Most women have cursed them at some point in their lives. At best, we’ve tolerated or even ignored them. It isn’t until we’re trying to get pregnant that most of us focus intently on our menstrual cycles. Then, suddenly, we’re observing every detail like a wildlife expert on assignment. We’ve got charts littered with notes and numbers, calendars with stars and smileys, ovulation prediction kits and a dizzying array of pee sticks we never even knew existed before.
For some women, all this attention reveals something they may have suspected but never focused on – that their menstrual cycles are “irregular.” There are many women who have irregular periods and thus, irregular ovulation. Some women ovulate only occasionally. Some menstruate occasionally but don’t ovulate. Some don’t do either at all.
About half of women with infertility have what are known as “Ovulatory Disorders.” Often physicians and healthcare literature will say that these disorders are “easy to treat”. Dr. Ricardo Yazigi, of Shady Grove Fertility’s Baltimore-GBMC office clarifies, “The better thing to say is that there are treatments that are very effective in treating ovulatory disorders.”
Pinpointing a couple’s obstacles to conceiving and designing treatment plans that are tailored to each patient are the keys to that success.
What Are Ovulatory Disorders?
For women who are not ovulating regularly, the cause is usually that the ovary is not receiving the appropriately timed signals to mature and release an egg. The pituitary gland, at the base of the brain, produces the hormones that control the ovaries – FSH (follicle stimulating hormone) and LH (luteinizing hormone). If ovulation is not occurring in a regular, timed fashion, it is likely that the ovaries and the pituitary are not communicating appropriately.
Ovulatory disorders broadly break down into two groups: anovulation – when no ovulation at all occurs; and oligo-ovulation – when ovulation occurs infrequently or irregularly.
Polycystic Ovarian Syndrome or PCOS is the most common cause of anovulation and oligo-ovulation. PCOS can prevent women from ovulating but can also cause a number of additional symptoms such as small cysts in the ovaries, obesity, and unwanted facial hair.
“Any woman with an ovulatory disorder, regardless of the type, should seek treatment if she wants her chances of becoming pregnant to be similar to the average for women who ovulate regularly,” advises Dr. Yazigi.
Fertility Treatment for Ovulation Problems
Most women with an ovulatory disorder will begin treatment with their Ob/Gyn, using oral medications like clomiphene – also known as Clomid or Serophene. These medications are designed to increase FSH and LH levels in the pituitary gland, thus signaling the ovaries to produce follicles and ovulation to occur. Several studies have shown that the majority of women using clomiphene will begin to ovulate regularly and may become pregnant within three to six treatment cycles.
Dr. Yazigi says this finding is extremely important. He explains, “What this says to me is that any woman who has done three cycles of clomiphene and is still not ovulating, or has not become pregnant, should undergo additional evaluation with a fertility specialist.”
When to Seek Help for Ovulation and Menstruation
Dr. Yazigi advises that couples don’t wait too long to see a Shady Grove Fertility physician if they are not having success. “I often see patients who have already gone through six or seven unsuccessful treatment cycles with their Ob/Gyn. They are frustrated and demoralized, but I know there is more that we can do to help.”
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The first thing a fertility specialist will do is determine whether there are any issues in addition to the ovulatory disorder that would affect a couple’s fertility. One study shows that of the women who responded to clomiphene by ovulating but failed to conceive, 87% had an additional cause of infertility such aspelvic lesions, tubal disease, endometriosis, male factor infertility, or a combination.
Once a treatment plan has been created based on each individual patient’s diagnosis, our physicians will monitor and adjust the plan throughout the patient’s cycle. “We will use blood tests and ultrasounds to closely monitor progress, so a patient will know right away if the treatment making a difference,” explains Dr. Yazigi.
Medication doses can be adjusted, or additional medication added, during the cycle until the patient is able to achieve ovulation. Other advantages of working with a fertility specialist include the ability to time intercourse more accurately, and adding additional treatment methods like Intrauterine Insemination (IUI) or, if necessary, In Vitro Fertilization (IVF), to help achieve pregnancy. In fact, Shady Grove Fertility patients who are diagnosed with ovulatory disorders have a 52% chance, per IVF cycle, of successfully having a baby.
“When treatment is tailored to a woman’s individual response, it greatly increases the chances for success,” says Dr. Yazigi.
Getting Pregnant with Ovulation Disorders
Ovulatory disorders are the most common and treatable causes of infertility, but this doesn’t mean that everyone has success right away. Dr. Yazigi advises that couples be aware of the many possible causes of infertility and the benefits they can gain from the monitoring and treatment provided by a fertility specialist.
“Most patients we see at Shady Grove Fertility do overcome ovulatory disorders and have successful pregnancies,” Dr. Yazigi says. “This is a great source of hope for all couples struggling with this issue.”
55 Comments
Favour Ngozi
November 4, 2015 - 2:25 pmwent for scan (pelvic scan) last month. Suggestion from Dr., to me was PID & fibroid. Pls., what do i do sir.
Shady Grove Fertility
November 11, 2015 - 12:18 pmHello Favour – Fibroids are often easily treated either with medications or sometimes through surgery. To learn more about your options contact our New Patient Center at 1.877.971.7755 or visit http://bit.ly/SGFappt.
To learn more about fibroids: https://www.shadygrovefertility.com/diagnosing-infertility/infertility-causes/female-infertility-causes/fibroids
Nicole
December 13, 2015 - 2:53 pmHello;
I have Endometrosis and I have been trying to conceive since June. So far nothing. Should I see a gyno, a fertility specialist, or an Endo specialist? Thanks!
Janaila
January 29, 2016 - 9:24 pmI would like to know, What are the chances of me getting pregnant if I use TTC or Conceive plus during the time I am not ovulating? will it still work? What if I use it every time my husband and I are having sex
shalom Emmanuel
November 5, 2015 - 9:28 pmHello,
I had a miscarriage a year and 9months ago , but I still test positive. I have been trying to conceive but it seems like am not ovulate . What am I going to do? Please reply.
Shady Grove Fertility
November 11, 2015 - 12:20 pmHi Shalom – It is not uncommon for it to take several months to get your period back (and therefor ovulation) after a pregnancy loss. However, you may want to consult with a physician to see if there are any other issues that may be delaying the return of your monthly cycle as well as if there are other contributing factors to your pregnancy loss. To learn more, please contact our New Patient Center at 1.877.971.7755 or visit http://bit.ly/SGFappt.
chinyere
November 11, 2015 - 8:36 pmI have been trying to get pregnant for close to one year now but all to no avail, I have done pelvic scan and it shows I have cyst,how do I get that remove and it also shows that I don’t ovulate regularly, some times my period come twice a month some times it comes within the interval of 11 days pls I dont know what to do and I want to get pregnant. Thanks
Shady Grove Fertility
November 12, 2015 - 12:32 pmHi Chinyere – Given the length of trying to conceive and your other medical indicators, it is definitely time to consult with a reproductive endocrinologist. They can review your history and potentially do new testing to see what might be causing your irregular cycles and whether or not the cyst will need to be removed. Please contact our New Patient Center to learn more about the options available to you: 1.877.971.7755 or visit http://bit.ly/SGFappt.
Irene
November 12, 2015 - 12:59 amHi I have two healthy boys. I was on Mirena for 4 years no period
I’ve been off it since 9/11 /15 I don’t think I’m ovulating I’m very dry down there and
My ovulation strips came back negative I’m on CD 16 and still negative
What is going on with my body my periods got back to normal now
Shady Grove Fertility
November 12, 2015 - 12:35 pmHi Irene – It is very common for it to take several months to start ovulating again after stopping any type of birth control. While it may not be time to raise any red flags, you may want to talk with a fertility specialist to see if there are any other factors that might be impacting ovulation. To learn more, contact our New Patient Center at 1.877.971.7755 or visit http://bit.ly/SGFappt.
Diamon44
November 13, 2015 - 7:24 amHi Dr, my monthly cycle sometimes its irregular and at a time it became regular but I don’t seems to see my ovulation and I have been trying to conceive for 5yrs now any idea on what to do?
Shady Grove Fertility
November 13, 2015 - 12:38 pmIf you are concerned about whether or not you are ovulating, you should definitely come in for some diagnostic testing and consultation with a fertility specialist. They can determine if you are ovulating and what next steps should be. Often medication alone can help women to ovulate and the conceive without more advanced treatment. To learn more, contact our New Patient Center at 1.877.971.7755 or visit http://bit.ly/SGFappt.
Lola
November 13, 2015 - 1:49 pmI usually have ovulation pains,but not every month. Does that mean that i dont ovulate monthly?
Shady Grove Fertility
November 13, 2015 - 2:01 pmHi Lola – Everyone experiences different symptoms. If you are currently trying to conceive and it is taking longer than expected (<35 years and trying to conceive for 1 year, 35+ and trying to conceive for 6 months), it is advised to speak with a reproductive endocrinologist to see what may be interfering with your ability to conceive. To schedule a consultation, please call our New Patient Center at 1.877.971.7755 or visit http://bit.ly/SGFappt.
cassi
November 14, 2015 - 2:09 amHello, I’m 24 years old and me and my husband have been trying to conceive now for 8 months I have a period every 30 to 33 days but I’m pretty sure I’m not ovulating I’ve been checking my cervical mucus and nothing has pointed to ovulation except around my 14 day I have
a slight spot that last a few days. Any advice?
Shady Grove Fertility
November 17, 2015 - 6:30 pmHi Cassi,
Great questions. Typically, we recommend women who are 35 or younger to try for one full year before seeing a fertility specialist. However, if you are not ovulating, it may be time to meet with one. During your first visit, your physician will review both yours and your husband’s medical history and will review any testing you may have already completed. 90% of patients with insurance have some coverage for this initial appointment. To schedule an appointment, please call 1-877-971-7755 or you can fill out this brief form to get started: https://www.shadygrovefertility.com/appointment
Thank you again!
Joi
November 15, 2015 - 3:43 amI’ve been off depo for 2 years now, femara induced my period the past 4 months, ive had regular cycles for the past 4 months 25-28 days but i dont think i ovulate, ovulation predictors say no ovulation. We are trying to get pregnant. Is it possible to not be ovulating with a regular period? Please help, this is frustrating! I do have 2 children ages 10 and 8.
Shady Grove Fertility
November 17, 2015 - 6:25 pmHi Joi,
Great question. Yes, it is possible to not be ovulating but still have a regular period. Also, secondary infertility—the inability to get pregnant naturally or carry a pregnancy to term after successfully conceiving one or more children—is actually quite common. Please find more information about secondary infertility here: https://www.shadygrovefertility.com/diagnosing-infertility/how-to-get-started/facts
If you are trying for your third child and not ovulating, we recommend seeking an opinion of a reproductive endocrinologist. Please call 877-971-7755 or fill out this brief form to schedule an appointment: https://www.shadygrovefertility.com/appointment
carmen portal
November 19, 2015 - 12:56 amWhat make a women not ovulate
Shady Grove Fertility
November 20, 2015 - 4:30 pmHi Carmen,
The natural hormones in a woman’s body create the menstrual cycle – a part of this cycle is ovulation. Here is more information about ovulation and the menstrual cycle: https://www.shadygrovefertility.com/fertility-health/female-reproduction/understanding-cycle
angel
November 19, 2015 - 4:30 pmpls, I want to knw why I’m not ovulating again, I’m 20 yrs of age use to ovulate normal b4, I broke my virginity in this my 20yrs of age. used some pills but not regular, but right now I’m anxious to know why I’m not ovulating as I will be getting married soon. also I had like virgina discharge which is no more. what should I do? my cycle is 28 cycle and is regular
Shady Grove Fertility
November 20, 2015 - 4:29 pmHi Angel,
If you are currently taking birth control, then you will not ovulate. When you stop taking birth control ovulation should occur again naturally. Here is an article that will help you better understand your menstrual cycle and when you should ovulate. Ovulation predictor kits are also available to help measure if and when you are ovulating, again this will only be helpful if you are not currently taking birth control. https://www.shadygrovefertility.com/fertility-health/female-reproduction/understanding-cycle
If you find yourself unable to conceive after one year of trying (having unprotected sex), we recommend seeing a fertility specialist. If you have additional questions, please call our New Patient Center at 877-971-7755.
stephanie
November 24, 2015 - 12:25 pmHi i am 38 years old with 4 childern i had my tubes tied 14 yrs ago well this year i had them reverse and two months i had gotten pregnant but i miscarried at 7 weeks .well since then we have been trying but nothing happening and i dont think that i am nessing ovulation because my periods are all not regular.plz help.
Nicole
December 13, 2015 - 2:54 pmHello;
I have Endometrosis and I have been trying to conceive since June. So far nothing. Should I see a gyno, a fertility specialist, or an Endo specialist? Thanks!
Taylor Nelson
January 3, 2016 - 7:12 pmI haven’t had my period in over 4 months. I have gone up to 2 years without it, My boyfriend and I are sexually active and using condoms. I don’t quite understand why I haven’t gotten my period. please reply.
Golddy
January 5, 2016 - 12:16 pmi have d n c due to miscarriage two years ago and since then av been trying g to conceive to no avail. i have a regular period, i dont think am ovulating and sperm use to leaking out of my v**g**l after sex pls what can i do?????
SERAH
January 26, 2016 - 10:28 amAm 28year old, got married 3month ago and av bn trying to get pregnant bt I noticed am not ovulating, pls wat can I do.
regina
January 29, 2016 - 2:33 pmI have been trying to conceive for 2 years now, no way.i have a regular cycle.i only don’t ovulate.what test can I do?
vicky
February 3, 2016 - 1:34 amPls I recently did an hormonal test and the result showed that far was 3 while LH is 3.6. Pls what does it mean and is it so bad?
Silva
February 29, 2016 - 1:22 pmI am 54 have a new partner we want to have children but I had my last period July 2015 feel my cycle may have ended if so can this be reversed.
Blessed
April 12, 2016 - 7:16 amI have done hormonal imbalance test,menstrual disorder, scan, etc yet all result proves am fine apart from d scan that shows I don’t produce follicles. Yet I don’t see my menstruation on a regular basis and I used to ovulate b4 not until January dis year. What should I do?
Heather
May 23, 2016 - 2:04 amI have had 3 lighter than normal periods and then bleeding after a period. The ultrasound showed fluid so Doctor said I either ovulated earlier than I thought or I had a cyst that burst. This was on cd10 and She said there was no follicle to become a dominate Corpus Luteum showing on the ultrasound. However, on cd12 I had positive for ovulation on the Clearblue advanced digital. What could possibly be going on. I am 32 and have just recently began trying to get pregnant for the first time.
Heather
May 23, 2016 - 2:11 amI should note that the doctor said I did have a cyst on my right ovary, but could it have actually been a dominate follicle?
Heather
May 23, 2016 - 2:13 amI should note that the doctor did say I had cyst on my right ovary but could that have actually been a dominate follicle and did ovulate?
Patricia
June 15, 2016 - 8:41 pmHi My name is Pat I have been trying to conceive for 4 years now and nothing has happens. I went to the doctor and he prescribed me Clomid I only did one cycle and it dint work now after reading this article I’m confuse do I have to finish three cycles or more to get it to work. Please help.
Vivian
June 22, 2016 - 3:21 pmi went for hormonal test and the result shows
luteinizing hormone 4.16, FSH 3.15, prolactin 11.94, progesterone 2.90, estradiol (E2) 39.12
my doctor said am not ovulating with this result but i notice the mucus sign each month. He said the fast and best option is to go IVF and that is not a better option for me. please is there a best option for me to conceive. it 6yrs already.
Kate
July 6, 2016 - 12:39 amHello, me and my husband been ttc for more than a year and last may we went to specialist to find out why ..so after all the test and ultrasound he said that I don’t ovulate every month and he mentioned also that I have a small fibrous and my proclatin level is a little high which he said this shouldn’t be a main reason for not to get pregnant? He told us to start IUI right away but I’m a little nervous to start right away? Should we maybe start or try a little more? Btw I’m 30 years old
Christy
July 19, 2016 - 9:11 pmHello –
For over a year I have had irregular periods around January I went to the OBGYN and was diagnosed with PCOS since then I have gone on metformin and clomid, changed my diet drastically (no dairy, nightshade veggies, white flour, processed sugars) and lost weight despite the struggle PCOS causes, my period is still around 35 days and whenever I have my ultrasound on day 14 there is never a mature folical. They can see that I have lots of eggs but none that are ever ready. My uterine lining always looks healthy. I have been pregnant before but can seem to get pregnant now. I just turned 29 and I’m unsure if I should just give it a break or if I’m actually NOT ovulating despite having a period every month and ovaries filled with eggs.
Mida
August 3, 2016 - 7:32 pmI just stumbled upon this site as I was searching for answers as regards the irregular heartbeats (fast) I am currently experiencing after having embryos transfer yesterday (IVF) The comments and answers are encouraging. Dr., do I need to worry?
Joseph Mom
September 20, 2016 - 8:50 amI have been trying to conceive since 2014 and was diagnosed with early menopause last year, what are the chances of me falling pregnant again. I also do not have a menstrual cycle.
sim
September 23, 2016 - 6:15 pmHello,
I have a 6 years old daughter from my first husband, and about a 7 months back I had a miscarriage with my second husband. I am 39 and we are trying to have a baby from past 4 months but no luck. I know its hard to get pregnant at my age but what are the chances, am I have any kind of infertility issue, or any problems that I am not getting pregnant. Please help I am very scared.
FYI- I have no issues with my periods, they are pretty much on time, just a few days up or down.
Oluchi Uche Njoku
October 12, 2016 - 7:58 amI am 36years and still trying to conceive since 6years now. I’ve been pregnant once around 2004/05 before I got married. Had an ovarian cyst surgery in 2014 and been on some fertility drugs till 2015 but no positive result please I need immediate help. Thanks
Marisol
October 23, 2016 - 7:46 pmI’am 34 years old and have a an almost 7 year old got pregnant right after getting married with no problem. For the past 5+ years I have been trying to get pregnant again with no success. Went to to the gynecologist and got everything checked. The only problem is that I’m not ovulating at all. She wants to put me on clomid, but after reading all the side effects I was skeptical. So I decided to start taking a supplement called pregnitude. I want to know if this actually works the same way as clomid or not? And if there is anything out there natural that can help me start ovulating . Thanks in advance
sandra lopez
November 16, 2016 - 12:46 ami am here to share my testimony on how i conceived my baby. i have been married to my husband for 11 years without no issue.i had problems with my in-laws even my husband started to have new affairs aside our marriage. it was a very terrible thing to bear. i became a laughing stock among my pear, i prayed and fasted and nothing happened. i was now seen as always unhappy.i was even ready to pack out of my marital home and stay on my own because my husband was not given me any attention that i needed from him. i decided to focus on my job and try to live happy on my own. on this faithful day, i decided to check the net for updates on healthy living and i came across a story of a man who Dr NOSA helped his wife to conceive a baby. i decided to put a try because this has been my greatest problem in life. today i am a proud mom with two son. words will not be enough to explained what this man did for me.i am a happy mother,i know there is someone in same condition and you feel there is no way. i urge you to contact him. This is the solution to every single mother around the globe. distance is not a barrier, he will surely make your dreams come trough. contact him today via email: drmosaspellcaster@gmail .com
Samantha Poggemann
January 15, 2017 - 2:20 pmHey I have a question about why Everytime I take a ovulation test it’s low always so far. My husband and I are trying to get pregnant and I want to make sure I still can get pregnant. I just don’t want to think I can’t get pregnant help me
Shawnie
January 21, 2017 - 2:38 pmI have recently stopped ovulating for the past 3 months my doctor told me that my level is at 6 and I should be at a 10 what should I do
Analymous
January 29, 2017 - 9:45 pmHello, I am 35+, so far my periods are very regular of 28 days. Period last for 2 days in every cycle, with the third day as spotting. For this month used OPK to predict my ovulation day but it is showing continuously negative. Am i Ovulating?
happiness
March 22, 2017 - 8:07 ammy name is happiness i has my first baby but is Stillbirth, and even since dey i am unable to get Pregnant and have be Clomid for more then 7 cycle. and now the doctor said i don’t ovulate pls what will do
rebecca barnett
March 24, 2017 - 4:44 ami have been trying to concieve for about 7 months now and no luck.
i have regular periods but bleed really heavy i dont think im ovulating at all, should i go to the hospital and get an ultrasound? im thinking i am either just not ovulating o r i have polycystic ovaries
Divine
April 24, 2017 - 7:21 amAm having the same problem with you. What is the best solution? Someone should help us please.
Adrian Walker
April 25, 2017 - 8:22 pmHello,
I was on the Paraguard IUD for 5 years and finally decided to remove it before it expired which was 10 years. Well, since I have removed the IUD I have not been ovulating at all. My obgyn put me on birth control pills for 2 months so that it could tell my ovaries what to do and still no ovulating. I’m not trying to get pregnant at the moment but I do plan to have more children and do not want this to effect me getting pregnant on down the line. And also when I don’t ovulate I don’t have a cycle. Without birth control my cycles are irregular. It’s not like clock work, coming on the same day every month. Now i’m not ovulating or having a menstrual cycle. What do you suppose is causing this?
Favour
June 16, 2017 - 11:31 amHello I used to see my ovulation but for the past 8mothns now I have not seen it and I always have Virgina discharge but it has stopped and that was when my ovulation stopped coming out please what is the problem
mandi masters
July 24, 2017 - 6:45 pmhi i have been on my period all month now and this has happened to me several times now. its frustrating and its taking a emotional toll on me. Im tried alot, no energy. The most I have been on my period is 34 days at one time. Ive been to my Dr. and he said im skipping my ovulation. I tried birth control and it makes me sick What do you think is the deal?
moreen
August 17, 2017 - 7:38 amI am a lady aged 30 years .I have serious problem with my periods I get periods twice a month .sometimes I stay for about 4 months without periods .I went to the doctor last year august and went to the scan everything was normal no cytes,no fibroes,uterus size was normal .Im not taking any birth control pill or something.last week I had a period n I was bleeding very heavy
Joann james
August 23, 2017 - 10:03 pmI have a 5 days period and then 20 normal days and then back to period again so in a nutshell a 25 days cycle. It comes on time but I don’t ovulate and I did a hsg after trying to convince and having difficulties and they said my tubes are blocked. Does it mean that the tube blockage is affecting my ovulation? And what can be taken or eaten naturally to make u ovulate?