Can You Ovulate and Not Get Pregnant

Been doing the baby dance for months but no positive pregnancy test just yet? You may be wondering if you're not ovulating. Here's what you need to know about this relatively common condition, also called anovulation, including causes, symptoms and treatments.

What is anovulation?

Anovulation is when your ovaries don't release an egg during a menstrual cycle. Ovulation happens about two weeks before you get your period.

Can you get pregnant if you don't ovulate?

If you don't ovulate, you can't get pregnant during that cycle. Fortunately, many treatments can trigger your body to release a mature egg so that you can conceive.

What causes anovulation?

Your brain tells your body to secrete the hormones estrogen and progesterone, which stimulate the ovaries to produce a mature egg every month. Women who have anovulation usually have an imbalance in these hormones.

A few common causes of anovulation include:

Polycystic ovary syndrome (PCOS). PCOS is the most common cause of anovulation. The disorder, which affects between 8 and 10 percent of women of childbearing age, causes an imbalance in the hormones that regulate ovulation.

Hypogonadotropic hypogonadism (HA). In this condition, your pituitary gland isn't making the hormones that stimulate ovulation. Bloods tests reveal that follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels are very low.

Ovarian insufficiency. For women over 40, hormone levels might be irregular because there are few eggs left to ovulate. For women under 40, premature ovarian failure is when ovaries stop working normally. In 90 percent of cases of premature ovarian failure, the cause is unknown. However it could be linked to a genetic disorder (like Fragile X syndrome, a very rare condition affecting more males than females and resulting in childhood learning disabilities and other developmental problems, or Turner syndrome, a rare disorder affecting girls that causes them to be short in stature and have early ovarian function loss) or an autoimmune diseases (like Addison disease, a very rare but serious disorder affecting the adrenal glands that results in the body not producing enough of two vital hormones).

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Sometimes, anovulation can be due to very high prolactin levels (hyperprolactinemia) or severe thyroid dysfunction (hypothyroidism).

Other factors that can contribute to anovulation include:

• Poor diet
• Not getting enough exercise
• Obesity

Anovulation symptoms

Women who aren't ovulating usually have irregular cycles, which can include light periods with very little bleeding or heavy ones with unusually heavy flow. A short cycle (meaning there are fewer than 21 days between your periods) or a long cycle (there are more than 35 days between periods) can also point to ovulation problems.

PCOS symptoms vary, but can include breakthrough bleeding between periods, acne, weight gain and abnormal hair growth. On an ultrasound, your practitioner may note multiple cysts on your ovaries, which appear when your body doesn't release a mature egg.

Other symptoms can include:

• Hypogonadotropic hypogonadism: low libido, decreased energy, mood swings, weight gain
• Hyperprolactinemia: irregular or no periods, vaginal dryness and breast discharge when you're not breastfeeding
• Hypothyroidism: extreme fatigue and weight gain
• Ovarian insufficiency: menopause-like symptoms including missed periods, hot flashes, night sweats, decreased sex drive and irritability

How does anovulation affect your chances of getting pregnant?

Anovulation can make getting pregnant tricky; in fact, it accounts for an estimated 25 to 30 percent of infertility cases in women. Even if you do ovulate occasionally, irregular periods can make it hard to time sex.

The vast majority of women with PCOS who go on ovulation medications, however, do conceive. The same goes when you start taking medications to treat other conditions, including hypogonadotropic hypogonadism, hyperprolactinemia and hypothyroidism.

If you're going through ovarian failure, it is possible to spontaneously conceive — but the chances are low, especially if you haven't had a period in several months. Although medications can increase your odds of conceiving by stimulating ovulation, they can't make new eggs grow.

Fertility and other treatments if you don't ovulate

Many treatments can balance the hormones you need to have regular periods.

Clomiphene citrate or letrozole can help regulate your hormone levels if you have PCOS to help you ovulate and get pregnant. These drugs can maximize your odds of getting pregnant if you're nearing menopause too.

Some medication lowers prolactin production and decreases tumor size if you have hyperprolactinemia, while other drugs can regulate thyroid hormone levels to treat hypothyroidism. And estrogen and progesterone pills or skin patches can treat hypogonadotropic hypogonadism.

If you have ovarian insufficiency, IVF may help you to get pregnant. But since the number of eggs in your body is fixed at birth, you may need to use donor eggs.

When to call the doctor

If you have irregular cycles or any other symptoms of anovulation, schedule a visit with your practitioner. Treating conditions including PCOS, hypothyroidism and hyperprolactinemia can greatly increase your odds of getting pregnant.

Also call your doctor if you're under 35 and haven't conceived within a year of trying, or if you're over 35 and haven't conceived after six months. She may refer you to a specialist who can figure out why you're not getting pregnant and suggest treatments that can help.

If you think you might have anovulation, don't hesitate to check with your doctor. While anovulation is a major cause of infertility, in many cases the problem can be treated to boost the odds that you'll conceive soon.

From the What to Expect editorial team and Heidi Murkoff, author ofWhat to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

Can You Ovulate and Not Get Pregnant

Source: https://www.whattoexpect.com/getting-pregnant/ovulation/anovulation-not-ovulating/

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