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Home :: Anovulation
Anovulation - Treatment of Anovulation
What is Anovulation?
Anovulation is a condition when women do not properly develop and release a mature egg every month as they should normally. Naturally, with no egg available for sperm, a woman cannot become pregnant. Anovulation is physiologic at the extremes of reproductive age. Anovulatory cycles tend to occur occasionally throughout the childbearing years, but are most common during adolescence and in the years before menopause ("perimenopause"). During menarche, absence of ovulation is due to immaturity of the HPO axis, leading to an uncoordinated secretion of GnRH (pulsatility).
Anovulation is a prime factor in infertility. Anovulation can also be difficult to detect. Some women have seemingly normal menstrual periods even though they are not ovulating.
Causes of Anovulation
A number of possible causes are as -
- Obesity
- Polycystic ovary syndrome
- Hypothalamic dysfunction
- Premenopause
- Ovulatory dysfunction
- Thyroid disorders
- Hyperprolactinemia
- Excessive exercise and weight loss
- Hirsutism
- Congenital adrenal hyperplasia
- Adrenal insufficiency
Treatment of Anovulation
Clomiphene induces ovulation by stimulating the pituitary to release gonadotropins, namely FSH, in much the same manner that GnRH does. Most causes of dysfunctional uterine bleeding respond to either oral or intravenous estrogen. Treatment using the parenteral route can be initiated with estrogen (Premarin) 25 mg IV q4h by accelerating the mitotic activity at the level of the endometrium. If no response is seen after 12-16 hours, suction dilation and curettage is warranted.
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