Possible Causes and Treatments of Anovulation

■ Pituitary insufficiency: Treat with intramuscular luteinizing hormone/ follicle-stimulating hormone (LH/FSH).

■ Hypothalamic dysfunction: Treat with bromocriptine (a dopamine agonist)

■ Polycystic ovary syndrome: Treat with clomiphene or human menopausal gonadotropin (hMG).

■ Other causes: Hyper/hypothyroid, androgen excess, obesity/starvation, galactorrhea

If ovulation analysis and semen analysis are normal, analysis of the internal architecture is performed to determine if there is an anatomical impediment to pregnancy.

Hysterosalpingogram is neither sensitive nor specific (smooth muscle spasm occludes tubes) for determining the presence of anatomical problems.

Endometriosis is found in about one third of infertile women.

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