Under normal circumstances, women experience ovulation once a month, which is an important manifestation of their fertility. However, some women may experience anovulation due to various reasons, which is certainly abnormal. So what are the reasons for ovarian failure to ovulate? What exactly is anovulation? Friends who don't know, follow the editor to take a look.
1、 What is anovulation
Women of normal reproductive age ovulate once a month, usually about two weeks before their next menstrual period. The main organs that dominate ovulation are the hypothalamus, pituitary gland, and ovarian axis. The reasons for female anovulation include pituitary anovulation, hypothalamic anovulation, central nervous system anovulation, brain lesions, immune or psychological factors. Women who do not ovulate have a high chance of conceiving with normal ovulation as long as they receive appropriate treatment. But we need to first identify the cause and then develop a diagnosis and treatment plan based on your specific situation.
The incidence rate of anovulation in infertility can be as high as 25%~30%, which is a common endocrine disease. In addition to infertility, patients often exhibit menstrual disorders such as oligomenorrhea, infrequent or absent menstruation, heavy hair, obesity, etc. The risk of developing endometrial cancer or breast cancer is relatively increased due to long-term anovulation, endometrial hyperplasia, and no antagonism of periodic progesterone.
Normal ovulation relies on the regulatory function of the complete hypothalamic pituitary ovarian axis and the normal secretion function of the ovaries. The causes of ovulation disorders are often attributed to three aspects: dysfunction of the hypothalamic pituitary axis, abnormal feedback mechanisms, and local ovarian factors.
The "endocrine dysfunction" or disorder in modern medicine, such as anovulation, is equivalent to the "menstrual disease" in traditional Chinese medicine. The treatment of infertility with traditional Chinese medicine mainly focuses on tonifying the kidneys, while the promotion of ovulation with traditional Chinese medicine is still mainly based on clinical symptom differentiation and treatment. Traditional Chinese medicine adopts the methods of nourishing the kidneys, promoting blood circulation and removing blood stasis, filling essence and marrow, and nourishing both qi and blood to soothe the liver and invigorate the spleen, so as to balance qi and blood, promote the circulation of Ren and Yuan, and thus have children.
2、 Reasons for 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 testosterone, 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, but 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 but 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.
This article provides a detailed explanation of what causes female anovulation and the specific reasons behind it. If you are a woman who does not ovulate, then you should carefully refer to the content of this article in the end, so that you can learn more about what does not ovulate and take measures to deal with this situation.
