Key Risk Factors: PCOS, hypothalamic dysfunction, hyperprolactinemia, ovarian failure.

Diagnostics / Treatment Pathways:
Initial Consultation:
Assess menstrual irregularities, BMI, stress, diet, and exercise.
Identify underlying hormonal imbalances.
Diagnostics:
Hormonal assays: FSH, LH, TSH, Prolactin, AMH.
Imaging: Pelvic ultrasound for PCOS or ovarian pathology.

Treatment Options:
1) Lifestyle Interventions:
  When Appropriate: For PCOS, obesity, or stress-related anovulation.
  Decision Factors: If BMI is high or stress levels are interfering with ovulation.
Weight management (Dietary changes, regular exercise) for obesity or PCOS.
Stress management techniques.

2) Medications:
  When Appropriate: If anovulation persists despite lifestyle changes.
  Decision Factors: Hormonal profile and ovarian reserve.
Ovulation induction: Clomiphene citrate or Letrozole.
Metformin for insulin resistance in PCOS.

3) Surgical Options:
  When Appropriate: For clomiphene-resistant PCOS.
  Decision Factors: Persistent ovarian dysfunction after medications.
Ovarian drilling using laparoscopy for clomiphene-resistant PCOS.
 
4) ART (Assisted Reproductive Technology):
  When Appropriate: If ovulation induction and/or ovarian drilling fail.
  Decision Factors: Age, ovarian reserve, partner’s fertility.
IVF, ICSI for anovulation not responding to induction.
Cryopreservation (egg freezing for fertility preservation) for women with declining ovarian reserve.
Donor egg programs for ovarian failure.