Is there a relationship between immature follicular development and infertility?

Patient's question:

Married for three years, had tubal surgery last year, with endometriosis. Then in August last year, pregnancy stopped developing at fifty days, and has not been pregnant since. Menstruation has not stopped, with blood clots, disappearing completely in one day.

Doctor's answer:

Ovarian immaturity can lead to central nervous system anovulation, hypothalamic anovulation, pituitary anovulation, ovarian anovulation, polycystic ovary syndrome (PCOS), and luteinized unruptured follicle syndrome. Additionally, abnormal adrenal cortex function in women or malnutrition can also affect the regulation of ovarian function, leading to immature follicular development, inability to ovulate normally, or poor quality oocytes, all of which can impact normal conception and fertility. This is because only when follicles develop maturely and functionally, the oocytes released will be mature and healthy. If follicular development is poor, forcibly using ovulation-inducing drugs in a short period to compel ovulation may result in oocytes being released, but since these oocytes are immature, they cannot achieve normal fertilization.

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