Anovulatory Infertility
2 medicines
Anovulatory infertility happens when the ovaries don't release an egg each cycle, so there's no egg to fertilize. It's diagnosed with hormone blood tests and treated with ovulation-inducing medicine such as clomifene.
Key facts
- Anovulatory infertility happens when the ovaries don't release an egg during a menstrual cycle; without ovulation there's no egg to fertilize, so conception can't occur.
- It's one of the most common and treatable causes of female infertility, accounting for roughly a quarter of infertility cases worldwide.
- Polycystic ovary syndrome (PCOS) is the most frequent underlying cause; thyroid disorders, elevated prolactin, low body weight, and stress are other triggers.
- Clomifene is a well-established first treatment for ovulation induction when PCOS or unexplained anovulation is the diagnosis.
Why ovulation fails
The most frequent underlying cause is polycystic ovary syndrome (PCOS), which affects a significant share of women of reproductive age. Other triggers include thyroid disorders, elevated prolactin levels, low body weight, and stress. Cycles may be irregular or absent altogether, though some women have apparently normal cycles yet still don't ovulate, which is why testing rather than cycle-watching alone confirms the diagnosis.
Diagnosis and restoring ovulation
The first step is usually confirming anovulation through blood tests, mid-cycle progesterone, LH, and FSH, plus an ultrasound to check the ovaries and womb lining. Once confirmed, treatment targets the root cause. Where PCOS or unexplained anovulation is the diagnosis, ovulation induction with clomifene is a well-established approach, typically taken for five days early in the cycle and monitored with follow-up scans or blood tests. Lifestyle changes, particularly reaching a healthy weight, can restore ovulation on their own in some women. Further options within women's health include gonadotrophins or, when structural factors are involved, a surgical referral.
When to see a doctor
A fertility evaluation is worthwhile if you've had unprotected sex for twelve months without conception, or six months if you're over 35.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.