If you’re trying to conceive and are experiencing symptoms like irregular periods or excessive hair growth, you may be wondering what’s going on. One possibility is ovulatory dysfunction (abnormal, irregular, or absent ovulation).

This article covers the basics of ovulatory dysfunction, including its main symptoms and treatment options.

What is ovulation?

Ovulation occurs when one ovary releases a mature egg (ovum), which travels into the fallopian tube. It usually happens around the middle of the menstrual cycle (people with a 28-day menstrual cycle may experience ovulation 14 days before their next menstrual period; however, it’s different for each person).

Once released, the egg can be fertilized for up to 24 hours.

Sperm can live inside the female reproductive tract for three to five days, so having intercourse in the days leading up to and during ovulation can increase the chances of getting pregnant.

If the egg isn’t fertilized, it dissolves and is shed as menstrual blood during the next period.

How does ovulation happen?

The follicle-stimulating hormone (FSH) and the luteinizing hormone (LH) work together to regulate ovulation.

FSH stimulates the growth of eggs in the ovary, while LH triggers the release of a mature egg from the follicle.

At the beginning of the menstrual cycle, FSH is released by the pituitary gland, signaling the ovaries to start developing eggs. Multiple eggs develop within their own fluid-filled sacs called follicles during this follicular phase. Growing follicles produce estrogen, which thickens the uterine lining to prepare for pregnancy.

One follicle becomes the dominant follicle, and as it grows, it produces more estrogen.

Estrogen levels rise throughout the menstrual cycle, eventually triggering a surge in LH production. The LH surge triggers the release of the mature egg from the follicle (ovulation).

After ovulation, the empty follicle develops into a corpus luteum, which produces progesterone. Progesterone helps to prepare the uterus lining for the implantation of a fertilized egg.

Signs and symptoms of Ovulation

Some common signs and symptoms of ovulation include the following, however not all women will experience symptoms when they ovulate:

  • Change in cervical mucus
  • Slight increase in basal body temperature (BBT)
  • Mild pelvic pain or twinges on one side of the lower abdomen
  • Increased sex drive

Why is ovulation necessary for conception?

Without ovulation, conception (without medical intervention) isn’t possible. Ovulation ensures:

  • The release of a mature egg for fertilization.
  • The optimal conditions for the sperm to meet and fertilize the egg.
  • The thickening of the endometrium to support the implantation of a fertilized egg.
  • The production of progesterone to sustain a pregnancy if fertilization occurs.

If ovulation doesn’t occur or is irregular (ovulatory dysfunction), it can make it difficult to conceive without medical intervention or fertility treatments.

Several factors can contribute to ovulatory dysfunction, including hormonal imbalances, menopause, polycystic ovarian syndrome (PCOS), thyroid disorders, and amenorrhea (due to excessive exercise and stress)

What is ovulatory dysfunction?

Ovulatory dysfunction describes irregular or absent ovulation, which can make it difficult or impossible to conceive naturally.

Ovulatory dysfunction is one of the leading causes of female infertility, affecting an estimated 20% of couples trying to get pregnant.

While some people may not have any noticeable symptoms of ovulatory dysfunction, others may experience:

  • Irregular or absent menstrual periods
  • Heavy or light bleeding during menstruation
  • Excess hair growth or acne
  • Weight changes

Causes of Ovulatory Dysfunction

PCOS is the most common cause of ovulatory dysfunction in premenopausal women. Other potential causes of anovulation include excessive exercise or stress, abnormalities in thyroid or prolactin production, and certain medications.

Potential causes of ovulatory dysfunction:

  • Polycystic ovarian syndrome (PCOS)
  • Hyperprolactinemia (elevated levels of the hormone prolactin)
  • Hypothalamic dysfunction (disruption of communication between the hypothalamus and pituitary gland)
  • Thyroid disorders, including hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)
  • Premature ovarian failure (early menopause)

Symptoms of Ovulatory Dysfunction

Symptoms of ovulatory dysfunction can vary from person to person, but common signs may include:

  • Irregular menstrual cycles
  • Difficulty predicting or tracking ovulation
  • Abnormal or absent periods
  • Excessive or prolonged bleeding during menstruation

Chronic Ovulatory Dysfunction

It is uncommon, but some women may experience chronic ovulatory dysfunction, which means that a woman has consistent irregular or absent ovulation over a prolonged period. Experiencing chronic ovulatory dysfunction makes it especially difficult to conceive, which is why it is crucial to seek the assistance of a fertility specialist as soon as possible. A Reproductive Endocrinologist will be able to address the severe hormonal imbalances associated with the condition. Long-term conditions like PCOS, stress, or rapid weight loss and gain may cause these symptoms. Health issues stemming from chronic ovulatory dysfunction may extend beyond fertility and may affect your overall health.

Diagnosis and Medical Evaluation

Diagnosing an ovulatory disorder often involves an initial thorough medical evaluation. This may include a review of medical history, physical examination, hormonal blood tests, and imaging studies such as ultrasounds.

A fertility specialist may also recommend:

  • Home testing kits: At-home testing kits, such as ovulation predictor kits, can help track hormone changes and predict ovulation (though they’re not 100% accurate).
  • Baseline body temperature charting: Tracking basal body temperature can help identify ovulation patterns, although it is cumbersome and often inaccurate
  • Pelvic ultrasonography: Pelvic ultrasonography is a diagnostic tool that uses sound waves to view the pelvic organs. During this procedure, the doctor can evaluate the size and appearance of the ovaries, look for abnormalities or cysts, and assess follicle development.
  • Serum progesterone levels: Progesterone rises after ovulation, and an elevated serum progesterone level confirms that ovulation has occurred.

Treatment Options for Ovulatory Dysfunction

Treatment options for ovulatory dysfunction may include:

  • Treating underlying medical conditions: If an underlying medical condition, such as hyperprolactinemia or thyroid disorder, is causing ovulatory dysfunction, treating the underlying condition may help restore regular ovulation.
  • Letrozole (Femara): Letrozole is a medication that’s often used as a first-line treatment for anovulatory or oligo-ovulatory infertility, especially in people with PCOS.
  • Clomiphene Citrate (Clomid): Clomid is a medication that can induce ovulation in people with ovulatory dysfunction.
  • Gonadotropins: Gonadotropins are injectable medications that contain FSH and LH and are used for ovulation induction in people who do not respond to first-line treatments such as clomiphene citrate or letrozole.

Success Stories

With an accurate and timely diagnosis, appropriate treatment, and support from a fertility specialist, people with ovulatory dysfunction have a good chance of achieving pregnancy and starting or growing their families.

Here are two stories of couples who overcame ovulatory dysfunction and built their families:

  • Lacey and Reed from Florida: Lacey had a severe form of PCOS and struggled with ovulatory dysfunction for years. After meeting with an RMA fertility specialist, they developed a customized treatment plan and soon welcomed their son, Luke, into the world.
  • Jena: Jena also had PCOS, but after getting her progesterone levels in check, she was able to carry twin boys to term and become a mother. She is now pregnant with her fourth child through IVF.

These stories demonstrate that ovulatory dysfunction is not the end of the road. With the help of a fertility specialist, many people with ovulatory dysfunction can achieve their dream of parenthood.

Detect Peak Ovulation

It is possible to detect your peak fertility using an ovulation test. Understanding when you ovulate is vital when trying to get pregnant. There are at-home testing kits or you can visit one of our offices to speak with a fertility specialist who will be able to perform more accurate fertility tests.

Lifestyle and Dietary Recommendations

Incorporating particular lifestyle and dietary changes can help improve ovulation and overall reproductive health.

Here are a few lifestyle and dietary recommendations that can support ovulation in individuals with ovulatory dysfunction:

  • Engage in regular physical activity to promote weight loss and improve insulin sensitivity.
  • Maintain a healthy weight, as excess body fat can contribute to hormonal imbalances and ovulatory dysfunction.
  • Follow a balanced and nutritious diet, including foods rich in antioxidants, omega-3 fatty acids, and low-glycemic index carbohydrates.
  • Avoid processed and sugary foods,
  • Ensure adequate sleep and manage stress levels
  • Consider alternative therapies such as acupuncture or herbal supplements

Emotional and Psychological Impact of Infertility

Ovulatory dysfunction can have a devastating emotional and psychological impact on individuals and couples struggling with infertility. The agonizing wait for a positive pregnancy test, followed by the disappointment of a negative result, can be a relentless cycle of hope and despair. Feelings of inadequacy, self-blame, and isolation can compound the emotional pain. The strain on relationships can be immense.

If you’re experiencing infertility, know that you’re not alone. Millions of people around the world are facing the same challenges. There is hope. With support from loved ones, healthcare professionals, and support groups, you can overcome the emotional and psychological hurdles of infertility and ovulatory dysfunction.


Infertility is a complex issue with many causes, but ovulatory dysfunction is a common culprit. Some common signs of ovulatory dysfunction include irregular or absent periods, weight gain, acne, and excessive hair growth.

Treatment for ovulatory dysfunction typically involves addressing the underlying cause. It also may include medications to stimulate ovulation and lifestyle changes such as dietary changes and regular exercise.

If you’re experiencing any of the signs of ovulatory dysfunction, it’s essential to talk to your doctor. With the proper treatment, many people with ovulatory dysfunction go on to conceive and have healthy babies.

Speak with Our Fertility Specialists

At RMA Network, we understand that infertility can be a challenging and emotional journey. That’s why we offer a wide range of fertility treatments and services to help you achieve your dream of parenthood. Our team of experienced and compassionate fertility specialists is here to support you every step of the way.

If you’re struggling to conceive, consider scheduling a consultation with one of our fertility specialists. They’ll work with you to develop a personalized treatment plan that meets your needs and goals.