Some women have difficulty getting pregnant because their ovaries do not release an egg. About 25% of women struggling with infertility have problems with ovulation. Subtle or obvious hormonal imbalances can interfere with the normal development, maturation, and fertilization of an egg.
Certain conditions can affect ovulation leading to infertility including polycystic ovarian syndrome (PCOS), thyroid disease or other hormonal disorders. Women who are overweight or significantly underweight are also less likely to ovulate consistently than women of a normal body weight. Sometimes the cause of ovulatory dysfunction cannot be identified for certain.
Women with ovulatory dysfunction typically benefit from ovulation induction with fertility medications. These medications can help a woman to ovulate more regularly or allow for multiple eggs to develop and be released at one time. Ovulation induction medications work by either lowering estrogen levels or by making the brain think they are low. Low estrogen levels tell the pituitary gland to produce FSH, which helps a follicle to grow and release an egg. The most common risk in using these medications is multiple pregnancy. The chance of twins on oral OI medications is 5%-8% and the chance of triplets is less than 1%. Ovarian cysts may occur although it is uncommon for these cysts to require any treatment. In women who do not ovulate on their own, about 80% of women who use these medications over several months will ovulate.