Hypothalamic-pituitary-ovarian axis disorders impacting female fertility

Sasha Mikhael, Advaita Punjala-Patel, Larisa Gavrilova-Jordan

Research output: Contribution to journalReview articlepeer-review

46 Scopus citations


The hypothalamic-pituitary-ovarian (HPO) axis is a tightly regulated system controlling female reproduction. HPO axis dysfunction leading to ovulation disorders can be classified into three categories defined by the World Health Organization (WHO). Group I ovulation disorders involve hypothalamic failure characterized as hypogonadotropic hypogonadism. Group II disorders display a eugonadal state commonly associated with a wide range of endocrinopathies. Finally, group III constitutes hypergonadotropic hypogonadism secondary to depleted ovarian function. Optimal evaluation and management of these disorders is based on a careful analysis tailored to each patient. This article reviews ovulation disorders based on pathophysiologic mechanisms, evaluation principles, and currently available management options.

Original languageEnglish (US)
Article number5
Issue number1
StatePublished - Mar 1 2019


  • Hypothalamic-pituitary-ovarian axis
  • Infertility
  • Ovulatory dysfunction
  • Primary ovarian insufficiency
  • WHO ovulation disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology(all)


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