Not Ovulating: What to Do When Your Cycle Skips Ovulation

Not ovulating is common and fixable. If you’re tracking periods or trying to get pregnant and notice no ovulation signs, start by checking a few simple things at home. An easy first step: take a pregnancy test if your period is late. Then record your cycle for at least three months—note period dates, basal body temperature, cervical mucus, and any ovulation kit results.

Common causes include PCOS (polycystic ovary syndrome), high stress, low body weight or rapid weight loss, excessive exercise, thyroid problems, high prolactin, recent stopping of hormonal birth control, and natural perimenopause. Certain medications and chronic illnesses can also block ovulation.

Tests Your Doctor Might Order

Your care team will usually start with a few blood tests timed to your cycle: day-3 FSH, LH and estradiol to check ovarian reserve and hormone balance; TSH for thyroid function; prolactin if you have unusual nipple discharge or missed periods; and a mid-luteal progesterone to confirm ovulation. Many doctors order AMH to estimate ovarian reserve and a pelvic ultrasound to look at ovarian follicles and rule out structural issues.

Ovulation predictor kits (LH tests) and basal body temperature charts are helpful at home. They won’t replace medical testing, but they help pinpoint missing ovulation and time clinic visits.

Practical Treatment Options

Treatment depends on the cause. If PCOS and insulin resistance are the issue, lifestyle changes and metformin can help. For weight-related anovulation, losing or gaining weight to reach a healthier range often restores ovulation. If your thyroid or prolactin is off, treating the underlying condition usually fixes the cycle.

If you’re trying to conceive and lifestyle fixes don’t work, doctors often use ovulation induction drugs. Letrozole is commonly preferred for many women with PCOS; clomiphene citrate is another option. Injectable gonadotropins are used when oral meds fail or in assisted reproduction. For some PCOS cases, laparoscopic ovarian drilling is an option, but it’s less common today.

If fertility is urgent or other treatments fail, intrauterine insemination (IUI) or in vitro fertilization (IVF) may be recommended. Each step should match your fertility goals, age, and medical history.

When to see a doctor? If you’re under 35 and trying to conceive without success for 12 months, or over 35 after six months, talk to a specialist sooner. Also see a clinician if you have very irregular periods, severe pelvic pain, or symptoms of thyroid or pituitary problems.

Quick practical tips: track cycles, use ovulation kits, keep a healthy weight, lower intense training temporarily, manage stress, and avoid smoking and excessive alcohol. Honest conversation with your provider gets you a targeted plan faster—don’t wait if getting pregnant matters now.

Simple check before clinic: start daily folic acid, check vitamin D, stop smoking, and cut alcohol. Keep a cycle log and bring it to appointments. If tests show low ovarian reserve or blocked tubes, ask about IVF options and timelines. Early referral speeds things up. You deserve clear answers and a plan today.