Ovulation Disorders

Understanding ovulation problems and how we can help you conceive

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Ovulation disorders are one of the most common causes of female infertility. If your ovaries do not release an egg regularly, or stop releasing eggs altogether, it becomes much more difficult to conceive naturally.

While this can be worrying, ovulation disorders are also among the most treatable causes of infertility. Advances in fertility medicine mean that many women who are not ovulating regularly can restore ovulation through lifestyle changes, medication or fertility treatment.

At Manchester Fertility, we understand that every patient's fertility journey is unique. Our experienced team will take the time to investigate why ovulation isn't happening, rather than simply treating the symptoms. Through comprehensive fertility testing, personalised treatment plans and ongoing support, we'll help you understand your options and maximise your chances of pregnancy.

Whether you've noticed irregular periods, have been diagnosed with PMOS, or have been trying to conceive without success, our team is here to provide expert guidance every step of the way.

Book a Fertility Assessment

A fertility assessment involves a series of simple tests and a consultation with a doctor.

We will assess your current fertility status, identifying any factors affecting your ability to conceive and providing insight into potential treatment options.

Our Fertility assessments are £465 for heterosexual couples and £365 for single females.

Ovulation is a key part of the menstrual cycle and is essential for natural conception.

Each month, hormones released by the brain stimulate a group of follicles within the ovaries to begin developing. Usually, one follicle becomes dominant and contains a mature egg. Around the middle of the menstrual cycle, this egg is released from the ovary and travels into the fallopian tube, where it may be fertilised by sperm.

If fertilisation doesn't occur, hormone levels fall, your womb lining sheds, and your next menstrual cycle begins. For pregnancy to happen naturally, ovulation must occur regularly and at the right point within the menstrual cycle.

When ovulation becomes irregular, or doesn't happen at all, it can significantly reduce the chance of conception.

An ovulation disorder occurs when the normal process of releasing an egg is disrupted.

This disruption may be caused by hormonal imbalance, medical conditions, problems affecting the ovaries themselves or changes in communication between the brain and reproductive organs.

Ovulation disorders can present in different ways. Some women never ovulate, while others ovulate only occasionally or unpredictably. In some cases, ovulation may occur, but the hormonal changes needed to support implantation are insufficient.

Many women assume that having a monthly period means they are ovulating. While regular periods often suggest ovulation is occurring, this isn't always the case. Equally, women with irregular cycles may still ovulate.

Because symptoms vary considerably, fertility investigations are often needed to determine whether ovulation is happening normally.

Ovulation disorders are one of the leading causes of female infertility worldwide.

Research suggests they account for approximately 25% of female infertility cases, making them second only to problems affecting the fallopian tubes and combined fertility factors.

In the UK:

Around 1 in 7 couples experience infertility.
Approximately 25% of female infertility is caused by ovulation disorders.
PMOS affects around1 in 10 women of reproductive age and is the single most common cause of irregular ovulation.
Many women remain undiagnosed until they begin trying for a baby.

These statistics highlight why early assessment is so important. Identifying an ovulation problem early often allows treatment to begin sooner, improving the likelihood of conception.

Ovulation depends on a complex interaction between the brain, pituitary gland, ovaries and reproductive hormones. If any part of this system is disrupted, ovulation may become irregular or stop completely.

Polyendocrine Metabolic Ovarian Syndrome (PMOS)

PMOS is responsible for the majority of ovulation disorders seen in fertility clinics.

Women with PMOS often have an imbalance in reproductive hormones that prevents follicles from maturing normally. Instead of a single dominant follicle developing each month, multiple immature follicles remain in the ovary, preventing regular egg release.

Symptoms commonly include:

Irregular or absent periods
Difficulty conceiving
Acne
Excess facial or body hair
Weight gain
Thinning hair

Ovaries with multiple small follicles visible on ultrasound

Not every woman with PMOS experiences all of these symptoms, and many have successful pregnancies following appropriate treatment.

Thyroid disorders

The thyroid gland regulates many important functions throughout the body, including reproductive hormones.

An underactive thyroid (hypothyroidism) can reduce ovulation frequency, while an overactive thyroid (hyperthyroidism) may cause menstrual irregularities or absent periods.

The good news is that thyroid-related fertility problems often improve significantly once hormone levels are corrected.

Hypothalamic Amenorrhoea

The hypothalamus is an area of the brain responsible for releasing hormones that trigger ovulation.

Factors such as:

Significant emotional stress
Excessive exercise
Rapid weight loss
Eating disorders
Being underweight

can disrupt this hormonal signalling, leading to absent or infrequent ovulation.

This condition is particularly common among endurance athletes or women experiencing substantial lifestyle changes.

Premature Ovarian Insufficiency (POI)

Premature ovarian insufficiency occurs when ovarian function declines before the age of 40.

Unlike the natural menopause, ovarian activity may fluctuate, meaning occasional ovulation can still occur. However, fertility is significantly reduced.

POI may result from:

Genetic conditions
Autoimmune disease
Previous chemotherapy or radiotherapy
Surgery affecting the ovaries
Unknown causes

Elevated prolactin

Prolactin is the hormone responsible for milk production after childbirth.

When prolactin levels become abnormally high outside pregnancy or breastfeeding, they suppress the hormones needed for ovulation.

Raised prolactin levels may result from:

Certain medications
Pituitary gland disorders
Thyroid disease
Unknown causes

Treatment is often highly effective and can restore normal ovulation.

Symptoms vary depending on the underlying cause, but common signs include:

Irregular menstrual cycles
Long cycles (more than 35 days)
Very short cycles
No periods
Heavy or unusually light periods
Difficulty becoming pregnant
Acne
Increased facial or body hair
Weight changes
Hot flushes (particularly with POI)

Some women experience no obvious symptoms at all.

Because ovulation disorders aren't always easy to recognise, fertility assessment is often the most reliable way to establish whether you're ovulating normally.

Accurate diagnosis is the first step towards choosing the most effective treatment.

Our consultants combine your medical history, symptoms, ultrasound findings and hormone tests to build a complete picture of your reproductive health.

Medical history

We'll discuss:

Your menstrual cycle
Previous pregnancies
Medical conditions
Current medications
Lifestyle factors
Family history
Previous fertility investigations

This information often provides valuable clues about the underlying cause.

Hormone Blood Tests

Hormone testing helps us understand how the ovaries are working, and how the ovaries and brain are communicating.

Depending on your cycle, tests may include:

Anti-Müllerian Hormone (AMH)
Follicle Stimulating Hormone (FSH)
Luteinising Hormone (LH)
Oestradiol
Progesterone
Thyroid hormones
Prolactin
Testosterone and other androgens

These results help identify conditions such as PMOS, thyroid disease, premature ovarian insufficiency and hormonal imbalance.

Pelvic Ultrasound

A transvaginal ultrasound scan allows us to examine the ovaries and uterus in detail.

We assess:

Number of developing follicles
Ovarian appearance
Signs of PMOS
Ovarian reserve through antral follicle count
Uterine abnormalities

Ultrasound also allows us to monitor follicle growth during treatment.

Treatment depends entirely on the cause of your ovulation problem and your wider fertility circumstances.

Our aim is always to recommend the least invasive treatment likely to achieve a healthy pregnancy.

IVF Treatment

For some patients, IVF offers the highest chance of pregnancy.

During IVF, carefully controlled hormone medication encourages several eggs to mature simultaneously before they are collected and fertilised in our laboratory.

Our embryologists then monitor embryo development before selecting the embryo with the highest implantation potential.

Learn More

Induction of Ovulation

If lifestyle changes alone aren't enough, medication may be used to stimulate egg development.

Throughout treatment, ultrasound scans monitor follicle development to ensure medication is working safely and effectively.

Careful monitoring also helps reduce the risk of multiple pregnancy.

Learn More

Lifestyle Changes

For some women, relatively small lifestyle adjustments can improve ovulation.

This may include:

Achieving a healthy BMI
Improving nutrition
Managing stress
Reducing excessive exercise
Stopping smoking
Limiting alcohol

Even modest improvements in weight can significantly improve ovulation in women with PMOS.

Learn More

Our experienced fertility specialists understand the complex relationship between endometriosis and fertility.

When you choose us, you'll benefit from:

Personalised fertility care tailored to your diagnosis
Experienced consultants with expertise in complex fertility conditions
Over 40 years of experience
Advanced fertility investigations
Access to the latest fertility treatments and technologies
Dedicated nursing and patient support
Transparent pricing and treatment plans
Compassionate care throughout your journey

Dr Raj Mathur

Medical Director

Dr Raj Mathur is our Medical Director. A Consultant Gynaecologist with a long and established career in Reproductive Medicine. He is also the former chair of the British Fertility Society (BFS).

Dr Anamika Rao

Senior Fertility Consultant

Dr Anamika Rao is our Fertility Consultant with 20 years of experience in Obstetrics, Gynaecology, Infertility and Early pregnancy. She has completed her postgraduate training both from India and the UK and is a Fellow of Royal College of Obstetricians and Gynaecologists.

Meet the Team

Can you get pregnant if you don't ovulate every month?

Yes. If ovulation occurs occasionally, natural conception is still possible, although it may take longer. Treatment can often improve the frequency and timing of ovulation.

Can ovulation disorders be cured?

Many can be successfully managed or treated. Some women regain regular ovulation with lifestyle changes or medication, while others may benefit from assisted reproductive treatments such as IVF.

Does having regular periods mean I'm ovulating?

Not necessarily. Some women experience bleeding without releasing an egg. Fertility testing is the most accurate way to confirm ovulation.

Is PMOS always associated with infertility?

No. Many women with PMOS conceive naturally, while others may require ovulation induction or fertility treatment. Success depends on several individual factors, including age, ovarian reserve and overall reproductive health.

When should I see a fertility specialist?

If you're under 35 and have been trying to conceive for 12 months, or you're 35 or older and have been trying for six months, it's advisable to seek specialist advice. You should also arrange an assessment sooner if you have irregular or absent periods, a diagnosis of PMOS, thyroid disease, premature ovarian insufficiency or another condition known to affect fertility.

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