Anovulation and pregnancy

Anovulation may be occasional or recurrent. If ovulation resumes in another cycle, conception may be possible, so irregular periods do not reliably predict fertile days or rule out pregnancy.

Ovulation releases an egg that can meet sperm. When this step does not happen, fertilisation cannot occur during that cycle. Recurrent anovulation can present with irregular or absent periods and trouble getting pregnant, although bleeding can still occur without egg release.

Possible causes include polycystic ovary syndrome, thyroid or prolactin changes, major shifts in weight or exercise, perimenopause and premature ovarian insufficiency. Finding the cause matters because the appropriate fertility plan differs for each situation.

Track cycle dates and bleeding, but do not rely on an app alone to confirm ovulation when cycles vary. A fertility assessment may include a health history, examination, hormone tests, ultrasound and evaluation of other factors that influence conception, including semen and the fallopian tubes.

Care may focus on an underlying condition, nutrition or activity changes when relevant, or medicines that encourage egg release. The choice and monitoring plan depend on the diagnosis, other health conditions and whether there are additional fertility factors.

Seek a clinical review if periods are repeatedly absent or very irregular, or if you are concerned about delayed conception. Earlier discussion is appropriate when cycles have stopped, a known condition may affect ovulation, or you have pelvic symptoms.

Take a pregnancy test when a period is late and pregnancy is possible. Urgent assessment is needed for a positive test accompanied by one-sided or severe abdominal pain, shoulder-tip pain, fainting, marked dizziness or heavy bleeding.

Ask how ovulation will be assessed, which causes are being considered and whether both partners need evaluation. If treatment is proposed, ask how it works, what monitoring it requires, what side effects warrant a call and when the plan will be reassessed.