries will be unable to ovulate properly if either too much or too little of these substances is produced.  This can occur due to physical injury, a tumor or if there is a chemical imbalance in the pituitary.

(2) Scarred Ovaries

      Physical damage to the ovaries may result in failed ovulation. For example, extensive, invasive, or multiple surgeries, for
      repeated ovarian cysts may cause the capsule of the ovary to become damaged or scarred, such that follicles cannot mature
      properly and ovulation does not occur.  Infection may also have this impact.

(3) Premature Menopause
      This presents a rare and as of yet unexplainable cause of anovulation.  Some women cease menstruation and begin
      menopause before normal age.  It is hypothesized that their natural supply of eggs has been depleted or that the majority
      of  cases occur in extremely athletic women with a long history of low body weight and extensive exercise.  There is also
      a genetic possibility for this condition.

(4) Follicle Problems

     Although currently unexplained, "unruptured follicle syndrome" occurs in women who produce a normal follicle, with an egg
     inside of it, every month yet the follicle fails to rupture.  The egg, therefore, remains inside the ovary and proper ovulation
     does not occured.
common causes of female fertility

Common
Causes of
Female
Infertility

Information courtesy of Stanford University
To read more on the causes of female infertility