One reason why couples might come in to see a fertility specialist is if they are not ovulating regularly. If you don’t release an egg, it’s not going to be possible to get pregnant. So we see women who as a common cause infertility and those women we’re happy to see them whenever they’re ready to be seen. There is some testing that we can do to try and get an idea of why women don’t ovulate regularly. We can look at their thyroid, there’s another hormone called prolactin we can allow polycystic ovary syndrome and check testosterone levels, we can make sure they have a good number of eggs, and aren’t carrying menopausal. But for a lot of women we still even after that testing aren’t exactly sure why they don’t ovulate regularly although they might have some risk factors which we can’t test for. Things like stress, things like exercising too much being overweight or being underweight. We don’t have specific blood tests for those but they can cause women not to ovulate regularly. We have a number of different ways to help women who don’t ovulate, ovulate. We have pills that can help stimulate the ovaries to grow an egg or we can use injections which will directly stimulate the ovaries to make one or more eggs that month to help women get pregnant. Often time I’m asked what’s the chances of success with our fertility treatments. Well in women who don’t ovulate if we can just get them to release an egg there’s some of our best candidates for our fertility treatments. If you took two 20 year-olds and you told them to go to an island and get pregnant their chances of getting pregnant that month are gonna be around 20% or so. In women who don’t ovulate, if we can just get them to ovulate either with these pills or with injections they can have as high of a 20% chance of getting pregnant. When we get women to ovulate more than one egg, that can increase their chances of pregnancy but can also increase the risk of twins so when we use pills to help women ovulate their chances of twins will be less than 10% and when we use injections to help women evaluate their chances of twins can be as high as 25%. The risks of more than twins also depends on whether it’s pills or injections but can range anywhere from less than 1% to 5%.