in this issue
Sonja Kristiansen, MD
Medical Director & co-founder
of
the
Infertility Center
of Houston, Dr. Kristiansen is double board certified in
Reproductive
Endocrinology and Obstetrics & Gynecology and
specializes in surgical and IVF procedures.
She has
advanced training in hysteroscopy, laparoscopy, and
microtubal reconstruction. She also works with
female endocrine abnormalities relating to
menstrual and reproductive development.
Quick Links...
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One of the first things that will be assessed when you
visit a fertility specialist is the quality of your ovulatory
function. Naturally, ovulation is a crucial key to getting
pregnant, and disorders of the ovulatory cycle are not
rare. Fortunately, many causes of these disorders are
treatable.
The results of having an ovulation disorder are:
- fewer opportunities to conceive
- difficulty detecting a woman's fertile periods
- eggs not breaking through the follicle
- eggs being released off-sync with other factors
that are crucial to fertilization or implantation
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What Could Be the Problem?
Overall, we use the term "ovulation disorder" to refer to
infrequent or absent ovulation (also called anovulation.)
While ovulation disorders may result in infrequent
periods (oligomenorrhea), that's not always the case.
Some women may be experiencing poor ovulation even
though they have a regular period.
Some typical causes of ovulation disorders include:
- hypothalamus or thyroid dysfunction
- hyperprolactinemia
- polycystic ovarian syndrome
- luteal phase defect
- tumors of the pituitary or adrenal glands or
ovaries
Less typical ovulation disorders are:
- Primary ovarian failure (POF)
- Resistant ovary syndrome
- Autoimmune oophoritis
Diagnosing ovulation disorders may begin with the
following lab tests:
* serum FSH
* serum LH
* serum prolactin
* serum testosterone
* free androgen index
* thyroid stimulating hormone (TSH)
and may also include:
- CAT scan or MRI scan of pituitary and hypothalamus
- endometrial biopsy
- ovarian biopsy
- more specific antibody tests (antithyroid, adrenal,
islet-cell, gastric parietal cell)
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What Can Be Done?
Once we've determined the cause of your ovulation
disorder through diagnostic testing, the treatment will
vary.
Treatments may include:
- use of ovulation-inducing fertility medications
- use of other drugs more specific to the diagnosed
cause
- nutritional adjustment
- stress reduction
- surgery (in the case of tumors)
Only primary ovarian failure and the related conditions
of resistant ovary syndrome and autoimmune oophoritis
are considered untreatable in regards to fertility.
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In Closing
While the term "ovulation disorder" may sound scary,
the simple truth is that many women deal with some
disorder of their ovulatory cycle at some point in their
lives. If you're experiencing problematic ovulation at
the same time that you're trying to get pregnant,
appropriate treatment is crucial to your goal. I'm happy
to talk with you about specific concerns and how my
staff and I may help.
Sincerely,
Sonja B. Kristiansen, MD
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