Ovulatory dysfunction, is a disorder in which ovulation does not occur regularly. Ovulation is the term used to define the release of an egg from the ovary. This process is essential for pregnancy to occur. Ovulation is a complex process and depends on an adequate amount of appropriate hormones at appropriate times of the menstrual cycle. Anything that disrupts the hormonal regulation of the female cycle may result in ovulatory dysfunction.

Ovulatory dysfunction can occur in any woman that has undergone puberty. Women who have reproductive organs that did not develop fully may not be capable of ovulating. Ovulatory dysfunction is very common in women approaching menopause. Once menopause sets in, women stop ovulating. As many as 30-40% of all women may experience ovulatory dysfunction. This is one of the most common and most manageable causes of infertility.

The ovaries contain thousands of eggs, which are housed in small sacs called follicles. In order for ovulation to occur, one of these follicles must grow to a mature size. Various hormones play an important role in this growth and maturation process. The levels of hormones fluctuate throughout the menstrual cycle but must always be at the appropriate level at the appropriate time for a normal menstrual cycle. LH (luteinizing hormone) and FSH (follicle stimulating hormone) are two hormones needed for a follicle to grow to maturity. Estrogen, FSH, and LH levels must rise in order to release the egg. After the egg is released from the ovary, it travels to the uterus through the fallopian tubes, where it may get fertilized if sperm are present. The uterine wall thickens to allow implantation of a fertilized egg. If a viable sperm does not fertilize the egg, then the lining of the uterus sheds and menses occurs. This marks the start of a period and a new menstrual cycle.

In women with ovulatory dysfunction, ovulation does not occur consistently. Most causes of ovulatory dysfunction are related to an imbalance of hormones. Organs within the brain (the hypothalamus and pituitary glands) play an important role in regulating amounts of FSH and LH. Inadequate amounts of FSH and LH in the beginning of the menstrual cycle can cause ovulatory dysfunction. Therefore, any changes in how the hypothalamus and pituitary function can affect ovulation.

There are numerous causes of ovulatory dysfunction. The hypothalamus and pituitary regulate FSH and LH. Most of the causes of ovulatory dysfunction in some way affect the hypothalamus or pituitary glands and cause deficiencies of FSH and LH.