If you are trying to get pregnant but are not releasing eggs, there are a few potential causes to consider. Let’s go through some quick questions and answers to help identify possible reasons and solutions.
Are you tracking your cycle?
The first step is understanding your menstrual cycle and tracking your ovulation. Ovulation is when an egg is released from your ovaries and is available for fertilization. This typically happens about 14 days before your next period starts. Tracking ovulation is important to know when you are most fertile each month.
There are a few ways to track ovulation:
- Calendar tracking – Mark down when you get your period each month to identify when you usually ovulate.
- Tracking cervical mucus – Check for clear, egg-white cervical mucus which indicates ovulation.
- Ovulation predictor kits – These test your urine for hormones that surge before ovulation.
- Tracking basal body temperature – Your temperature rises slightly after ovulation. Taking your temperature daily can help identify this.
If you are not carefully tracking ovulation, you could be missing your fertile window each month. Start tracking using one of these methods to pinpoint when ovulation is occurring.
Do you have irregular cycles?
If you have irregular menstrual cycles, this can make ovulation unpredictable and difficult to track. Common causes of irregular cycles include:
- PCOS (polycystic ovary syndrome) – Hormonal disorder causing irregular ovulation
- Thyroid problems – Can impact reproductive hormones
- Low body weight – Fat stores are needed to produce hormones for ovulation
- Stress – Can disrupt hormone regulation
- Breastfeeding – Can suppress ovulation
See your doctor for evaluation if you think you may have one of these underlying issues. They can check for hormonal imbalances and health conditions and provide treatments to regulate your cycle and promote ovulation.
Could it be a luteal phase defect?
A luteal phase defect occurs when the luteal phase of your cycle (between ovulation and menstruation) is too short. This phase must be at least 10 days long to allow time for an egg to implant and begin developing properly. With a short luteal phase, progesterone levels may not rise long enough to support a pregnancy.
Causes include:
- Poor egg quality
- Problem with ovulation
- Underlying health condition
- Stress
Progesterone supplements may be used to lengthen your luteal phase. Getting treated for any underlying medical issues can also help correct this defect.
Could you have a fertility health condition?
There are various health conditions that can impact ovulation and fertility. Here are some to be aware of:
Polycystic Ovary Syndrome (PCOS)
PCOS is a common hormonal disorder causing irregular ovulation due to high levels of androgens. Symptoms include irregular cycles, excessive hair growth, acne, and weight gain. It is treated with medications and lifestyle changes.
Endometriosis
This condition causes endometrial tissue to grow outside the uterus, often impacting the ovaries and fallopian tubes. It can cause inflammation leading to impaired ovulation. Surgery helps remove areas of endometriosis.
Premature Ovarian Failure
Also known as primary ovarian insufficiency, this means the ovaries stop functioning properly before age 40. It results in irregular ovulation and cycles due to low estrogen and follicles. Hormone therapy or egg donation may be options.
Pelvic Inflammatory Disease
PID is an infection of the female reproductive organs which can scar the fallopian tubes and damage tissues. This scarring interferes with ovulation and egg transport. Treating the infection and clearing blockages can improve fertility.
See a reproductive endocrinologist for proper diagnosis and treatment if an underlying medical issue could be impacting ovulation.
Are you overweight or underweight?
Having a body mass index (BMI) in the normal range of 18.5-24.9 is optimal for ovulation. The table below shows theimpact of weight extremes:
| Weight Status | Impact on Ovulation |
|---|---|
| Underweight (BMI <18.5) | Lower estrogen levels and missed periods |
| Overweight (BMI 25-29.9) | Hormone imbalances lead to irregular ovulation |
| Obese (BMI over 30) | High androgen levels cause absent/irregular ovulation |
Aim for a healthy BMI through diet and exercise. Losing just 5-10% of your body weight can help restore ovulation if excess weight is interfering.
Could medications be interfering?
Certain medications can affect ovulation. These include:
- Hormonal birth control – Prevents ovulation while using it
- Anti-depressants – Impacts reproductive hormone levels
- Blood pressure medications – Can increase prolactin levels
- Steroids – Interfere with hormone balance
- Chemotherapy – Damages eggs and ovaries
Talk to your doctor aboutalternative medications or adjusting dosages ifyou suspect your medication is impairing ovulation.
Are you under too much stress?
Stress can wreak havoc on your hormone levels and menstrual cycle. Increased cortisol and reduced estrogen when stressed can disrupt normal ovulation. Chronic stress also impacts the hypothalamic-pituitary-ovarian axis which controls the menstrual cycle.
Try stress management through:
- Exercise
- Meditation
- Yoga
- Massages
- Making time for hobbies
If you are going through significant emotional stressors, counseling may also help you cope better and reduce fertility-interfering stress.
Could it be early menopause?
Premature ovarian failure leading to early menopause could be preventing ovulation. Menopause officially occurs when you have had no period for 12 consecutive months and elevated follicle stimulating hormone (FSH). With non-surgical menopause, estrogen levels fall and ovulation stops, leading to infertility.
If you are under 40 and your FSH is elevated while estrogen is low, see your doctor for confirmation. They can run bloodwork to check hormone levels. Treatment may involve egg donation, embryo freezing at younger ages, or hormone replacement.
Are you breastfeeding?
Breastfeeding can prevent ovulation from returning. The relationship is as follows:
- First 6 months – Ovulation unlikely
- 6-12 months – 50% ovulate
- After 12 months – 95% ovulate
As nursing decreases, ovulation typically resumes. Supplementing feedings with formula or pumping to allow longer times between nursing sessions may help.
Could it be compromised egg quality?
As women age, egg quantity and quality decline, particularly after 35. Poor egg quality can lead to irregular ovulation or failed ovulation. Issues include:
- Abnormal chromosome numbers
- Poor cell division
- Developmental problems
- Damaged proteins or structures
Using donor eggs may be an option if your own eggs are not ovulating properly or are of poor quality. Freezing your eggs at a younger age for future use is also something to consider.
Are you exercising excessively?
Too much intense exercise can disrupt menstrual cycles and prevent healthy ovulation. Excessive exercise leads to decreased body fat levels, which reduces estrogen production needed for properly maturing eggs. Aim for moderate exercise – about 30 minutes per day.
Have you had ovarian surgery?
Past ovarian cyst removal or other ovarian surgery can sometimes damage the ovaries enough to impair ovulation. Scarring and adhesions may prevent eggs from being released properly. Similarly, radiation therapy in the pelvic region can damage the ovaries and impact ovulation.
Could it be premature ovarian failure?
Also called primary ovarian insufficiency, this diagnosis means your ovaries stop functioning normally before age 40. It leads to irregular or absent ovulation due to low estrogen levels and diminishing follicles. Your doctor can test hormone levels and evaluate your fertility status.
Treatment options may include egg donation, embryo freezing at a younger age, or hormone replacement therapy. Ovarian tissue freezing may also be considered experimental option.
Are you over age 40?
Fertility declines with age due to lower egg quantity and quality. By age 40, chances of not releasing an egg in a cycle increases to 61%. By 45, less than 10% of women ovulate regularly each month.
Irregular ovulation and missed cycles become more common as you near menopause. Use of donor eggs from a younger woman may improve chances if your own eggs are not ovulating properly.
Could it be genetic factors?
Research shows that genetics can play a role in ovarian reserve and onset of menopause. Having family members with early menopause or fertility issues raises your own risk.
Gene mutations like FMR1 premutation and BMP15 mutation are associated with impaired ovulation and early ovarian decline leading to infertility issues.
Have you lost a significant amount of weight?
Weight loss of 15% or more of body weight can throw hormones out of balance and disrupt ovulation. Dramatic weight loss stresses the body and alters energy balance hormone signals between fat, brain, and ovaries.
Allow your weight to stabilize and focus on maintaining a healthy BMI. Ovulation may resume after several regular menstrual cycles at a steady weight.
Could it be a thyroid disorder?
The thyroid gland produces hormones that interact with the ovaries and reproductive system. Both hypothyroidism and hyperthyroidism can lead to menstrual cycle irregularities and ovulation issues like:
- Irregular periods
- Luteal phase defects
- High prolactin levels
- Hormonal imbalances
Getting proper treatment for thyroid disorders often helps restore ovulation.
Are you taking ovulation suppressing medication?
Medications used to help prevent ovulation will impair your ability to release eggs while using them. These include:
- Birth control pills
- Depot medroxyprogesterone acetate injections
- Norethindrone tablets
- Levonorgestrel IUD
Discuss your fertility plans with your doctor and adjust contraceptive methods accordingly when you want to conceive.
Could it be a pituitary tumor?
Tumors in the pituitary gland may lead to low FSH and LH levels which signal ovulation. Prolactin-secreting tumors also inhibit ovulation. Symptoms besides absent ovulation may include vision loss, headaches, and excess thyroid hormones.
Your doctor can order MRI scans to identify pituitary tumors. Treatment involves surgical removal and/or medication to shrink growths and normalize hormone levels.
Have you made major dietary changes?
Drastic reductions in calories or nutrients can throw off hormone production and ovulation. Low carbohydrate diets and eating disorders especially impact fertility by disrupting leptin levels and estrogen’s role in ovulation.
Aim for a healthy, balanced diet with sufficient calories for your body’s needs. Eating adequate protein and fats is important for hormones. If you have significantly restricted your diet, resume normal balanced nutrition and wait for ovulation to restart.
Conclusion
In summary, reasons you may not be ovulating include:
- Not tracking ovulation
- Irregular cycles
- Luteal phase defect
- Underlying medical condition
- Weight extremes
- Medications
- Stress
- Early menopause
- Breastfeeding
- Poor egg quality
- Excessive exercise
- Past ovarian surgery
- Genetic factors
- Significant weight loss
- Thyroid issues
- Birth control use
- Pituitary tumor
- Restricted diet
See your doctor promptly if you are trying to conceive but not ovulating regularly. There are many possible causes to explore. Treatment options like medications, surgery, IVF or lifestyle changes can often help restore normal ovulation and improve your chances of pregnancy.