Issues around ovulation, either irregular ovulation, sever ovulation symptoms or anovulation, account for around 30 – 40% of infertility cases. The presentation can vary greatly. Some women may experience regular menstruation yet not be ovulating, for some women their cycles may vary in length each month making it hard to predict when ovulation is occurring.
For most women, a good predictor of ovulatory dysfunction is when cycles are less than 21 days or longer than 36 days or in some cases women may have no menstrual bleeding at all. This may be related to conditions such as Poly Cystic Ovarian Syndrome (PCOS) or thyroid imbalance. However it is common to present with ovulation issues without the presence of any underlying disorders.
Ovulation symptoms and signs are a great way to help know when you’re ovulating and discover your unique fertile window. Ovulation symptoms can vary however there are certain ovulation symptoms and signs which are similar in everyone. Knowing and recognising these ovulation symptoms is a great way to improve your chances of getting pregnant.
The main causes for non-medically related ovulatory dysfunction include
Very low body weight
High stress levels
If you are experiencing ovulation issues, it is important to seek the advice of your Health Care Professional. There are also dietary and lifestyle modifications that can be useful in helping to resolve ovulation difficulties.
If very low or very high body weight is suspected to be the cause of ovulation dysfunction, then addressing the diet is very important. You may be interested in reading The Fertility Diet which can help you reach and maintain a healthy weight as well as helping to provide key nutrients to support fertility. You can access a FREE introduction to the Fertility Diet here.
Either excessive or lack of exercise can contribute to fertility issues, particularly anovuation. When trying to fall pregnant and support ovulation, certain exercises are better than others. Check out our top fertility and preconception exerciese and lifestyle tips.
Stress is one of the biggest lifestyle factors affecting fertility, particularly ovulation symptoms and dysfunction. Chronic, high level stress places the body in constant fight or flight mode. This triggers the release of adrenaline and cortisol, which can be beneficial stimulants in cases of acute stress but negatively impact health when they remain chronically high. This is not conducive to carrying a baby. During times of high stress ovulation can be erratic or may stop completely. Read more about how stress impacts ovulation and what you can do. The psychology of fertility is often forgotten or neglected in the fertility process. Don’t underestimate the impact stress can have on your ability to fall pregnant.
Vitamin B6 plays an important role in hormone production and regulation. Vitamin B6 can be beneficial to support healthy hormone balance to aid healthy ovulation and help reduce ovulation symptoms. Supplementation of vitamin B6 can be particularly beneficial to help stimulate ovulation in those coming off hormonal contraception, as these medications can deplete the body of B6.
Vitex-agnus castus (Chaste Tree Berry)
Vitex is the most commonly prescribed herb for severe ovulation symptoms, ovulatory dysfunction or anovulation. It supports production of progesterone, which is vital for ovulation. It also helps regulate ovulation by supporting the lengthening of the luteal phase (the time from ovulation to the next menstrual period), which helps enable healthy fertilisation.
Clomiphene (Clomid/Serophene) is commonly prescribed to help stimulate ovulation. It works by blocking estrogen receptors, which in turn stimulates the release of follicle stimulating hormone (FSH) and luteinising hormone (LH). These hormones are naturally released during the cycle to stimulate ovulation.
Clomiphene is taken for 5 days typically starting around day 3 – 5 of your cycle, or as recommended by your specialist. Ovulation will generally occur about 7 days after taking the last tablet. If the medication works and ovulation is stimulated yet pregnancy is not achieved, the dose can be repeated for 3 – 6 months. After this time, alternative treatment should be sought.
If clomiphene fails to stimulate ovulation the dose may be increased from 50 mg per day to 100mg then 150mg if necessary.
The use of clomiphene increases the chances of multiple births from 1% in the general population to 10%. There are some symptoms and side effects that you should speak with your specialist about. There are also now alternative medications which may be suitable.
Depending on your presentation and ovulation symptoms, your specialist may prescribe other injectable hormones to stimulate egg production. The success rate of these medications stimulating ovulation is around 90% with pregnancy rates around 20 – 60%.