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Updated: May 21, 2026

Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Management of anovulatory infertility
Raymond Hang Wun Li1, Ernest Hung Yu Ng
1Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong.
Abstract:
Anovulatory subfertility is a heterogeneous condition with various underlying causes, which should be identified with appropriate history taking, physical examination and relevant investigations. Optimisation of body weight is essential in either underweight, overweight or obese individuals. Women with hypogonadotrophic anovulation can be treated with pulsatile gonadotrophin-releasing hormone therapy or a gonadotrophin preparation containing both follicle-stimulating hormone or luteinising hormone activities. For normogonadotrophic anovulation, clomiphene citrate should be used as first-line medical treatment. Metformin co-treatment with clomiphene citrate may be considered in a subgroup of women with polycystic ovary syndrome who are obese or clomiphene-resistant. Ovulation induction with gonadotrophin or laparoscopic ovarian drilling is the next option. Dopamine agonist is indicated for anovulation as a result of hyperprolactinaemia.
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