New Jersey fertility doctor, Dr. Jane Miller, evaluates patients and their partners to learn why they are having trouble conceiving. The first step in this process is a consult – a thorough discussion of the patient’s medical, surgical, endocrinologic, social, and family histories. Included in this is an “intimate” discussion of the patient’s reproductive, menstrual and sexual life. All these histories can give us clues as to why a person cannot conceive and will enable Dr. Miller to select the appropriate tests needed to identify the cause (s) and initiate appropriate treatment.
Female infertility has multiple causes including ovulatory dysfunction. This is found in 20% of couples having difficulty conceiving. New Jersey fertility doctor Miller may diagnose this problem and , if it exists, will offer solutions to treat it.
A typical menstrual cycle of 28 -30 days can be divided into two halves: in the first half an ovarian follicle grows in preparation to release an egg. The follicle, or sac, produces the hormone estrogen which thickens the lining of the uterus to prepare it for implantation.Ovulation occurs at midcycle and the egg is picked up by the adjacent fallopian tube where it can be fertilized. In the second half of the cycle the ovary produces both estrogen and progesterone which allow the fertilized egg (embryo) to implant.Ovulatory dysfunction occurs when this orderly sequence of events does not occur on a regular, monthly basis.
Women who don’t menstruate monthly are easy to identify as having dysfunctional ovulation. But stress, extremes of weight loss or gain, ongoing vigorous exercise, thyroid dysfunction, and elevated level of the hormone prolactin can all be causes of failure to ovulate.
New Jersey fertility doctor Miller will take a detailed medical history and perform a physical exam. These plus appropriate blood tests will help confirm the diagnosis.
Luteal Phase Defect
If the second half of the cycle (the days after ovulation) is too short (less than 12 days) the patient’s uterine lining may not develop sufficiently to allow implantation and allow a pregnancy to survive and thrive.
Diminished Ovarian Reserve
A woman’s eggs have a shelf-life – just like eggs in the supermarket. As a woman ages the quality of her eggs declines as does the number of eggs available for fertilization and pregnancy. Egg quality begins to decline after age 25 (!!) but ovarian reserve goes down dramatically in the late 30s and early 40s.
Polycystic Ovarian Syndrome (PCOS)
This is a hormone imbalance that leads to irregular periods, failure to ovulate consistently, and often excessive weight gain that is difficult to control. Affected women may also complain of excess hair growth in places where women don’t usually grow hair: the face, upper chest, abdomen and back.
Premature Ovarian Failure
An absence of menstrual cycles (in someone who used to have monthly periods) in a woman less than 40 years of age may indicate that the ovaries have used up their supply of eggs. Simple blood tests and ultrasound of the ovaries can help confirm the diagnosis.
Fortunately there are multiple successful treatment options for women with ovulatory dysfunction. New Jersey fertility doctor Jane Miller has greater than 25 years’ experience implementing these treatments and helping women have successful, ongoing pregnancies.