reasons for not ovulating other than PCOS?

A good friend of mine has been ttc for her first baby for over 2 years. She is 35 now. She suspected she might not be ovulating, so I urged her to see an RE who confirmed that she was right, she doesn't ovulate.

She did her own research & assumed she had PCOS (it sounded like it to me as well). The RE says she doesn't have PCOS though, because he said she has a lot of follicles but her ovaries don't appear to have cysts, and also all her bloodwork is normal.

But she's not ovulating & the RE told her he doesn't know why. She takes good care of herself, eats well, exercises some but not to an extreme, healthy weight, isn't overly stressed, etc. So if it's not PCOS, what could be another reason why she never ovulates (that wouldn't show up on bloodwork)? She is trying to figure it out & I told her I'd do some research & see if anyone has had a similar experience.

Re: reasons for not ovulating other than PCOS?

I have something similar. My cycles are very irregular - between 45 and 80 days, usually - and I ovulate only a few times a year. I don't have PCOS - no elevated hormone levels, no blood sugar issues, don't have tons of tiny cysts on my ovaries. But I don't produce enough LH (the hormone that makes you ovulate) to make ovulation happen. As a result, when I use OPKs they're positive all the time, even though I don't ovulate. My RE shrugged it off as "unexplained" and treated me with Clomid to make me ovulate. I do ovulate, eventually, every time I take Clomid, and once that happens my chances of getting pregnant are exactly the same as every other normal woman's.

My point is… maybe it doesn't matter why she's not ovulating. People's bodies are weird. If it's like me (i hope for her it is!), it's easily treatable, and she can get pregnant.

Re: reasons for not ovulating other than PCOS?

Thank you! I will pass on this info & tell her to check out her LH levels and possibly Clomid to help her. That's very interesting how there can be unexplained lack of ovulation... Her cycles were getting longer & longer so I just assumed pcos. Thanks for the info!

Re: reasons for not ovulating other than PCOS?

You're welcome. PCOS isn't a sickness or a disease; it's a collection of symptoms. There is a list of three symptoms and you have to have 2 of them to qualify as having PCOS. The symptoms are: extra testosterone, ovulatory dysfunction, and polycystic ovaries. I only have ovulatory dysfunction. They can easily test for extra testosterone (blood test) and polycystic ovaries (a sonogram). But your friend might already suspect she has higher testosterone levels if she has excess body/facial hair, acne, obesity, or blood sugar problems.

They don't really test your LH. It is supposed to fluctuate all cycle, depending on where you are in relation to ovulation. So a test wouldn't tell her anything useful. Your body makes a follicle (egg) and then your LH is supposed to increase, until it finally gets so high that the egg is released (ovulation). My LH gets pretty high several times a cycle, but not high enough. It happens to everyone sometimes (like when you're sick or stressed), but the LH usually tries again a few days later and it works. For me, it often doesn't work. Again, Clomid and an HCG trigger take care of that easily enough for me. Hope your friend finds an easy fix too! Is she going to an RE or an OB? RE's specialize in this stuff and will do specialized monitoring and testing, while OB's tend to just give everyone Clomid for a number of cycles and wait it out.

Re: reasons for not ovulating other than PCOS?

Re: reasons for not ovulating other than PCOS?

I was never diagnosed with PCOS, but when I TTC #1 coming off the pill my hormones were out of whack. I eventually ended up under the care of a RE and because I did not ovulate on my own, I had to induce it by taking a HCG trigger shot.