As we all know with the development of society the incidence of infertility has increased and the incidence in our country is about 7-10%. Failure to conceive after at least 12 months of uncontraceptive sex is called infertility in women and infertility in men. The causes of infertility may be female factors, male factors or unknown. Female factors include: 1. Pelvic factors 2. Ovulation disorders. Ovulatory disorders account for 25-35% of the cases, and the main causes include persistent anovulation; PCOS; premature ovarian failure and ovarian hypoplasia; congenital gonadal hypoplasia; hypogonadotropic gonadal dysfunction; hyperprolactinemia, and luteinized follicular non-rupture syndrome. Below I will focus on introducing ovulation disorder infertility to you. Polycystic ovary: Polycystic ovary is one of the most common gynecological endocrine diseases. Clinically, it is characterized by clinical or biochemical manifestations of hyperandrogenism, persistent anovulation, and polycystic changes of the ovaries, often accompanied by insulin resistance and obesity. Its etiology has not yet been elucidated, and current research suggests that it may be due to the interaction of certain genetic and environmental factors. The ovaries are enlarged and polycystic and contain multiple small follicles. These follicles are a kind of atretic follicles, which are unable to become normal eggs, much less show signs of ovulation. So the patient is not easily conceived or even infertile. Kaohsiung is characterized by hirsuteness and acne, and more than 50% of the patients are obese, which is related to insulin resistance, hyperandrogenism, increased percentage of free testosterone and leptin resistance. Grayish-black hyperpigmentation with thickened skin and soft texture is seen in the patient’s labia, back of the neck, armpits, inframammary and inguinal skin folds. On ultrasound, both ovaries were enlarged with enhanced peripheral echogenicity, and one or both ovaries had more than 12 echogenic areas of 2-9 mm in diameter, which surrounded the edges of the ovaries and were arranged in the shape of a wheel, known as the “necklace sign”. There was no sign of follicular development or ovulation in the main follicle on continuous monitoring. Endocrinology: serum androgens are increased, LH/FSH>2-3. Hyperprolactinemia: blood prolactin secretion can be >25ug/ml, which is called hyperprolactinemia. The causes include hypothalamic disease, pituitary disease, primary hypothyroidism, idiopathic hyperprolactinemia. Clinical manifestations include: (1) menstrual disorders and infertility (2) breast milk overflow (3) headache, ophthalmoplegia, and visual disturbances (4) changes in sexual function. Diagnosis can be made by combining clinical symptoms with serum prolactin levels. When prolactin secretion in blood is >100ug/ml, MRI of pituitary gland should be performed to clarify whether there is pituitary microadenoma or adenoma. 3.Premature ovarian failure and ovarian hypoplasia: Ovarian failure occurs before 40 years of age due to follicular depletion in the ovary or medical injury. Hormonal characteristics are FSH>40U/L, accompanied by a decrease in estrogen level. 4, congenital gonadal dysgenesis: such as Turner syndrome 5, hypogonadotropic gonadal dysgenesis: mostly due to the hypothalamus secretion of GNRH insufficiency or pituitary secretion of gonadotropin insufficiency and primary amenorrhea occurs, the most common for the physical pubertal delay, followed by olfactory deficiency syndrome. 6, luteinized follicle does not rupture syndrome: patients in the ultrasound detection of follicle development and ovulation process, found that the follicle is not ruptured after maturity, the oocyte has not been discharged and in situ luteinization, the formation of the luteum and the secretion of progesterone, the effect of the body effect organ occurs a series of changes similar to the ovulation cycle. Clinically, it is characterized by long menstrual cycle, ovulation-like performance but persistent infertility, and is also one of the important causes of infertility. The pathogenesis of luteinized follicular non-rupture syndrome is not well understood. Most of them are thought to be related to central regulatory disorders, local disorders, and mental and psychological factors. The incidence rate is reported differently, but most of them think that it is about 5%-10% in natural menstrual cycle and about 30%-40% in drug ovulation promotion cycle. According to the ultrasound dynamic monitoring can be divided into three types: small follicle type, follicle retention type and continuous enlargement type. Treatment precautions: 1, for the cause of the disease, to establish a different treatment plan, such as polycystic ovary syndrome patients should be given to lower androgens and hyperprolactinemia, endocrine levels stabilized, given to promote ovulation treatment. 2, pay attention to ultrasound to monitor ovulation After the application of ovulation stimulating drugs or natural cycle, it is best to take ultrasound to detect ovulation. That is, starting on the 8th-10th day of the menstrual cycle, observe the emergence and development of dominant follicles until ovulation, when the follicles are about 20mm-24mm in diameter, and give intramuscular chorionic gonadotropin to promote follicle rupture if necessary. 3, pay attention to the prevention of miscarriage Ovulation disorder infertility patients after treatment of pregnancy, the chances of miscarriage is also very high, the appropriate application of progesterone, chorionic gonadotropin and other treatments can reduce the rate of miscarriage, the use of medication should be to choose the fetus is safe and effective medication to protect the fetus. For the treatment of luteinized follicular non-rupture syndrome, before applying ovulation promotion therapy, the local mechanical factors causing luteinized follicular non-rupture syndrome, such as endometriosis, chronic pelvic inflammatory disease, pelvic adhesions, etc., must be actively dealt with. Surgical treatment is required in the following ways: (1) Follicular puncture curettage. (2) Laparoscopic or caesarean section treatment. In addition can also assist the mental psychotherapy: mental decisive tension, anxiety, etc. can lead to the occurrence of luteinized follicles do not rupture syndrome, mental psychological counseling treatment section can help to restore normal ovulation function