A menstrual cycle that is too long (35 days or more), too short (less than 21 days), irregular or absent can mean that you are not ovulating and may have an ovulation disorder. This happens in 1 out of 4 infertile couples and is the commonest cause of infertility in women. The common causes of anovulation are –
Polycystic ovary syndrome (PCOS)
PCOS is one of the most common hormonal conditions affecting 1 out of 10 women during their reproductive years, disrupting the cyclical hormonal secretion and altering the menstrual cycle. Insulin resistance and the resulting excess male hormone is the underlying issue and this results in the common symptoms such as irregular infrequent periods. Some women have acne and/or abnormal hair growth as well. Most but not all patients complain of weight gain.
Hypothalamus/pituitary gland problems
The hypothalamus and pituitary are the parts of the brain that help orchestrate the secretion of reproductive hormones that stimulate egg growth and ovulation (the release of egg). Excessive stress, significant weight changes or extremes of body weight and certain medications. can result in hypothalamic -pituitary dysfunction resulting in irregular or absent periods
Premature ovarian failure
A woman’s fertility gradually declines from its peak in the twenties until menopause, which is around the age of 50. This is caused by a gradual reduction in the number of eggs in the ovaries. For some women, autoimmune disease, genetic disorders or exposure to certain cancer therapies result in menopause prior to the age of 40. This is called premature ovarian failure and affects around 1% of women in the reproductive age group.
Advancing age is one of the most common causes of female infertility. With age, both the number and quality of eggs in the ovaries decline, resulting in poorer quality embryos and hence a reduction in implantation. If you are a woman over 35 and have not been successful in conceiving after 6 months of regular unprotected sex, you should consider fertility investigation and treatment.