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 Ovulation or ovulation is defined as the expression of the ovaries producing eggs and then releasing them during the menstrual cycle, and it should be noted that ovulation often occurs every 21-35 days for normal people, but in some cases it may require more than 35 days, which is called low Ovulation, and some ovulation disorders may lead to a complete lack of ovulation, and ovulation disorders resulting from problems in the ovaries or one of the hormones cause 25% of infertility cases in general, which calls for some tests and checks during the menstrual cycle to determine the cause of the ovulation disorder Such as hormone level tests, ultrasound examination of the uterus and both ovaries. This is to help the doctor choose the appropriate medical treatment.


How to treat poor ovulation:

 In fact, treatment for poor ovulation often depends on the underlying cause. The inability of the ovaries to produce eggs may be due to severe weight loss or gain, and weakness may be the result of excessive exercise, and in these cases, making some changes to the lifestyle may be sufficient to return the ovulation process to normal, and it should be noted that Many cases may require drug treatment using fertility drugs, and the following is a list of some of the drugs used to stimulate ovulation if they are weak:

 Clomiphene:

 Clomiphene is usually chosen for treatment if ovulation is weak or absent for long periods of time, and weak ovulation due to polycystic ovaries is the most responsive to this treatment, and usually women with impaired ovulation begin to take clomiphene a few days after the start of menstruation. Where one pill is taken daily by mouth for five days, and ovulation occurs about 5-10 days later, followed by the return of menstruation in 14-16 days, and it should be noted that in the event that ovulation does not occur, it is advised to re-take the drug for another five days At a higher dose, and repeat until ovulation has occurred or the maximum dose of clomiphene has been reached.



Gonadotropins:

It is a hormonal treatment that is given through an intramuscular or subcutaneous injection, and the doctor usually resorted to it in the absence of clomiphene or letrozole. This is due to the high cost of treatment and the side effects associated with it, and gonadotropins contain the follicle-stimulating hormone and the luteinizing hormone, which work to stimulate the follicles in the ovaries to produce eggs, and it should be noted that ovulation occurs in 95% of women who receive gonadotropins.


Letrozole:

It is one of the aromatase inhibitors used in the treatment of breast cancer in women who have passed the menopause, and that works by blocking the action of estrogen in the body, and letrozole is used to stimulate the egg in a manner similar to clomiphene. That is, it begins to be taken within several days of the onset of menstruation, and the woman undergoing treatment continues for five days, but letrozole causes fewer side effects than those associated with clomiphene, and it should be noted the importance of not taking either of these two drugs until after making sure that there is no pregnancy, when Both have risks associated with causing birth defects in a fetus.


Causes of poor ovulation:

 In fact, the biggest consequence of poor ovulation in females is the difficulty of conceiving in the event of ovulation disorders or in the event that they do not occur entirely, in addition to the impact of this on irregular menstruation, and ovulation often occurs in women during the years of pregnancy, regularly And natural in the absence of any health problems or hormonal disorders; As there are many health conditions, medications, and other factors that may lead to weak or lack of ovulation, and the following is a statement of some of the most important:

Lifestyle:

Urging that excessive weight gain or loss may result in impaired ovulation, and ovulation problems may result from excessive exercise, intense exercise, following some types of dietary patterns, in addition to psychological stress.


Polycystic ovaries:

Where women with PCOS suffer from an increase in the level of insulin and the hormone testosterone, which leads to disturbances in the levels of hormones in the body and thus to a weak ovulation. Usually, these hormonal disorders can be controlled through receiving appropriate medical and drug treatment. It should be noted that about 20% of females develop polycystic ovaries during their pregnancy years.

 Early menopause:
 also known as premature ovarian insufficiency, and early menopause is diagnosed if ovulation stops before the age of forty.

 Hormonal contraception:
 Some methods of contraception depend on taking birth control pills that contain the hormones estrogen and progesterone, which prevent pregnancy by affecting the ovaries, blocking the formation and removal of eggs from them, and thus the woman goes through a regular menstrual cycle but without ovulation during the period of taking the pills Contraception.

 Steroids:
 such as cortisone and prednisone used to treat inflammatory conditions, and according to studies, steroids may cause irregularity in the menstrual cycle if you receive an injection before your period.

 NSAIDs:

Used in pain relief, such as ibuprofen and naproxen, as some studies have shown the possibility of weak or interrupted ovulation when taking these drugs for more than ten consecutive days.

Other medicines:
 Other medicines may affect the menstrual cycle and ovulation if taken, including: medicines used to treat epilepsy, cancer treatments, and some natural remedies and herbs.

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