Causes and Treatment of Ovulation Disorders

Ovulation disorders are commonly caused by a problem in the hypothalamic–pituitary axis or ovarian dysfunction, but they can also be secondarily caused by a chronic disease. An example of the latter case is amenorrhea (i.e. absence of a menstrual period), which can occur due to severe stress or extreme exercise. In this case, elimination of the underlying cause can allow the resumption of menstruation as normal.

Causes
  • Problem in the central nervous system : Pituitary tumors, severe stress, excessive exercise, anorexia
  • Problem in ovarian function : Ovarian aging (premature menopause), polycystic ovaries, ovarian lesions (ovarian tumors, ovarian inflammation)
  • Problem in metabolic processes : Thyroid disease, diabetes, abnormal hormonal secretions (hyperprolactinemia)
Types of Ovulation Disorders
Absent or rare menstruation

“Absent menstruation” refers to cases in which the woman does not have her period for more than 3 menstrual cycles, and “rare menstruation” refers to cases in which the menstrual cycle lasts over 2 to 3 months.

Menstruation without ovulation (anovulation)

Anovulation refers to cases in which a follicular egg exhibits abnormal or suspended growth, or grows until ovulation but is not released by the ovary.

Excessively short follicular phase

The basic body temperature is classified into low-temperature phase and high-temperature phase, but “excessively short follicular phase” refers to cases in which the time period between menstruation and ovulation is extremely short.

Sporadic anovulation

This occurs in cases when the low temperature phase of the basic body temperature occurs continually and irregularly. However, in these cases, the woman may still conceive naturally.

Treatments for Ovulation Disorders
Administration of Clomiphene

50 to 100mg of the drug is taken a day for 5 days starting on the third or fifth day after menstruation begins. Ovulation then occurs on the sixth or tenth day after taking the drug. Ovulation must be confirmed by ultrasound, and once confirmed, the couple are advised to have a sexual intercourse to conceive a child.

Administration of Bromocriptine

This is an effective drug for hyperprolactinemia. The patient must taken one tablet a day for 2 weeks and take note of her menstruation. Taking Parlodel on an empty stomach can cause nausea, so patients are recommended to take the drug before bed or after a meal.

Human Menopausal Gonadotropine (hMG) and Human Chorionic Gonadotropine (hCG) Method

hMG is involved in ovum maturation by influencing the ovaries, while hCG commands ovulation. Intramuscular injections of hMG are administered for 7 to 12 days starting on the fourth day of the patient’s menstruation. When the follicular egg becomes mature, hCG is injected into the muscles a couple of times to induce ovulation.

Surgical method

When the membrane enveloping an ovary is too thick and hard, matured egg cannot be released. In this case, laparoscope is used to make holes on the surface of the ovary to induce ovulation.