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Expert Q&A

	By Louis Weckstein, MD Fertility Specialist Reproductive Science Center® Bay Area Fertility & Gynecology Medical Group, Inc. San Ramon, California

Do women ovulate every month? If not, why not? - Cassandra, Brisbane, Australia"

The majority of women of reproductive age ovulate almost every month. Many women will however have an occasional anovulatory (not ovulating ) cycle which may be due to significant stress. A minority of women ovulate very irregularly or do not ovulate at all and it is this group of women that will benefit from medication to help induce ovulation.

There are a number of reasons women may not ovulate. Having no eggs left in the ovaries is one reason that should be ruled out prior to using ovulation inducing medication. This can even occur in very young women. It can be ruled out with a blood test (FSH level). Not ovulating may be due to improper signals being sent to the ovary from the brain. This can occur with extremes of stress, severe weight changes, or secondary to a benign tumor in the pituitary gland that produces an excess of the hormone prolactin which can interfere with ovulation. There is also a condition known as Polycystic Ovarian Syndrome that some women have due to an imbalance of hormones that leads to persistent failure to ovulate.

Fortunately, most cases of anovulation are easy to treat with ovulation inducing medication, and this can be one of the most successful treatments for infertility disorders."

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