Ovulation Problems

The typical menstrual cycle is 28 days long, and most women ovulate on day 14 of each cycle. However, for some women, this is not the case. Many women have trouble getting pregnant because they do not have regular menstrual periods each month and experience problems with ovulation. Problems with ovulation is one of the most common reasons for infertility.


What is Ovulation?

Ovulation is simply the process where an egg is released from the ovaries. Inside each ovary is many tiny ovarian follicles. These sacs are filled with fluid and contain eggs. On day one of the menstrual cycle, bleeding starts. Several follicles and eggs begin to develop and mature at this time.

Two weeks later, the most mature egg (dominant egg) will burst out of the follicle and ovary. The egg must travel into the fallopian tube, where it is penetrated by sperm and fertilized. The resulting embryo travels down the tube to the uterus where it can implant into the uterine wall.


Hormones and Ovulation

Fertilization and implantation are possible when ovulation occurs. Any problems with ovulation will affect fertility. For ovulation to occur, a woman’s hormones must be balanced. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, and progesterone all play a significant role in ovulation process.

After the period starts, the ovulation cycle begins. FSH is released, the ovarian follicles and eggs develop, and estrogen levels rise. After 2 weeks, LH levels rise (LH surge), which causes ovulation. Progesterone levels will also rise, which thicken the uterus lining so the egg can implant.


Risk Factors for Ovulation Problems

Some women have a higher risk for ovulation problems. Common risk factors include:

  • Being overweight or underweight
  • Having high stress
  • Abusing drugs or alcohol
  • Thyroid or hormonal disorders
  • Tumors, cysts, or masses of the reproductive organs



Anovulation simple means lack of ovulation. This medical condition is the main cause of infertility. The woman’s body cannot form and release eggs without medication, which is related to hormone imbalances and lack of a normal menstrual cycle.

The main cause of anovulation is polycystic ovarian syndrome (PCOS). Ovulation is stimulated by two hormones, which are both secreted by the pituitary gland. The follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are two specific hormones relative to ovulation.


Irregular Ovulation

Also called delayed ovulation, irregular ovulation is related to inconsistent or infrequent menstrual cycles. Ovulatory dysfunction causes cycles less than 21 days or longer than 35 days. Irregular ovulation must be addressed medically, where the goal is to achieve proper hormonal balance. Common causes of irregular ovulation include premature ovarian failure, premature ovarian insufficiency, thyroid disease, and high levels of prolactin (hormone).


Luteal Phase Defect

A defect in the luteal phase interferes with embryo implantation. The luteal phase occurs between ovulation and the start of your menstrual period. The ovulation cycle has two phases: the follicular phase (focused on ovarian follicle growth) and the luteal phase (LH and progesterone production). When the luteal phase is shorter than normal, it causes infertility because the fertilized egg cannot implant into the uterus lining.


Treatment of Ovulation Problems

Ovulation problems are sometimes treated with Clomid, which is a fertility medication that stimulates egg development and maturation. In vitro fertilization (IVF) is a useful form of assisted reproductive technology for women with ovulation problems. Around 80% of couples who take medication for ovulation problems are able to ovulate, and around 35%-45% of these women are able to become pregnant.