A natural approach to ovarian factor infertility.
Ovarian factor infertility is the most common female factor and also one of the most complicated to work up. Ovulatory disorders account for about one-quarter of all female infertility types and are closer to one-third when hyperprolactinemia is included.
The factor can be divided into two categories, ovulatory dysfunction and diminished ovarian reserve. Ovulatory dysfunction refers to any condition or process that interferes with the follicle development or ovulation. Diminished ovarian reserve is diminished egg quality and count, and includes: advanced maternal age (>35 years old) and naturally occurring ovarian decline.
Clues in determining the presence of ovarian factor infertility from a patients history can include irregular menses, premenstrual or mid-cycle bleeding, abnormally light or heavy menses. A patient may also experience fatigue, hair loss, signs of hirsutism, galactorrhea or obesity. In the case of diminished ovarian reserve an abnormal menstrual history may be accompanied by a variety of menopausal symptoms.
There is no single test for ovarian factor infertility but, we can begin with a serum luteal-phase progesterone reading. Ovulation predictor kits are a convenient at-home way for women to determine ovulation timing by measuring luteinizing hormone levels in the urine. Transvaginal ultrasound can also help demonstrate signs of ovulation by revealing free fluid and/or a collapsed follicle, although not commonly practiced in ovarian factor work up unless the woman is preparing for IUI or IVF.
When testing for ovarian reserve, the most commonly used are early follicular-phase follicle-stimulating hormone combined with estradiol, anti-Mullerian hormone and antral follicle count. As ovarian reserve declines, follicular phase will shorten and FSH will rise. We can run comprehensive labs to check your general health and your genomic health.
Infertility and the vaginal microbiome. It is estimated that 7.5 million women between the ages 15 and 44 have impaired fertility and fecundity. It is established that the maternal microbiome influences the risk of chronic diseases and mood disorders throughout life. It plays a central role in protecting and influencing the balance of bacteria in the vaginal tract. Bacterial infections also affect fertility and the risk of preterm labor and post-partum complications, such as STDs, bacterial vaginosis, UTIs, and Group B streptococcus. The vaginal tract is regulated by the vaginal microbiome. Antimicrobial peptides (AMP) are released from epithelial cells of the female reproductive tract in response to chemical signals from the local microbial community to protect against inflammation and pathogen invasion. The microbiome is influenced by hormonal changes, estrogen stimulates the vaginal epithelia to produce glycogen, which is then metabolized by lactobacilli.
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Dunlap, C., ND, MS. (2018, February). Ovarian Factor Infertility. Ndnr, pp. 1-5.