If women experience symptoms of anovulation, they need to be taken seriously. If left untreated, it may affect future fertility issues. For women, ovulation is a unique physiological characteristic. So, what are the reasons for not ovulating? Only by identifying the right reasons can we start from the root. Next, let's take a look at the common causes of female anovulation.
1. Turner syndrome and simple gonadal dysplasia with chromosomal abnormalities are both characterized by primary amenorrhea, elevated levels of gonadotropins, and decreased levels of estrogen. Pregnancy can be obtained through in vitro fertilization and embryo transfer using eggs donated by others.
2. Premature ovarian failure and ovarian resistance syndrome: High gonadotropin-induced amenorrhea caused by ovarian failure before the age of 40 is called premature ovarian failure, which accounts for about 20% to 28% of primary amenorrhea and 4% to 20% of secondary amenorrhea. Women with primary amenorrhea or secondary amenorrhea before the age of 30 who have elevated levels of endogenous gonadotropins and normal follicles present in the ovaries but exhibit low response to high-dose exogenous gonadotropin stimulation are referred to as ovarian insensitivity syndrome or ovarian antagonistic syndrome. The causes of both are not yet clear, and they both manifest as amenorrhea and anovulation.
3. Polycystic ovary syndrome. Often manifested as amenorrhea or infrequent menstruation, long-term anovulation, excessive androgen levels, and no periodic fluctuations in estrogen. It is currently a major cause of anovulatory infertility.
4. Untreated luteinization syndrome. During normal menstrual cycles or drug-induced ovulation cycles, follicles develop into dominant follicles in the ovaries. However, by 48 hours after the LH peak during ovulation, the follicles do not disappear or maintain growth, and persist for several days. Granulocytes have undergone luteinization while the follicles have not ruptured. The basal body temperature (BBT), cervical viscosity, and changes in the endometrium of LUFS are similar to normal ovulation, giving people the illusion of ovulation, which is one of the reasons for infertility and also one of the reasons for the low pregnancy rate of clomiphene induced ovulation. The incidence of LUFS reported in literature ranges from 31.8% to 2.9%, which is significantly higher than the natural cycle's 10%. Ultrasound monitoring shows that the follicles do not rupture or enlarge, and there are light spots inside the follicles that often disappear before the next menstrual period. If laparoscopic examination is performed, the ovulation hole cannot be seen.
