Anovulation

  Definition of anovulation:-Anovulation can be defined as absence of ovulation without follicular rupture and no follicles persisting after an initial period of growth. In primary anovulation, ovulation has never commenced. In secondary anovulation, there is an ovulatory period, followed by subsequent anovulation.

In anovulation, a peak in LH and FSH is missing and there is a continuous rather low oestradiol and progesterone produc­tion. Recurrent initial growth antral follicles for few days can lead to cyst formation in the ovary (PCO) . Such cysts can  frequently prevent the development of ovulatory follicles by compression of the ovarian cortex. Using ultrasound, absence of growth in one of the ovarian follicles during the cycle can be observed. Tr:- In most cases  , anovulation can also be treated by endocrine stimulation, such as clomiphene, HMG/HCG or FSH/HCG stimulation, under the continuous observation of oestradiol and progesterone levels and most importantly careful ultrasound measurements of follicu­lar growth are warranted .