Women with irregular menstrual cycles often experience more difficulty conceiving due to underlying ovulation disorders that disrupt regular ovulation. Irregular menstrual cycles commonly indicate anovulation or oligo-ovulation, which reduces the frequency of fertile periods and thus lowers the chances of conception NICE CG156.
UK clinical guidelines classify ovulation disorders contributing to irregular cycles into three main groups: hypothalamic pituitary failure (Group 1), hypothalamic-pituitary-ovarian dysfunction (Group 2, often including polycystic ovary syndrome), and ovarian failure (Group 3). Many women with irregular menstruation fall into Groups 1 and 2, where ovulation is impaired or absent, directly leading to reduced fertility NICE CG156.
Management strategies recommended for these groups, especially Groups 1 and 2, focus on restoring ovulation through lifestyle modifications and medical treatments such as gonadotrophins, clomifene citrate, or metformin. For example, weight management is emphasized, as both low and high BMI can worsen ovulation issues and irregular cycles, impeding conception NICE CG156.
From a broader reproductive physiology perspective corroborated by literature, the irregularity of cycles signals inconsistent hormonal regulation and ovulatory timing, making it more difficult to predict and achieve conception. This aligns with evidence that emphasizes the importance of regular ovulation for natural conception rates Tarlatzis & Zepiridis 2003.
Therefore, while many women with irregular cycles can conceive, these women tend to have a lower likelihood of conception and may require assessment and treatment aimed at correcting ovulatory dysfunction to improve fertility outcomes. Detailed evaluation and personalized management improve chances of pregnancy NICE CG156 Tarlatzis & Zepiridis 2003.