Cork Natural Fertility Clinic

Ovulatory Dysfunction

Detecting and predicting your own body's ovulation cycle is key to enhancing your fertility. The "window of opportunity" for conception is much shorter than many people realize; therefore, advance preparation is needed to make the most of that brief time. Some cases of female infertility are caused by ovulation disorders. Disruption in the part of the brain which regulates ovulation can cause luteinizing hormone (LH) and follicle stimulating hormone (FSH). Even slight irregularities in the hormone system can affect ovulation.

This is the single most frequent cause of female infertility and denotes a problem with the monthly release of an egg (ovulation). There are varying causes for ovulatory dysfunction; the most frequent one is Polycystic Ovarian Syndrome (PCOS). Others include:

  • Hypothyroidism, an under-active thyroid

  • Hyperthyroidism, an over-active thyroid

  • Post-partum thyroiditis

  • Thyroid autoimmunity

  • Adrenal hyperplasia

  • Polycystic Ovarian Syndrome (PCOS)

Women are born with two ovaries that contain all of their eggs for a lifetime. Ovulation occurs each month when the ovaries are stimulated by the hormone FSH and eggs are recruited within the ovarian follicles. Once the egg matures it is ovulated and travels through the fallopian tubes to the uterus.

In a normally ovulating female, an egg matures and is released during each monthly menstrual cycle. Anovulation is "lack of ovulation" and oligoovulation is "irregular ovulation" both of which cause infertility. Ovulation is a complex event under the influence of many hormones.

The hypothalamus is a small gland at the base of the brain that, among many other functions, produces gonadotropin releasing hormone (GnRH). GnRH travels through the bloodstream to the pituitary gland where it stimulates the production of follicle stimulating hormone (FSH) and leutinizing hormone (LH).

FSH stimulates the recruitment and development of eggs within the ovarian follicles. As the follicles develop, estrogen production increases which stimulates the development of the endometrium and signals a reduction in FSH production. Approximately twelve hours after the peak estrogen level, the pituitary signals a surge of LH which causes ovulation

Measuring morning body temperature daily can help determine whether and when ovu.lation is occurring. However, this method is often inaccurate and has an error margin of 2 days. More accurate methods include home testing kits, which detect an increase in urinary luteinizing hormone (LH) excretion 24 to 36 h before ovulation, and pelvic ultrasonography, which is used to monitor ovarian follicle diameter and rupture. Also, serum progesterone levels of ≥ 3 ng/mL (≥ 9.75 nmol/L) or elevated levels of one of its urinary metabolites, pregnanediol glucuronide (measured, if possible, 1 wk before onset of the next menstrual period), indicate that ovulation has just occurred.

Irregular ovulation should prompt evaluation for disorders of the pituitary, hypothalamus, or ovaries (eg, PCOS).

Biomedical treatment of ovulatory dysfunction depends on the underlying reason. In luteal insufficiency, the luteal phase is supported with a progesterone suppository. Women with complete ovulation failure can, with the correct treatment, expect a virtually normal chance of conceiving. Women with oligomenorrhea have a less good chance of conceiving because of the underlying pathologies of PCO.

Chinese medicine can be equally effective in treating ovulatory dysfunction as biomedicine. Chinese herbal medicine restores ovarian function effectively and promptly. It offers a valuable option for treating infertility in patients with premature ovarian failure and/ or raised FSH and LH levels, as well as treating patients with polycystic ovarian syndrome. Many studies demonstrate that the correct application of herbs can restore a regular cycle with a good basal body temperature and an efficient luteal phase.

Acupuncture can be equally effective in the treatment of ovulatory dysfunction. Studies suggest that acupuncture adjusts FSH and LH and normalize oestrogen and progesterone levels, thus regulating ovulation.