Anovulation

Anovulation also may occur at any time during the reproductive years due to a pathologic cause. The most common causes of non-physiologic ovulatory dysfunction and their prevalence rates11 are ... 

Anovulation may result from a problem at any level of the HPO axis. In addition to various physiologic life stages such as adolescence, perimenopause, pregnancy, and lactation, other causes of anovulation include 11... 

Hyperandrogenic anovulation (PCOS, congenital adrenal hyperplasia, androgen-producing tumors)... 

Amenorrhea related to anovulation resulting from PCOS may respond to the use of agents that reduce insulin resistance. The use of metformin for this purpose will be discussed in the anovulatory bleeding section that follows. 

In the adolescent population, specific blood dyscrasias should be treated. In addition, acute, severe bleeding may be managed with high-dose estrogen. Low-dose OCs (less than or equal to 35 meg ethinyl estradiol) are the treatment of choice in adolescents with chronic anovulation.11... 

Ovitrelle (tradename in EU, sold as Ovidrel in the USA and also known as choriogonadotropin alfa) is a recombinant hCG approved for general medical use in the EU and USA in 2001. It is indicated for the treatment of female infertility due to anovulation and for patients undergoing assisted reproductive technology. It is used to trigger final follicle maturation and luteinization after follicle stimulation. 

PCB diets were associated with reproductive impairment including anovulation, fetal resorption, delayed ovulation, increased gestation, and decreased litter size. Hepatic estrogen binding site concentrations decreased with increasing dietary PCB concentrations but not uterine estrogen receptor sites... 

Medical treatment of endometriosis has focused on the hormonal alteration of the menstrual cycle in an attempt to produce a pseudopregnancy, pseudomenopause, or chronic anovulation (Olive et al. 2001). 

Gellert RJ. 1978. Kepone, mirex, dieldrin, and aldrin Estrogenic activity and the induction of persistent vaginal estrus and anovulation in rats following neonatal treatment. Environ Res 16 131-138. 

Treatment of growth failure in children due to inadequate growth hormone secretion Anovulation and superovulation Anovulation and superovulation Some forms of infertility... 

The menotropins, human menopausal gonadotropin (HMG) and urofollitropin are prepared from the urine of postmenopausal women. HMG has approximately equal amounts of FSH an LH. Urofollitropin has only FSH activity. Follitropin alpha and follitropin beta are two FSH products which are made with recombinant DNA technology. Lutropin alpha is recombinant human LH. Human chorionic gonadotropin (HCG) is produced in the placenta and excreted in the urine. It has mainly LH activity. Choriogonadotropin alpha is the world s first recombinant chorionic gonadotropin (r-hCG) for the treatment of anovulation, the most common cause of infertility in women. 

Mechanism of Action A testosterone derivative that suppresses the pituitary-ovarian axis by inhibiting the output of pituitary gonadotropins. Causes atrophy of both normal and ectopic endometrial tissue in endometriosis. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are depressed in fibrocystic breast disease. Inhibits steroid synthesis and binding of steroids to their receptors in breast tissues. Increases serum levels of esterase inhibitor. Therapeutic Effect Produces anovulation and amenorrhea, reduces the production of est rogen, corrects biochemical deficiency as seen in hereditary angioedema. 

Hamilton M, White J Factors related to the outcome of depression treated with ECT. Journal of Mental Science 106 1031-1041, 1960 Hammarback S, Backstrom T Induced anovulation as treatment of premenstrual tension syndrome a double-bhnd crossover study with GnRH-agonist versus placebo. Acta Obstet Gynecol Scand 67 159-166, 1988 Hamon M Neuropharmacology of anxiety-perspectives and prospects. Trends Pharmacol Sci 15(2 36-39, 1994... 

Results from a clinical trial of cabergoline in women with hyperprolactinemia and anovulation. A The dotted line indicates the upper limit of normal serum prolactin concentrations. B Complete success was defined as pregnancy or at least two consecutive menses with evidence of ovulation at least once. Partial success was two menstrual cycles without evidence of ovulation or just one ovulatory cycle. The most common reasons for withdrawal from the trial were nausea, headache, dizziness, abdominal pain, and fatigue. 

Kistner RW. The use of clomiphene citrate in the treatment of anovulation. Semin Drug Treat 1973 3(2) 159-76. 

Insler V, Lunenfeld B. Anovulation. Contrib Gynecol Obstet 1978 4 6-77. 

BeckJI, Boothroyd C, Proctor M, et al. Oral anti-oestrogens and medical adjuncts for subfertility associated with anovulation. Cochrane Database Syst Rev. 2005 CD002249. 

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