When you're trying to conceive, chances are you'll be paying a lot more attention to your ovulation cycle than you may have before. Particularly if you don't get pregnant quickly, perhaps you've turned to ovulation calculators and test kits or have become a pro at figuring out your ovulation symptoms. You may think that if you get your period you'll be ovulating as normal too, but this may not be the case.
What is anovluation?
Simply put, anovulation is when your body does not release an egg during your menstrual cycle. It's a common cause of infertility, as you've essentially skipped your ovulation cycle. Anovulation can happen to women occasionally, and the likelihood is you won't even notice as your body will still have a period. However, if you begin to regularly anovulate, this could reduce your chances of getting pregnant.
In a normal ovulation cycle, a mature egg is released from the ovarian follicle from one of two ovaries. It then travels down the fallopian tube, which links the ovary and the womb (uterus), where it stays for up to 24 hours so it can be fertilised. The release of the egg produces progesterone – which helps maintain regular periods, but if no egg is released this can lead to a hormone imbalance of progesterone, which can trigger heavy bleeding.
Symptoms of anovulation
As mentioned above, it's possible that you have already experienced anovulation without realising it, as sometimes there are no symptoms. However, if you are struggling to conceive and are experiencing the below, it may be a sign of anovulation:
• Irregular periods
• Heavy or light bleeding with periods
• Missing periods
• Lack of ovulation symptoms
• Irregular basal body temperature (BBT)
• Sore or painful breasts
What causes anovulation?
There are a range of potential causes for anovulation, the key one is hormones – fluctuations or sudden changes in hormone levels can trigger anovulation, for example it's quite common during puberty and menopause, or if you have Hypothalamus or pituitary gland dysfunction.
• Obesity
• Low body weight
• Excessive exercise
• Stress
• Polycystic ovary syndrome
• Diminished ovarian reserve (DOR)
Diagnosing anovulation and potential treatment
More than 8 in 10 couples, where the woman is under 40, will conceive naturally within a year of having regular unprotected sex. If it's been over a year, the woman is over 36, or you have a health issue that could affect your fertility, the NHS recommend going to your GP.
A blood test can be done to check if you're ovulating. Your doctor may also suggest an ultrasound to check your ovaries, womb (uterus) and fallopian tubes.
According to the NHS, the most common fertility treatments include:
• Clomifene – encourages the monthly release of an egg (ovulation) in women who do not ovulate regularly or cannot ovulate at all
• Tamoxifen – an alternative to clomifene that may be offered if you have ovulation problems
• Metformin – is particularly beneficial for women who have polycystic ovary syndrome (PCOS)
• Gonadotrophins – can help stimulate ovulation in women, and may also improve fertility in men
• Gonadotrophin-releasing hormone and dopamine agonists – other types of medicine prescribed to encourage ovulation in women
If medicinal assistance proves unsuccessful, surgical procedures or intrauterine insemination (IUI) and in vitro fertilisation (IVF) will be the next step.
Can you get pregnant when you're not ovulating?
It is possible to get pregnant outside of your official ovulating window, during your ovulation cycle as you may be experiencing late ovulation. However, if you don't ovulate, ie release an egg, then you can't get pregnant.