Ovulatory dysfunction is defined as the absence of normal or regular ovulation.  Menses can also be irregular or even absent in patients with ovulatory dysfunction.  The pathology can often be diagnosed by a study a the patient's medical history, hormone measurements or serial pelvic ultrasonography.  The treatment normal prescribed for ovulatory dysfunction is normally treated with clomiphene or other drugs depending on the chemical and hormonal make-up of the patient.

In premenopausal women, ovulatory dysfunction is most often caused by polycystic ovary syndrome (PCOS), however can have other causes including the following:

When we receive a patient, ovulatory dysfunction is often suspected if menses are irregular or non-existent, and not proceeded by symptoms such as swelling of the lower abdomen, breast tenderness, and/or increased emotional volatility.

In order to diagnose ovulatory dysfunction, our patient's basal body temperature will be monitored, and we will also measure urinary or serum progesterone hormones, as well as use pelvic ultrasonagraphy to define a precise diagnosis.  Absent or irregular ovulation will also require immediate exams of the hypothalmus, pituitary and/or ovaries - determining PCOS.

Ovulation can be induced with drug therapy.  Anovulation not related to hyperprolactinemia is first treated with an antiestrogen citrate (clomiphene), and is most effective when the ovulatory dysfunction is caused by PCOS.  Clomiphene is started between the 3rd and 5th day after uterine bleeding begins and is continued for five days.  Ovulation begins 5-10 days after the last day of clomiphene and if ovulation occurs, menses follows within 35 days of the induced bleeding.  Treatment can be applied for up to 4 ovulatory cycles.  Seventy-five percent to 80% of women treated with clomiphene, however rates of pregnancy are around 40-50%.  Metaformin is also a possible substitute for clomiphene in women who have a body mass index of less than 35, as well as patients diagnosed with PCOS or glucose intolerance.

Gonadotrophins can be used for patients that do not respond to clomiphene.  Gonadotrophins are normally given once a day, afte the 3rd to 5th day of induced or spontaneous bleeding.  Within 7 to 14 days, they should stimulate 1-3 folicles - this is determined ultrasonographically.  Click here to read more on gonadotrophin therapy...

There are various additional ovulatory disorders associated with infertility, all of which can be addressed in our fertility clinic in Bogotá. Please contact our infertility doctors personally through the below link, so me may properly address which course of action is best for your individual case.
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