What is the reason for not ovulating?

If you always feel that you cannot ovulate, it is because you have suffered from ovulation disorder, which is currently the most likely factor causing infertility among female friends. After it occurs, many female friends need to spend a long time to cure this disease, so it is particularly important to prescribe the right medicine, so as to prevent female friends from using drugs indiscriminately during treatment.

(1) Turner syndrome and simple gonadal dysgenesis are chromosomal abnormalities that both present with primary amenorrhea as the main clinical manifestation, with elevated gonadotropin and decreased estrogen. Pregnancy can be achieved through in vitro fertilization and embryo transfer using eggs donated by others.

(2) Premature ovarian failure and ovarian antagonism syndrome: Hypergonadotropic amenorrhea caused by ovarian failure that occurs before the age of 40 is called premature ovarian failure, which accounts for about 20% to 28% of primary amenorrhea and 4% to 20% of secondary amenorrhea. Women with primary amenorrhea or secondary amenorrhea before the age of 30 have elevated levels of endogenous gonadotropin and normal follicles in their ovaries, but are low-responsive to high-dose exogenous gonadotropin stimulation. This is called ovarian insensitivity syndrome or ovarian antagonism syndrome. The causes of both diseases are still unclear, and both present with amenorrhea and anovulation.

(3) Polycystic ovary syndrome: often manifested as amenorrhea or infrequent menstruation, long-term anovulation, excessive androgen, and no cyclical fluctuation of estrogen. It is currently a major cause of anovulatory infertility.

(4) Unruptured luteinized syndrome: In a normal menstrual cycle or a drug-induced ovulation cycle, an ovarian follicle develops into a dominant follicle, but the follicle does not disappear or continues to grow 48 hours after the LH peak during ovulation, and persists for several days. The granulosa cells have become luteinized, but the follicle has not ruptured.

The basal body temperature (BBT), cervical viscosity and endometrial changes of LUFS are similar to normal ovulation, giving the illusion of ovulation. It is one of the causes of infertility and one of the reasons why the pregnancy rate of clomiphene-induced ovulation is low. The incidence of LUFS is between 31.8% and 2.9%, which is significantly higher than the 10% of the natural cycle. B-ultrasound monitoring shows that the follicles do not rupture or increase in size, and light spots appear in the follicles, which usually disappear before the next menstruation. If laparoscopy is performed, the ovulation orifice cannot be seen.