New International Federation of Gynecology and Obstetrics ovulatory disorders classification system 2022. Diagnostic assessment of ovulatory dysfunction

Until recently, researchers and clinicians have used the World Health Organization classification of ovulatory disorders (1973), which was based on the levels of gonadotropins and estrogens in the blood serum (mainly follicle-stimulating hormone) and classified ovulatory disorders depending on the hypothalamic-pituitary-ovarian axis dysfunction levels. This review article presents a new classification system for ovulation disorders developed by the International Federation of Gynecology and Obstetrics (FIGO) in 2022. The first level of this classification system is based on an anatomical approach (hypothalamus, pituitary gland, ovaries), which is complemented by a separate category for polycystic ovary syndrome. At the second level, each anatomical category is classified according to the putative etiopathogenetic mechanisms underlying ovulation disorders. The third level suggests the presence of specific nosologies, which represent the direct cause of ovulation disorders. This new classification should be used after a preliminary examination that reveals the presence of an ovulation disorder. This review discusses various ovulation disorders and provides tools for their diagnosis in accordance with international guidelines and domestic recommendations.