Absence of ovulation

Absence of ovulation caused by insufficient GnRH drive from the hypothalamus, so that the pituitary gland doesn't produce enough follicle stimulating hormone. Usually accompanied by absent periods (amenorrhea).

Absent menstrual periods, either because of absent ovulation (anovulation) or because of absence of, destruction of, or obstruction to the menstrual flow from the uterus, such as with intrauterine adhesions (when it's known as Asherman's syndrome).

"Anorexia" means a profound loss of appetite, followed by loss of weight; "nervosa" means that there is a nervous or mental basis for the state, in this case a belief by the person affected, and contrary to the perception of others, that she (very rarely he) is overweight. She stops eating, may induce vomiting, and uses laxatives to keep the intestines empty and the stomach flat. The menstrual periods stop (there is amenorrhea for two reasons: the weight loss and the underlying mental disturbance, both of which cause hypothalamic anovulation. Medical complications from induced vomiting and laxative abuse can be serious, occasionally fatal. Treatment, which includes psychological and psychiatric counseling, is difficult and is not always completely accomplished. It's a condition chiefly of adolescent girls; the younger the patient the better the chance of cure. For fertility, ovulation induction as often required.

(BMI) An estimate of the amount of fat a person has, calculated by dividing his or her weight (expressed in kilograms) by the square of the height (expressed in meters). Normally between about 20 and 25, although the upper limit is higher with age. A BMI below 20 generally causes oligomenorrhea, then amenorrhea, through anovulation.

Overgrowth of the endometrium, caused usually by prolonged action of estrogen unopposed by progesterone (i.e. prolonged anovulation), as is the case in, particularly, the polycystic ovary syndrome. Potentially dangerous, because it can turn to cancer of the endometrium. Can be suspected by an echogenic appearance of the endometrium on transvaginal ultrasound and is confirmed by pathological examination of tissue obtained at curettage.

Congenital absence of gonadotropin releasing hormone in the hypothalamus (causing, in women, primary amenorrhea and anovulation and, in men, failure of puberty) in combination with a congenitally absent sense of smell.

The use of drugs to stimulate the development of follicles in the ovaries to undergo ovulation, such as clomiphene, various preparations containing follicle stimulating hormone (FSH), and human chorionic gonadotropin (hCG). The two main situations for it are: in the treatment of infertility due to anovulation typically when there is oligomenorrhea or amenorrhea; and for superovulation in assisted conception (e.g. in vitro fertilisation and gamete intrafallopian transfer)

A tumor, usually benign, of the pituitary gland, usually resulting in amenorrhea and anovulation. Often there is an increase (sometimes substantial) in serum prolactin. If the tumor is itself secreting prolactin it is called a prolactinoma. But other tumors can occur, some of which secrete other pituitary hormones. The tumor grows inside a confined space with walls of bone called the pituitary fossa: if it is still small and confined to the fossa we call the tumor a microadenoma; if it enlarges the fossa or pushes out of it, it is a macroadenoma, and is both more dangerous and capable of producing visual symptoms and headaches. Diagnosed on a CAT scan or a MRI scan. Prolactin-secreting microadenomas can usually be treated just with drugs.

The state of absolute infertility or complete infertility, with no chance of getting pregnant without special help. Causes include azoospermia, anovulation (especially primary ovarian failure), and blocked fallopian tubes.