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How Does Anovulation Affect Fertility? Causes & What to Do Next When Trying to Get Pregnant

How Does Anovulation Affect Fertility? Causes & What to Do Next When Trying to Get Pregnant

What is anovulation? Read on to understand the symptoms, causes, and treatment of anovulation, and how it affects getting pregnant.

Written By

Nicole Kainz

Instructor
November 9, 2021

Have you been trying to get pregnant for a while now? Becoming pregnant may seem to be an easy feat as you scroll Instagram or watch TV, but the truth is, seeing two little pink lines on a test can be difficult for many, for a number of reasons. So, while you are not alone in your waiting (1 in 8 couples struggle with conceiving), it doesn’t take away the grief, pain, and longing for family. If you have been trying for over six months to a year to become pregnant, we are here to help you navigate through this uncertainty. While there are many issues that may cause you not to get pregnant within the first year, one of the most common reasons is anovulation—lack of ovulation.

We are here to break down everything there is to know about ovulation, and how it affects you getting pregnant. 

What Is Anovulation?

During your menstrual cycle, which is actually an average of 28 days—not just your period, or menses—your ovaries release an egg. 

On average, the egg is released on the fourteenth day of your cycle. This is called ovulation. The egg travels down the fallopian tube, where it can become fertilized by sperm. If it does not become fertilized, it continues down to the uterus, where it is released with the shedding uterine lining. 

Anovulation is when your ovaries do not release an egg. It is normal for anovulation to happen once in a while. When anovulation happens more frequently, it can lead to different symptoms. Anovulation has different causes, including underlying medical conditions.

How Does Anovulation Affect Getting Pregnant?

Anovulation does affect getting pregnant. In order to become pregnant, an egg must be fertilized by the sperm. If your ovaries don’t release an egg, the sperm will just die off. If you suspect you are not ovulating, reach out to your doctor. 

Talking to a holistic fertility coach can also help you through the fertility process. They can be an incredible resource for you when you have questions and can provide more emotional support. 

Signs of Anovulation

If you are wondering if anovulation is what is causing you to not become pregnant, there are a few signs you can watch for. If you are unsure if you are ovulating, you can use ovulation testers. These are very similar to pregnancy tests in how they are used. Other physical signs to show you may be ovulating are tender breasts, ovulation pain, change in cervical mucus, and increased sex drive. 

Here are a few signs you may not be ovulating. If you are concerned that anovulation may be an issue for you, set up an appointment with your doctor. They can run tests to get a better idea of what is going on. 

Lack of Periods

Amenorrhea—lack of your period—may be a sign of anovulation. Amenorrhea can be caused by many different things. Low body weight and/or stress are both causes. A lack of periods can be caused by medications you are currently on. It can also be caused by an underlying health condition.

The tricky thing about amenorrhea is you may still ovulate, although it is very unlikely. If you are experiencing anovulation because of stress, if the stress is reduced in your life, you may start ovulating without warning. 

To find out if you are ovulating, you can use an ovulation tester or track your basal body temperature.

Irregular Periods

The average length of a period is 28 days, but a regular full menstrual cycle can be anywhere from 21 to 35 days. Emotional stress, smoking, physical stress, and medication side effects can all cause irregular periods. 

To find out if your periods are regular, start tracking them. The first day of your menstrual cycle is the first day of your period. When you get your period, mark down the day. The next period, note that day. The number of days between the two start dates will show you how long your menstrual cycle is, and whether or not you fall into the regular cycle range

Very Heavy or Light Periods

In order for the menstruation cycle to occur as it should, there is a synchronization of hormones. When ovulation occurs, it stimulates progesterone. Progesterone helps to keep periods regular. Without progesterone, periods may become heavy or lighter than normal. 

Normal blood loss during a period is between 30 ml to 80 ml or about 6 to 16 teaspoons. Most of us are not measuring the amount of blood we are losing each period. A simple trick is a heavy pad or tampon can hold a little less than one teaspoon. This trick is good to keep in mind  if you are trying to see how heavy your period is–simply count how many pads or tampons you soak during your period.

Lack of Cervical Mucus

During ovulation, your cervical mucus changes. Thanks to estrogen, your mucus will become more like the texture of an egg white. It is wet, slippery, and stretchy. This gives the sperm a better environment for its journey to the egg. 

Once ovulation is finished, progesterone makes the discharge less wet. It can become thick and tacky. Some women become a lot drier during this time. 

If you do not notice these changes in your cervical mucus, you may be experiencing anovulation. Everyone’s body is different, so pay attention to the changes in cervical mucus to see if you can spot a difference between different times of the month.

Irregular Basal Body Temperature

One way to check if you are ovulating is to monitor your basal body temperature—your temperature at complete rest. The average basal body temperature is between 97 and 98 degrees Fahrenheit

After ovulation, your basal body temperature will rise between one-half of a degree to one degree. If you do not see these changes or your basal body temperature is irregular, you may be experiencing anovulation.

The best time to take this temperature is as soon as you wake up in the morning. Have your thermometer by your bed for a quick morning check. 

When you wake up, before you have time to wipe the sleep from your eyes, take your temperature to get the most accurate reading. You should track your temperature for three to four months to be able to see a clear pattern.

Causes of Anovulation?

If you are trying to get pregnant, and you suspect anovulation, the best thing to do is find out why. There are many reasons a woman may not ovulate, let’s break them down here.

Extremes In Body Weight

Being overweight or underweight can affect the hormones in your body. Being overweight can cause you to have too much estrogen, and being underweight can cause you to have too low estrogen. If your estrogen is too high or too low it can cause anovulation. 

A woman’s weight is very personal. The healthiest weight for you should be determined where you feel the best. If you have concerns about your weight, talking to your doctor or a nutritionist can help you get to the weight that is best for you.

Excessive Exercise

If you follow an average exercise program, you will most likely not have issues with ovulation. Where some women may have an issue is when they engage in vigorous exercise. 

Women who participate in sports that require a lower weight—distance running, gymnastics, rowing—may also suffer from anovulation. Women who participate in extreme exercise are 44% more likely to not have their periods, which can be a sign of anovulation.

Stress

Another cause of anovulation can be stress. Everyone experiences stress from time to time, but when it is constant, it can begin to cause issues with your menstruation cycle. Stress can do a number on your hormones. Women who experienced high daily stress were 70% more likely to experience an anovulatory cycle than those who did not have excessive stress.

Hormone Imbalances

You may have noticed from what we have covered so far, the balance of hormones is extremely important to ovulation. If these hormones are out of balance, it can lead to anovulation. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), and gonadotropin-releasing hormone (GnRH) are three hormones that are specific to ovulation. There are other hormones that play a role as well, like estrogen and progesterone. 

Your pituitary gland, thyroid, and hypothalamus—an area in your brain—all work together to release these hormones. If you have an underlying medical condition that affects any of these areas, you may experience anovulation. 

PCOS

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. While the exact cause of PCOS is unknown, it does create an imbalance of reproductive hormones, including androgen. 

Androgen is often called the “male hormone” but women produce it as well. Usually, it is only produced in small quantities in the ovaries and adrenal glands. This imbalance of hormones can affect the ovaries. 

PCOS can cause abnormal periods, excess body hair, weight gain around the belly, acne, and infertility. Ovaries may become larger or develop cysts. Many women with PCOS experience  insulin resistance as well. One way to help reduce your symptoms of PCOS is to alter your lifestyle habits, including physical exercise and nutrition

Perimenopause/Menopause

A natural cause of anovulation is menopause. Menopause happens somewhere in your 40s and 50s.

Menopause is the ending of your menstrual cycles. Perimenopause is the period leading up to menopause. Your reproductive hormones will start to naturally decrease, and you may have some beginning signs of menopause. 

Once you hit menopause, ovulation will stop altogether. During perimenopause, you may not ovulate regularly or even get your period regularly. With irregular periods, it can be hard to track when you may be ovulating. 

If you are trying to get pregnant during this time, you may want to track your basal temperature and use ovulation testers. If you are older than 35, you should talk to your doctor if you have been trying to get pregnant for more than six months. 

When Is It Time To Call the Doctor?

Let’s start by saying, if you ever have questions about your body, you should never hesitate to reach out to your doctor. 

If you have been tracking your ovulation with no signs of ovulation or if you have irregular periods, you may want to reach out to your doctor. If you have been trying to get pregnant for over a year, and you are under 35, it may be time to see a doctor.

If you are older than 35, give them a call at the six-month mark. If you have been tracking your ovulation, bring that information in with you. If you have a known medical condition that may cause anovulation or infertility, you should talk to your doctor right away to make a plan together to help with fertility.

How Is Anovulation Diagnosed?

If your doctor suspects the reason you are not getting pregnant is anovulation, they will most likely run some tests. While it can be a little unnerving to have any tests run, these are pretty standard but will get you to understand what is going on with your body.

Blood Tests

The first thing your doctor will order are blood tests. In these tests, they can test hormone levels and thyroid levels. This can give them a clear picture of what is happening on the inside. Your anovulation may be caused by an imbalance in hormones or your thyroid, and they will be able to see it with these tests. 

Ultrasound

Your doctor will probably order an ultrasound, as well. An ultrasound will be able to look at your ovaries. Before ovulation, the follicle that will release the egg grows in size. Your doctor can look for signs of ovulation by looking for these follicles. 

What Are Treatments for Anovulation?

This has been a lot of information. You may feel a bit overwhelmed, but we are here to tell you, there is hope. Anovulation can usually be corrected. Once you and your doctor have determined why you may be experiencing anovulation, you can decide on the best treatment. 

Manage Weight

As we have learned, weight—both over and under—can create issues with your hormones. Talking to a fertility nutritionist may be the best place to start to manage your weight. They can help you come up with a plan to eat the best for you and your fertility.

Manage Stress

We all go through stressful times. Stress is a normal part of life. Knowing how to manage your stress can help reduce the effect it has on your hormone levels. One of the best ways is to practice meditation

Meditation can help lower stress, balance hormones related to stress, and support ovulation.

Adjusting Exercise Routine

If your workouts are incredibly intense, you may want to change them up a bit, if you are trying to get pregnant. You do not have to completely stop working out. In fact, working out is great for reducing stress and maintaining a healthy weight. Talk to your doctor about how you can change your workout routine to support ovulation. 

Medications

During testing, your doctor may find that you have an underlying medical condition. Perhaps your thyroid is overproducing or underproducing the thyroid hormones. If this is the case, they can prescribe you medication. They may also prescribe medication if you have PCOS.

Adjusting Current Medications

If you are currently on medications, your doctor may need to review your dosages to see if they are causing your anovulation. They may be able to adjust your dosage or prescribe another medication that does not affect ovulation, if that is available. 

Hormone Injections

Your doctor may recommend that you take hormone injections. In order to ovulate, your ovaries must release a mature egg. These injections can help support your ovaries. There are different hormone injections available, and your doctor will know what is right for you.

Some are used to block estrogen, reduce insulin, and support testosterone levels, and others are follicle-stimulating hormone injections.

Anovulation: What You Need to Know

Anovulation, or the absence of ovulation, can affect your ability to get pregnant. In order to get pregnant, an egg must be released from the ovaries to be fertilized by the sperm. Without this ovulation, there is no egg to become fertilized. 

There are many causes of anovulation. Extremes in body weight, excessive exercise and stress can all be causes of anovulation. Hormonal imbalances, gynecological conditions, and menopause or perimenopause can also be causes of anovulation. 

There is hope after anovulation. Working with your doctor, they can determine the cause and provide treatments such as weight and stress management, adjusting your exercise routine, reviewing medications, and providing hormone injections, if needed. 

At Expectful, we are here for you on your journey to motherhood. That journey looks different for everyone and sometimes can include different challenges. No matter what your journey looks like, we are here to provide you with support and resources on your care options. 

Nicole Kainz
Instructor
Perinatal Writer

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