The condition when an egg is not released during a woman’s cycle is technically called anovulation. Then the woman cannot get pregnant. Even in a healthy woman of childbearing age, it happens that some cycles are anovulatory. What to do when it happens more often?
At that time, the gynecologist should already send the woman for a special examination, because anovulation is a very common cause of infertility.
Women receive a limited number of sex cells as a gift. Girls are born with about two million eggs, but by puberty a large proportion are “used up” and a woman’s fertile period begins with about 400,000 eggs. “A woman may also have regular menstrual bleeding, but no one can tell without an examination whether her egg is maturing and being released. A woman herself will not discover that she is not ovulating unless it is associated with other symptoms,” says Miroslav Herman, MD, of the Gyncare Centre for Assisted Reproduction. “For women who cannot conceive, we investigate the hormonal conditions under which the egg matures and whether it is released. We use ultrasound to monitor the growth of the follicle , but also the hormone levels, which tell us if there is something going on and, most importantly, what quality.”
Anovulatory cycle often occurs as a part of endometriosis, polycystic ovaries, it can be triggered by inflammatory and post-inflammatory conditions, metabolic, endocrinological, autoimmune or tumor diseases, but anovulation is also influenced by genetics, psychiatric diseases or the use of certain medications.
If the test from the pharmacy confirms ovulation, but fails to
A woman who is trying to get pregnant takes a routine ovulation test from a pharmacy. The latter confirms that only the production of the LH hormone has begun – this action is associated with ovulation, but does not confirm ovulation. However, gynaecologists are now more interested in the background. By ultrasound, they observe the growth of follicles. Initially, more of them grow, but after a while one takes over, which cracks around the middle of the cycle and releases a mature egg. The remaining smaller follicles disappear. At the site of the ruptured follicle, a yellow corpus luteum is formed. In an anovulatory cycle, the follicle does not grow. In other cases, it grows but does not burst and the egg remains in the unbroken follicle. Over time, it turns into a cystic formation. Not infrequently, a ruptured follicle may not contain an egg, or contains an egg of altered quality. Egg quality is determined by various hormonal, metabolic and genetic regulatory mechanisms and even environmental influences.
If any of them fail, the egg is of poor quality and often its retention in an unbroken follicle is also attached. “Before ovulation, the egg divides into two genetically identical parts. One part will be available for fertilization, and the other is secreted under the egg shell as a half body. We are talking about a mature egg that is capable of fertilisation and has half of the genetic information. The other half is supplied by the sperm at fertilization. Only a genetic examination of a particular cell will tell how the egg has divided. In fact, one half may be genetically different from the other. Cell division abnormalities also occur during the first division of a fertilised egg and later in the cell division period of the embryo, which signals a problem. This problem is often experienced by couples who have repeated miscarriages or where the woman cannot conceive,” explains Dr. Herman.
Stress also influences the non-release of the egg
Hormonal changes during life, overweight or, on the contrary, too thin, physical exertion, change of environment, acute diseases – all this can affect anovulation. The chance of a young and fertile couple conceiving a child during unprotected intercourse within a month is only 17 percent, and after 35. year is further reduced.
If you are worried about infertility or are interested in a possible anovulation examination, make an appointment for an examination at the Gyncare Centre for Assisted Reproduction: https://gyncare.sk/kontakt/
