Why is there no ovulation? Treatment of concomitant diseases

Required condition offensive natural pregnancy is ovulation. Even in the womb of the mother, about 1 million follicles with eggs are laid in the ovaries of girls. But only 1% of them ovulate throughout reproductive period women. Some girls childbearing age The maturation and release of the egg does not occur. A diagnosis of ovulatory dysfunction makes it impossible to conceive a child without outside intervention.

Reasons for lack of ovulation

Ovulation usually does not occur in pregnant and breastfeeding women, as well as during menopause (menopause). The remaining factors are pathological. Among them are:

• Women's infectious diseases.
• Overweight or underweight.
• Deviations in endocrine system, affecting hormonal background women.
• Venereal diseases.
• Stress and big physical exercise.
• Genetic predisposition.

How to diagnose lack of ovulation

A cause for concern should be the failure to become pregnant within a year and a half. To make sure that ovulation is not occurring, you can measure your basal temperature at home or use pharmacy ovulation tests. These procedures must be carried out in several cycles.

The gynecologist will offer to undergo laboratory examinations, that is, donate blood for hormones, HIV, syphilis, general analysis urine, vaginal swabs, etc. You may have to go through this more than once.
Repeated ultrasound monitoring gives a clearer picture. Approximately on the 8-12th day of the cycle (depending on the duration of the cycle), the doctor evaluates the condition of the uterus, ovaries and follicles every 2-3 days and makes a conclusion. Based on its results, a treatment plan is drawn up.

Methods for restoring ovulation

If the reason for the lack of ovulation is not overweight and stress, then medicinal stimulation with hormonal drugs is prescribed. These are Clomiphene citrate, Duphaston, Clostilbegit. The gynecologist monitors the growth and development of follicles. When one of them becomes 20-25 mm in size, a hCG injection. After this, ovulation should occur within a day.

They are popular and traditional methods restoration of ovulation.

• Plantain seeds. Pour a tablespoon of seeds into a glass cold water, and then bring to a boil. After 40 minutes, strain the broth and take a tablespoon four times a day.
• Estrogens contained in sage and linden have a beneficial effect on the female body. To prepare a decoction, take a tablespoon of each herb and pour 200 ml of boiling water over them. After cooling, drink a tablespoon of the medicine three times a day from the 5th to the 15th day of the cycle. And thus for 3 months.
• Therapeutic mud fights inflammatory processes and restores reproductive function.

The phenomenon of lack of ovulation has its own medical name. The diagnosis that can be heard from a doctor in this case is anovulation.

When a woman does not ovulate, she is unable to become pregnant. Since the egg does not leave the ovary, the sperm cannot fertilize it. If a woman does not ovulate regularly, this can cause infertility. This means that the issue of diagnosing and treating this pathology must be taken seriously. To do this, you need to find out the reasons why there is no ovulation and figure out what to do next.

If a woman wants to get pregnant, then the lack of ovulation can be unpleasantly disappointing. Of course, it is impossible to calculate whether there is ovulation at home with 100% accuracy. You can only guess by the discharge, sensations, check with a test. But the test can determine this process in the body by almost 99%, so there is reason to think about it. This reaction is quite understandable, because the problem can really turn out to be sad consequences. But don’t panic right away, you need to find out the reasons.

There are two reasons why ovulation is absent:

1. Physiological.
2. Pathological.

Physiological ones include following reasons why there is no ovulation:

• pregnancy;
• postpartum period;
• preclimatic period;
• reception OK.

If the release of the egg does not occur for one of these reasons, the woman cannot influence this in any way. But physiological reasons do not pose any threat to health.

When ovulation does not occur, it makes sense to check for pregnancy. If it is confirmed, then there is no need to worry, because anovulation is absolutely natural during pregnancy.

The process of releasing the egg also does not occur for some time after childbirth. This is also the norm, especially if the child is on breastfeeding. During lactation, a woman’s body has an increased level of the hormone prolactin, which is responsible for the production breast milk. This hormonal process blocks the release of the egg from the ovary into the abdominal cavity.

In the period before the onset of menopause, anovulatory cycles appear more often and with greater regularity. Interestingly, this process begins at approximately the age of 30-35 and lasts until menopause. Women at this age can still afford to give birth to a child, so the chances of conceiving are reduced.

But don’t worry, because the number of ovulatory cycles increases gradually with age. After 30 years of age, getting pregnant can be a little more difficult than at a younger age, which means you have to put in a little more effort.

Action hormonal contraceptives is aimed precisely at suppressing ovulation. Due to the influence of this type of contraception, the release of the egg does not occur. This is a normal physiological reaction of the body to these drugs.

If physiological causes of anovulation are excluded, you should find out what is wrong and why ovulation does not occur for so long.

The following factors can provoke a lack of ovulation:

• obesity or excessive thinness;
• exercising too intensely;
• hormonal imbalances;
• stress;
• infectious diseases of the reproductive system;
• inflammatory processes in the pelvic organs;
• diseases of other organs and systems.

Of course, these factors must be eliminated so as not to aggravate the problem. Only experienced doctors able to help a woman cope with such a situation.

Enough long time a woman may not even realize that she is not ovulating. To identify this problem in a timely manner, you need to be attentive to your body. Some signs will help suspect anovulation:

• feeling in the middle menstrual cycle;
• basal temperature;
• duration of the menstrual cycle.

Women who experience characteristic sensations(pain, nausea, dizziness, etc.) may notice their absence in one or more cycles. But these are subjective signs that not everyone exhibits.

Those who regularly measure their basal temperature rectally will not be able to help but notice if it does not occur. sharp increase. This is a fairly reliable sign that ovulation is not occurring.

A change in the duration of the menstrual cycle can also indicate anovulation. At the same time, it can change both towards longer and longer short cycle. Uneven cycle length can be a symptom of other abnormalities, so it is difficult to judge ovulation by it. At least one cycle for sure. It is necessary to observe the duration of at least several cycles in a row.

In order to confirm that a woman is indeed not ovulating, the doctor will definitely recommend at least two types of examination:

• hormone analysis;
• Ultrasound control.

A blood test for various hormones will show the state of the woman’s general hormonal background and help the doctor draw conclusions. So, for example, in the second phase of the cycle there is normally increased level progesterone. If the analysis shows a different result, it means ovulation does not occur.

Ultrasound diagnostics is very informative if anovulation is suspected. With ultrasound you can see:

• how follicles develop;
• Is the size of the ovaries normal?
• is there polycystic ovary syndrome, etc.

To stage more accurate diagnosis, the doctor may ask the patient to undergo these examinations again after a short time.

Regardless of the reason why ovulation does not occur, the situation can be influenced. It is important to remember that the presence anovulatory cycles 2-3 times a year is normal. Every healthy woman is faced with the fact that she does not ovulate in one of the cycles. And she doesn't even notice it.

But even if a woman encounters this phenomenon often, this is not a reason to consider herself inferior. By using modern diagnostics You can not only accurately identify the problem, but also effectively eradicate it.

The main thing is that you should not try to solve the situation alone and neglect going to the doctor. Not only gynecologists, but also specialists such as

• endocrinologist;
• nutritionist;
• neurologist, etc.

Laboratory tests and prescriptions made by doctors almost always help a woman get rid of diseases and other factors that cause anovulation.

So, what to do if there is no ovulation? That's right, the first thing to do is calm down and make an appointment with a doctor. Then follow his recommendations, and ovulation will not take long.

Almost everyone strives to feel the joy of motherhood. When planning a pregnancy, many women are increasingly interested in such a concept as ovulation. And for good reason, since understanding the process will help speed up the conception of a child. But it also happens thatThere is ovulation, but pregnancy does not occur; the causes of the phenomenon in this case are not so easy to establish.

Read in this article

What is and how does ovulation occur?

The process of ovulation occurs when a mature egg leaves the ovary, which as a result confirms the body's readiness for pregnancy.

From the moment of birth in female ovaries there are more than a million eggs. Each of them has its own shell - a follicle, where they “live” until the girl reaches puberty, and then wait for their time to emerge. Many of them do not mature and die over time. During the validity period reproductive function In a woman’s life, there are only 400–500 mature eggs left, ready for ovulation.

Ovulation can be observed approximately on the 14th day of the menstrual cycle. Ovulation time does not last long, only a few minutes. An egg free from a follicle can be fertilized within 24 hours, and if during this time it encounters sperm on the way, then the conception of a child will be completed.

If fertilization has occurred, the cell then travels through the fallopian tube into the uterus and attaches to its wall near the ovary where it grew. This is how pregnancy occurs. If the fertilized egg, which will become an embryo after dividing, fails to enter the uterus, menstruation will occur and it will be released from the body.

Sometimes multiple eggs ovulate, which can result in the birth of fraternal twins.

For what reasons is it impossible to conceive during ovulation?

To increase the likelihood of conception, some couples are advised to concentrate their attention and efforts even before ovulation begins. If a woman is ovulating and the spouses have sex regularly, then most often a long-awaited child is born. But many are often tormented by the question: why does pregnancy not occur if there is ovulation?

To begin with, both spouses need to undergo a high-quality examination by good specialist. As a result, it is possible to determine female and male factors, affecting this.

Female factors:

• . It may arise due to nervous exhaustion or a minor cold. Or there are problems with the woman.
• . Negative reaction female body on male sperm, resulting in rejection and failure.
• Inflammatory or chronic diseases female genital organs, improper douching are the reasons why pregnancy does not occur.
• Lack of regular menstruation.
• Inflammation and... Defective and untimely maturation of the follicle, which takes part in ovulation. This can be determined through ultrasound examination.
• or infection of the uterus. The cause may be inflammatory processes, ectopic pregnancy, surgical intervention and others. Most often in initial stage With these diseases, a woman may not suspect that there is a problem. A special procedure, hysterosalpingography (HSG), will detect the lumen in the fallopian tubes and determine how freely a mature egg can move.
• Endometriosis of the uterus. A disease in which tissue similar to the endometrium spreads around the lining of the uterus, where adhesions and adhesions can form over time. Availability inflammatory processes and scars will also cause infertility.

Male factors

1. Insufficient percentage of strong and motile sperm. This indicator is determined using and must be at least 50%. The reason for an insufficient number of motile spermatozoa can be: age, past infectious diseases, excessive overeating spicy food and others.
2. Diagnosis. It manifests itself in the form of dilation of the seminal canal or venous vessels of the testicles. Sperm are very susceptible to elevated temperature and overheating of the testicles, which adversely affects the ability of fertilization.
3. Various diseases. The cause of male dysfunction is his past. Promiscuous sexual intercourse entails the presence of an infection in the body that can be transmitted to a woman. The most common among them are gonorrhea, syphilis, and trichomoniasis.

Even one of these factors may be a reason that affects the absence of pregnancy even in the presence of ovulation.

How to correctly determine ovulation

A few days before the ovulatory period, the composition changes vaginal discharge: They become more slimy, abundant and transparent. Under the influence of estrogen hormones, the cervix prepares to meet sperm and secretes a mucus plug. Due to the increased content of the hormone estrogen in the blood, a woman can feel increased sexual desire and emotional uplift. These are the days that are favorable for conception.

The presence of estrogen also affects , which is measured in the morning, without getting out of bed, by inserting a thermometer into the colon. Under the influence of the hormone, the temperature before ovulation drops by several degrees.

As a result, we can identify the symptoms that will be noticeable to a woman:

• copious, translucent vaginal discharge;
• pain in the ovarian area;
• decrease in basal temperature;
• increased sexual activity.

There are several basic methods that will help you find out how to determine ovulation:

• Calendar method. It will be relevant for a regular menstrual cycle. If the cycle length is 28 days, then ovulation will begin on days 13–16. If the cycle is 30 days, then on the 14th - 17th day.
• Carrying out ultrasound diagnostics. It will allow you to observe how the follicle in the ovary matures, from where the egg will later be released. It is necessary to undergo at least three ultrasounds for this procedure.
• Filling out the basal temperature calendar. Measured every morning by inserting a thermometer into anus and celebrating the results. At the end of the cycle, the temperature is 36.6–36.9°, before ovulation it decreases slightly, and then jumps sharply and is in the range of 37.0–37.3° until the start of the next cycle.
• Usage . They are able to determine the amount of luteinizing hormone contained in the urine.

An important question for many remains whether it is possible to get pregnant before ovulation. If sexual intercourse took place before the egg left the follicle, then pregnancy may occur, but conception itself occurs after. If present in the vagina alkaline environment, then it will have a positive effect on sperm being able to live in it as long as possible and wait for the egg to be released. To increase the chances of conception, after making love you need to lie down with your buttocks raised and not douche.

What sex positions will increase your chances of getting pregnant?

After repeated attempts, many couples do not conceive the desired child. The problem may not be related to health at all. If you follow simple techniques and recommendations, then in the near future you will be able to enjoy your long-awaited pregnancy.

Regular sexual intercourse

To increase your chances of conceiving, you need to have sex 3 times a week. Often a married couple has sexual intercourse only during the period of ovulation, but we must not forget about “ordinary” days. For many women, ovulation does not occur on schedule, so there is always a chance of getting pregnant.

Having sexual intercourse before ovulation

During the entire cycle, there is a period of time when conception can occur. Within 24 hours after ovulation, fertilization of the egg can occur.

Making love 2 to 3 days before ovulation increases the chances of pregnancy. The reason for this is the lifespan of sperm, which can live in the body for several days. You can not wait for ovulation to occur, but have sex a little earlier, since the sperm will still function in the body for several days, and conception may occur.

Don't forget about pleasure

With frequent unsuccessful attempts to get pregnant, sex between partners becomes a more habitual and mechanical activity. You must not forget about preliminary games and try to diversify your sex life.

A romantic evening or a sex toy will help with this. Strong arousal also has a good effect on conception. Joint orgasm among partners plays an important role. During it, the cervix rises and does not interfere with the path of sperm. The brighter the male orgasm, the better quality sperm.

Use correct postures

The optimal position for conception is missionary, when the man is on top, and its various variations. For better effect You can put a pillow under your buttocks during sex so that they are slightly raised.

It is better not to experiment with the “woman on top” position, since sperm flows out easily in this case.

Don't indulge in oral sex

Many studies show that the effects of saliva can negatively affect sperm quality. Therefore, it is better to refrain from oral pleasures so as not to leave saliva on the genitals.

How to increase your chances of becoming parents

The possibility of the desired conception can be influenced by many factors, such as living conditions, nutrition, social problems, abundance chemical substances. But there are certain actions that will help increase the body’s ability to get pregnant:

• refusal of admission;
• determining the exact period of ovulation;
• regular sex;
• strengthening physical health;
• consumption of products that promote conception;
• abstinence from antidepressants;
• refusal alcoholic drinks and nicotine addiction;
• artificial insemination. Before moving on to radical measures, you can try traditional methods. For example, you can learn from our article, which has been known for decades for its magical properties. In addition, the article describes the most current recipes its preparation, and also indicates to whom it is not recommended for consumption for health reasons.

  In order to achieve the desired result, and attempts to conceive are crowned with success, you should never give up and give up. The main thing is to try to change your usual pattern of behavior and lifestyle, especially sexual. And fate will definitely give you a chance to become happy parents. It’s a paradox, but for many couples, the treasured two lines on the test appeared precisely when they were not expecting them at all!

The main mission of any woman on earth is to give birth to children. But sometimes conceiving is not so easy. At first glance, everything seems to be fine: the partner is healthy, menstruation occurs regularly. However, it is impossible to get pregnant. A woman in this situation is in no hurry to go to her doctor, because she believes that everything is normal, it’s just that the time is not right yet. In reality, things may not be as smooth as they seem. After all, there is such a problem as with regular periods. conceptions may lie precisely in it.

Ovulation

Why does this happen? How to cope with this problem and conceive a child? In order to answer these questions, you need to understand what ovulation is. This is a function of the female body assigned to it by nature itself. The process occurs in the middle of the menstrual cycle. At the same time, an egg is released from the ovary, ready for fertilization.

Its maturation occurs under the influence of hormones. This process is controlled by the brain system. Having left the ovary, the egg enters the fallopian tubes, where it then meets the sperm. If fertilization does not occur, then it dies after 13-36 hours, and in its place a corpus luteum. It gradually decreases, and as a result, menstruation begins.

Physiological reasons

Why does it happen that a woman is bothered by regular periods? Causes this phenomenon different. But they are usually divided into physiological and pathological. The first include the following factors:

1. Puberty. Usually a girl cannot become pregnant in the first couple of years after the start of menstruation. She has not yet reached the stage of puberty, so the process of ovulation does not occur in her body.
2. Pregnancy.
3. The period after the birth of the child.
4. Lactation.
5. Menopausal period.
6. Use of hormonal contraceptives. Even after stopping them for several months, ovulation may not occur.

However, the absence of ovulation for one or two months a year is not considered a pathology. This phenomenon is typical for healthy woman reproductive age.

Pathological causes

These reasons are more common. In such cases it is usually necessary medical intervention. TO pathological reasons relate:

• Sudden weight loss or gain. All this contributes to changes in hormonal levels in women and can lead to anovulation.
• Disruption thyroid gland and pathology of the adrenal glands.
• Pathology of the brain system that controls this process. Various head injuries, tumors, circulatory problems, and increased prolactin production can lead to disruption of the central link responsible for ovulation.
• Gynecological diseases. The most common is polycystic ovary syndrome. Pregnancy during this illness is difficult. Indeed, with this disease, not only the structure of the female reproductive glands changes, but also their function.
• Great physical activity, especially with low body weight. This is the most common problem among female athletes. Since their lifestyle contributes to a decrease in the production of hormones responsible for
• Inflammation of the internal genital organs of a woman and various kinds infections. This reason is almost the most common and requires long-term treatment. Late diagnosis of inflammation or infection can lead to the development of a chronic disease.
• Stressful situation. A loss loved one, problems at work and in the family, moving - all this can cause prolonged depression, which negatively affects the functioning of the ovaries.
• The use of medications that affect the production of hormones.

The least common cause of failure to ovulate is an ovarian malformation. Treatment of the pathology is very difficult.

Signs of anovulation

A woman herself can feel the absence of ovulation during regular periods. The reasons for this phenomenon are different. And if they are not physiological, then the exact one can only be determined with the help of a gynecological examination or medical examination. The following signs indicate anovulation:

1. Male pattern facial hair, acne and obesity. All this is evidence of a lack of ovulation due to polycystic disease or adrenal disease.
2. Mastopathy. Development of this disease contributes to disruption of the production of sex hormones.
3. Change in basal temperature.
4. Lack of ovulation can manifest itself in the form of heavy menstrual flow over a long period of time.
5. Uterine bleeding is observed, which can be mistaken for menstruation.
6. A woman experiences uncharacteristic sensations before the start of her menstrual cycle.
7. Problems conceiving a child.

Diagnostics. What kind of examinations should a woman undergo?

Finding any of the above signs in yourself should be regarded as a signal to contact a doctor or center reproductive health. To make a diagnosis and prescribe the correct therapy, the gynecologist will first conduct an examination and ask the patient about all the nuances of her menstrual cycle. He can also measure basal temperature.

If necessary, the girl will be tested. It is done similarly to a pregnancy test on the date of expected ovulation. You can calculate the approximate time of egg maturation yourself. To do this, subtract seventeen from the number of days of the menstrual cycle. Testing must be done every day. The process lasts until ovulation or menstruation.

When the second line appears on an ovulation test, this indicates that the level of luteinizing hormone has reached the level at which the egg is ready for fertilization. If this result appears the first time, then you need to repeat the procedure the next day. Why? Because a second line on an ovulation test may also indicate a tumor. In order to find out the cause, the woman is given a referral for a blood test and ultrasound. If there is a possibility that ovulation is absent due to a disruption in the functioning of the central link, then craniography is also prescribed.

Lack of ovulation: treatment

Before you decide this problem, you need to accurately determine the cause of its occurrence. After all, the type of treatment will depend on this. Sometimes, in order to restore the ovulation process, a woman simply needs to reconsider her diet. In case of obesity, even a slight weight loss can help normalize this process. For problems with the thyroid gland, hormonal medications are prescribed.

If detected three times in a blood test elevated prolactin are appointed medical supplies, contributing to its reduction. It is also important for a woman to create a comfortable psycho-emotional environment around herself. It should also be noted that earlier pregnancy with polycystic ovary syndrome was considered impossible. However, medicine does not stand still. Today, this diagnosis is curable - conceiving a child becomes possible.

Drugs

If the cause cannot be eliminated, various medications are prescribed:

• "Clomiphene." It promotes the production of prolactin.
• "Menogon". It is used as an injection to stimulate the growth of the ovaries and stimulate their development.
• "Duphaston" are tablets containing synthetic progesterone. The reason for their appointment may be a pregnancy that is in danger of failure, lack of ovulation, or infertility. This tool very effective. It has no androgenic side effects.
• "Utrozhestan" - capsules containing natural progesterone. Before using any of these remedies, you need to make sure that there really is no way to overcome the reason for the lack of ovulation. After all, any hormonal intervention in the body can have its consequences. And they are not always favorable.

Contact a specialist!

For any problems conceiving a child the best option- contacting a reproductive health center. These institutions are created to combat infertility. In such a center you can go full examination. This is also where sperm is stored. Services are provided here in vitro fertilization, are carried out genetic research, cryopreservation. Pregnancy with polycystic ovary syndrome has become possible thanks to treatment in such clinics.

A little conclusion

Now you know why women lack ovulation during regular periods. The reasons may be different. Of course, infertility is one of the most terrible diagnoses, which only a representative of the fairer sex can hear. Lack of ovulation, of course, can cause it. But before you give yourself this verdict yourself, you should see a doctor and fight for the opportunity to be a mother.

Lack of ovulation is one of the main reasons female infertility. After all, if there is no release of a full-fledged egg from the ovary, then the process of fertilization is impossible. This means you need to apply for medical care to identify and eliminate the causes that cause this condition in the female body.

Before moving on to disturbances in the ovulation process, it is necessary to understand the concept itself and how the mechanism functions normally.

Ovulation (from the Latin “Ovulla” - testicle) is the process of release of a mature egg from the ovary when the follicle ruptures under the influence of hormonal factors. Occurs once during each menstrual cycle. A mature follicle is a vesicle with liquid contents and an egg located in this environment.

The maturation process begins immediately after the first day of menstruation. Regulates this complex mechanism hypothalamic-pituitary system of the brain. It is she who contributes to the maturation of one dominant follicle, which is significantly larger in size than all the others located in the cortical layer of the ovaries. The hormone responsible for the maturation of the dominant follicle is called follicle-stimulating (produced by the pituitary gland).

Most often, ovulation occurs in the middle of the cycle. For example, if a woman's menstrual cycle is 28 days, then ovulation occurs on the 14th day. However, it is considered normal deviation from this median value.

After the mature egg leaves the ovarian follicle, it enters the fallopian tube. Its promotion is facilitated by physical activity villi fallopian tube. Normally it is in fallopian tube fertilization of a mature female reproductive cell occurs. In the absence of fertilization, the egg will die after 12-36 hours, and a corpus luteum will form in place of the burst follicle. It is a temporary gland that synthesizes the hormone progesterone. The formation of the corpus luteum is also regulated by the pituitary gland under the influence of luteinizing hormone.

Progesterone plays a dominant role in preparing the uterus for the intended pregnancy. And if fertilization does not occur and the egg dies, the corpus luteum regresses: it decreases in size and secretes less and less progesterone. This is how menstruation begins, during which the lining of the uterus is shed. The menstrual cycle is counted from the first day of menstruation.

Reasons for lack of ovulation

The absence of ovulation is referred to as anovulation (the prefix “an” means negation). The reasons that cause it are quite varied. In addition, one should distinguish between physiological and pathological anovulation.

Natural or physiological anovulation includes:

• puberty (usually within 2 years after the first menstruation);
• pregnancy;
• postpartum period;
• lactation period (breastfeeding);
• postmenopausal period (menopause);
• absence of ovulation is allowed during regular menstruation in a healthy woman for 1-2 menstrual cycles per year;
• the use of hormonal contraceptives (their action is aimed at suppressing ovulation, and even after discontinuation of the drugs, several subsequent cycles may occur without ovulation).

The most common causes of pathological absence of ovulation are:

1. Significant weight gain or loss. It is known that with obesity, the hormonal background of a woman’s body changes, and this can cause anovulation. However, not everyone knows that with a significant weight loss, ovulation also does not occur. The body simply does not have the necessary resources to produce full-fledged germ cells.
2. Endocrine pathology. Most often, anovulation is caused by problems with the thyroid gland (hypo- or hyperthyroidism). Pathology of the adrenal glands can also cause a lack of ovulation.
3. Pathology of the hypothalamic-pituitary system. This system is a central link in the regulation of the ovulation process. Violations in this system can result from:

• head injuries;
• cerebral circulatory disorders;
• pituitary tumor;
• increased production of the hormone prolactin by the pituitary gland;
• functional disorders of the hypothalamus.

1. Gynecological diseases. The most common problem of the female genital area is polycystic ovary syndrome, in which not only the function, but also the structure of the ovaries changes.
2. Malformations of the ovaries. Not the most common reason for the lack of ovulation, but it is also much more difficult to influence.
3. Diseases of an inflammatory and infectious nature. The danger of this fairly common cause of anovulation is that when improper treatment transition from acute course diseases into chronic ones. And it is much more difficult to deal with such an asymptomatic, sluggish process. Often after inflammatory diseases requires taking ovulation-stimulating drugs.
4. Excessive physical activity. More often this applies to professional athletes. Especially if there is low body weight, such as in track and field athletes or ballerinas. This can cause suppression of the production of hormones responsible for follicle maturation.
5. Stress. This can be either an acute, severe stressful situation (for example, the loss of a loved one), or chronic stress. The response of the female body will not be long in coming, and will be expressed by disruption of the menstrual cycle or complete cessation of ovulation. Stressful situation For the body there may even be a change in climate or place of work.
6. Taking certain medications. Can disrupt ovulation processes long-term use hormonal drugs or some antidepressants. It may take some time to restore ovulatory function after stopping the medication. And sometimes they resort to drug stimulation of ovulation.

Lack of ovulation: signs

Of course, symptoms will come to the fore. main reason, which caused a violation or absence of ovulation. But there are also common manifestations:

• irregular menstrual cycle of a constant nature (the exception is regular cycle with anovulation caused by physiological reasons);
• lack of menstruation, or amenorrhea - this phenomenon can lead to chronic absence ovulation;
• very irregular menstrual cycle – oligomenorrhea;
• long and heavy menstruation. Because of hormonal imbalance During anovulation, the mucous layer of the endometrium of the uterus grows excessively. Therefore, when menstruation occurs, its uneven rejection occurs. Possible uterine bleeding that is not associated with the menstrual cycle;
• if the cause of anovulation is polycystic ovary syndrome or dysfunction of the adrenal glands, hirsutism (excessive hair growth of the face and limbs according to the male pattern) may occur, acne and obesity;
• at increased content the hormone prolactin in the blood (hyperprolactinemia), changes in the mammary glands (mastopathy) will be observed;
• changes in the manifestations of premenstrual syndrome;
• impossibility of conception - if pregnancy does occur, then the problem of bearing the fetus arises;
• change in basal temperature.

Lack of ovulation: diagnosis

If you notice symptoms of ovulation disorders, you should immediately seek medical help. The gynecologist will conduct mandatory diagnostics.

1. A thorough survey about the menstrual cycle: its regularity, subjective sensations that accompany menstruation, the amount of bleeding. Information about previous diseases, surgical interventions and injuries, gynecological manipulations.
2. General and gynecological examination. It will allow you to judge the correct development of the female reproductive system and recognize clinical manifestations anovulation.
3. Measuring basal temperature. This one is simple diagnostic method a woman will carry out this procedure on her own at home for several menstrual cycles (usually at least 3). It consists of daily measurement of temperature in the rectum. The technique is based on the property of the hormone progesterone (which is produced by the corpus luteum) to increase temperature. This simple manipulation has several features:

• you need to make sure there are no inflammatory and infectious diseases, as well as diseases of the genitourinary system;
• You can use a mercury or digital thermometer;
• measurement should begin on the first day of menstruation (i.e., the beginning of the cycle);
• basal temperature measurement is carried out strictly in the morning (preferably at the same time);
• total sleep time should be at least 6 hours;
• the thermometer is inserted into the rectum approximately 3-4 cm immediately after waking up, without changing the position of the body (therefore it is better to put it next to you in the evening);
• measurement duration 3 minutes;
• It is forbidden to drink liquids containing alcohol the day before;
• you cannot have sex during the time that precedes the temperature measurement;
• measurement is not carried out when taking hormonal drugs.

The results obtained are recorded in the graph: horizontal axis The days of the cycle are marked, and temperature data is reflected on the vertical.

In the 1st phase of the menstrual cycle (before ovulation), the basal temperature will be within 37 0 C. The day before ovulation, it usually decreases slightly. And when ovulation occurs, the basal temperature increases to 37.2-37.4 0 C. Thus, a temperature “spike” will appear on the graph. Its absence indicates a monophasic cycle, which means the absence of ovulation is most likely. However, do not rush into self-diagnosis: provide the chart data to your doctor.

1. Additionally, you may need to do an ovulation test. The test is purchased at a pharmacy and carried out similarly to a pregnancy test. The level of luteinizing hormone in the urine is determined. It is necessary to start the test a few days before the date of expected ovulation. For an approximate calculation, use the formula: number of days of the menstrual cycle minus 17. Then the test is carried out daily until ovulation or the onset of menstruation. When interpreting the test, it should be taken into account that, for example, in polycystic ovary syndrome, the concentration of luteinizing hormone is increased.
2. Subsequently, blood tests are performed to determine the level of hormones in the blood: prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), cortisol, progesterone and thyroid hormones (to determine thyroid function). In women with polycystic ovary syndrome and such external signs, such as hirsutism, testosterone levels are additionally examined.
3. If the doctor suspects that the cause is a violation of the central link in the regulation of the ovulation process - a failure in the hypothalamic-pituitary system, then craniography may be prescribed. This X-ray examination skull to identify a pituitary tumor. Magnetic resonance imaging (MRI) can be used to study brain structures in more detail.
4. Ultrasound will help identify structural changes in the ovaries (for example, with polycystic disease, tumors), inflammatory manifestations and determine the presence or absence of ovulation signs (number of follicles and their sizes, endometrial thickness, etc.). Particularly important is the detection of the dominant follicle. Its absence indicates anovulation. For reliability, ultrasound is performed repeatedly over several menstrual cycles.
5. Maybe diagnostic curettage endometrium. This procedure is carried out to visualize the structural changes in the endometrium that occur under the influence of hormones that are directly involved in the process of ovulation.

Lack of ovulation: treatment

Taking into account the fact that the absence of ovulation is not a separate disease, treatment, first of all, should be aimed at eliminating the cause that caused this pathological condition.

1. In some cases, it is enough for a woman to change her rhythm of life and normalize her diet. Sometimes ovulation with such changes may appear already in next cycle. It has been observed that weight loss in obese patients by just 10% of existing body weight can restore ovulation.
2. If the cause of anovulation is a pathology of the thyroid gland, then replacement therapy is prescribed. hormone therapy(thyroid hormones).
3. For hyperprolactinemia, the doctor prescribes drugs that help reduce the level of prolactin in the blood (for example, Bromocriptine, Parlodel). There is no need to take these drugs if the increase in prolactin in the blood is one-time. Only when the norm is significantly exceeded should this hormone be prescribed drug treatment. And the result was confirmed three times in laboratory tests.
4. It is important to eliminate psycho-emotional disorders in women.

If it was not possible to restore ovulation by eliminating the causes that contributed to its occurrence, then use medications. Their action is aimed at artificially stimulating ovulation.

1. Clostilbegit (clomiphene). Its use enhances the synthesis of gonadotropic hormones: FSH, LH and prolactin, as a result of which the ovulation process is stimulated:

• if a woman’s menstrual cycle is preserved, then treatment begins on the 5th day of the cycle;
• taken once 50 mg (1 tablet);
• monitoring of follicle growth using ultrasound is mandatory;
• at positive effect ovulation occurs on the 11-15th day of the menstrual cycle;
• in the absence of ovulation, treatment is continued in the next cycle with an increase in dose to 100 mg (2 tablets);
• at negative result re-stimulation, repeat treatment again at a dose of 100 mg;
• if all attempts are ineffective, repeated stimulation of ovulation can be carried out only after 3 months;
• the course dose should not exceed 750 mg;
• taking the drug is contraindicated in case of ovarian cysts, serious illnesses liver, uterine bleeding in the past, visual impairment and oncological processes;
• uncontrolled use and exceeding recommended doses can lead to early depletion of ovarian function;
• the drug should not be used if the level of estrogen is initially low, otherwise, while taking the drug, their level may decrease even more.

1. Menogon. Used in injection form. Contains FSH and LH 75 IU each. Strengthens the growth of the ovaries and stimulates their development. The treatment regimen is selected individually by the attending physician. Contraindications for use are the same as for Clostilbegit.
2. Puregon. Contains FSH, which is obtained using genetic engineering. Stimulates the growth and maturation of follicles, and also normalizes synthesis steroid hormones female reproductive system. Used as injections. After a course of treatment with Purigon, it is recommended to administer human chorionic gonadotropin (hCG) in order to induce the final stage of follicle maturation.
3. Duphaston. This synthetic progesterone is quite often used in the absence of ovulation. Available in 10 mg tablets. Its advantage over other analogues is that it does not have androgenic side effects that are undesirable for every woman (male-pattern hair growth, decreased voice timbre, etc.). Moreover, synthetic analogue far exceeds the potency of the natural hormone progesterone.

However, you need to know that Duphaston cannot be taken in the 1st phase of the menstrual cycle (i.e. before ovulation): it can interfere with ovulation. Therefore, Duphaston is used in the 2nd phase of the cycle (usually from the 14th to the 25th day of the menstrual cycle, 1 tablet per day). Many doctors play it safe, and in order not to disrupt the ovulation process, they first make sure that ovulation has occurred, and only then begin treatment with Duphaston. And if conception occurred while taking the drug, then treatment is continued during the first trimester of pregnancy without reducing the dosage. This prevents spontaneous miscarriage. But this approach to treatment is justified when the body’s own progesterone production is low. Otherwise, when receiving synthetic progesterone from the outside, you can ensure that your own corpus luteum stops producing this hormone.

1. Utrozhestan. Unlike Duphaston, it contains not synthetic, but natural micronized progesterone. Available in capsules of 100 and 200 mg.

You should always remember that hormone therapy is a serious intervention in the body, and you should not take it lightly. similar treatment. Before you start, you need to make sure that you have used all available methods in the treatment of anovulation, and all necessary examinations to identify the reasons for the lack of ovulation.

From side effects hormonal stimulation is possible:

• problems with the gastrointestinal tract;
• problems with the central nervous system;
• cyst formation;
• worsening hormonal disorders;
• early menopause (depletion of the functional capacity of the ovaries occurs);
• weight gain;
• development of multiple pregnancy.

Under no circumstances should hormonal medications be used independently! Stimulation must be carried out under medical supervision and ultrasound monitoring. This is the only way to monitor how a woman’s body reacts to a particular drug and identify it in time. negative effects. Otherwise, uncontrolled use of hormonal drugs can contribute not only to deterioration of health, but also pose a threat to life.

How to determine the day of ovulation: video