Ovulation disorders

chronic anovulation It is an abnormality in the functioning of the ovaries. that causes the process of growing eggs to a halt causing menstrual problems that do not come on schedule which is one of the causes of infertility

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Incidents have found that approximately 10% of adolescent girls have problems related to hidden ovulation disorders. The symptoms for each person can vary in several ways. Some have regular menstrual cycles, while others have irregular or frequent missing periods. Other common symptoms include persistent acne, oily skin, excessive weight gain in some cases, increased body hair compared to normal, or male-pattern baldness. However, some individuals may not experience any abnormal symptoms at all, except for the fact that they are unable to conceive and have been diagnosed with infertility due to ovulation problems.

Diagnosis of ovulation disorders can be challenging.

Physical examinations may not reveal any abnormalities, or in some cases, certain signs like excessive acne, oily skin, and obesity may be observed. Hormonal tests that control the functioning of the ovaries may show imbalances in hormone levels. Transvaginal ultrasound examinations can identify specific characteristics of the ovaries, such as the presence of numerous immature eggs arranged in a pearl necklace-like pattern inside the ovaries. This appearance is considered the most accurate diagnostic indicator of ovulation disorders.

Treatment approaches for chronic anovulation

The treatment methods for individuals facing chronic anovulation differ from those with regular anovulation. The primary goal of treatment is to stimulate ovulation while preventing complications during the process.

In cases of chronic anovulation, women often exhibit resistance to oral ovulation-inducing drugs. However, they might respond better to injectable medications. Nevertheless, achieving successful ovulation through medication might prove challenging, as stimulating only one or two eggs with natural methods can be difficult.

Conversely, using injectable medications to induce ovulation can lead to complications, such as producing an excessive number of eggs, making it impractical to pursue natural methods. It may also result in a higher likelihood of conceiving multiple embryos, leading to pregnancies with more than two fetuses. Additionally, this method can cause fluid retention, severe nausea, and vomiting during the ovulation stimulation phase and early pregnancy.

Approaches to Treat Persistent Anovulation for Infertility Treatment

To treat infertility caused by persistent anovulation, the following approaches can be considered:

1. Using oral ovulation-inducing medication may be combined with certain medications to enhance the response to ovulation induction. For example, in cases where the drug Metformin used to treat diabetes is not effective, it can be used as a subsequent treatment.
2. Low-dose injectable ovulation-inducing medication can be used to stimulate the growth of a small number of eggs, typically fewer than If successful, natural intercourse can be attempted if the sperm is normal, or insemination of the prepared sperm can be done if the sperm count is low. If unsuccessful, further treatment options can be considered.
3. Low-dose injectable ovulation-inducing medication can also be used to stimulate the growth of multiple eggs for external fertilization, in conjunction with in vitro fertilization (IVF). The embryos obtained are then frozen, and the transfer into the uterus is postponed to a natural menstrual cycle after the body returns to its normal state. This method is used in controlled ovarian hyperstimulation to avoid excessively high hormone levels, making it easier to control the ovulation induction process and subsequent embryo transfer, reducing complications.
4. Mature eggs that have not been stimulated to ovulate naturally are retrieved from the fallopian tubes and cultured to maturity. They are then fertilized through intracytoplasmic sperm injection (ICSI) to produce embryos. These embryos are transferred back into the uterus in a similar manner to the embryo transfer after in vitro fertilization. This method helps avoid ovulation induction and reduces the risk of ovarian hyperstimulation syndrome, although the pregnancy rate may not be as high compared to conventional in vitro fertilization.

With proper control and administration of these treatments, the chances of pregnancy are significantly increased, and the occurrence of complications can be minimized. Among the mentioned methods, conventional in vitro fertilization offers the highest pregnancy success rates while allowing control of potential complications. Additionally, frozen embryo transfer enables the occurrence of multiple pregnancies (twins or more), and ovarian hyperstimulation syndrome can be controlled and resolved without further treatment within approximately 7 days after egg retrieval. When selecting a treatment method, the possibility of achieving pregnancy should be considered along with the potential complications that may arise during the treatment process.

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