Infertility Information
Female Reproductive System
By understanding how the female reproductive system works, you can decrease your chances of having infertility issues. The main reproductive tissues in women are the ovaries, fallopian tubes, uterus, endometrium, cervix, and vagina. Hormones produced by the brain, the pituitary gland, and the ovaries primarily control these organs.
Ovaries:
- Produce female hormones: estrogen and progesterone
- Produce one ripened egg (called an ovum) each menstrual cycle
- Each month one of the ovaries produces an egg, which develops in a small fluid-filled sac called the follicle. When the egg is mature it is released from the ovary and passes through one of the fallopian tubes.
Fallopian Tubes:
- Two trumpet-shaped, flexible tubes connected to the uterus, are designed with flared projections (fimbriae) to catch the egg and move it into the tube.
- Egg and sperm meet in the fallopian tubes and it is here that the egg becomes fertilized and the resulting embryo is transferred to the uterus by cilia (small hairlike structures)
Uterus:
- The thick, muscular organ that is designed to support a growing fetus
Endometrium:
- The mucous membrane lines the uterus and plays a key role in the implantation of the embryo.
- The endometrium responds to the hormone progesterone, produced by the body, and must be thick and spongy to receive the embryo. If there is no implantation the lining is shed with a menstrual period.
Cervix:
- A ring of tissue at the top of the vagina is designed to collect sperm (with a cervical mucus), which are later released into the uterus.
- Observing changes in your cervical mucus will help you determine signs of fertility
Vagina:
- Sperm enter the woman’s body through the vagina which then leads to the cervix.
What is a normal menstrual cycle?
The menstrual cycle is a term used to describe the sequence of events that occur within your body as it prepares for the possibility of pregnancy each month. A menstrual cycle is considered to begin on the first day of a period. The average cycle is 28 days long; however, a cycle can range in length from 21 days to about 35 days.
The steps in the menstrual cycle are triggered by the rise and fall of chemicals in your body called hormones. Your pituitary gland (in your brain) and your ovaries (in your reproductive tract) make and release certain hormones at certain times during your menstrual cycle that cause the organs of your reproductive tract to respond in certain ways. The specific events that occur during your menstrual cycle can be described as follows:
- The menses phase: This phase, which typically lasts from day one to day five, is the time when the lining of your uterus is actually shed out through your vagina if pregnancy has not occurred. Most people bleed for three to five days, but a period lasting only two days to as many as seven days is still considered normal.
- The follicular phase: This phase typically takes place from days six to 14. During this time, the level of the hormone estrogen rises, which causes the lining of your uterus (called the endometrium) to grow and thicken. In addition, another hormone — follicle-stimulating hormone — causes follicles in your ovaries to grow. During days 10 to 14, one of the developing follicles will form a fully mature egg (ovum).
- Ovulation: This phase occurs roughly at about day 14 in a 28-day menstrual cycle. A sudden increase in another hormone — luteinizing hormone — causes your ovary to release its egg. This event is called ovulation.
- The luteal phase: This phase lasts from about day 15 to day 28. After the egg is released from your ovary, it begins to travel through your fallopian tubes to your uterus. The level of the hormone progesterone rises to help prepare your uterine lining for pregnancy. If the egg becomes fertilized by a sperm and attaches itself to your uterine wall, you become pregnant. If pregnancy does not occur, estrogen and progesterone levels drop and the thickened lining of your uterus is shed during the menstrual period.
Ovulation
A woman is born with all of the eggs she will ever have. Each month a woman who is ovulating normally will drop one egg, this process is called ovulation.
The Egg
As the eggs are formed, thin layers of cells (granulose cells) grow around them. The granulose cells and the oocyte are contained within a follicle. The follicle supports the egg it encloses for 50 years or more, providing it with nourishment but preventing it from maturing. The great majority of follicles and eggs never grow to maturity and ovulation. Follicles begin to develop, but if conditions for continued growth are not optimal, the eggs lose nourishment and die. The follicle cells then are absorbed back into the ovary (atresia.) Atresia continues throughout a woman’s life until all of the follicles are gone and she enters menopause.
During the hours leading up to ovulation when the mature egg is released from the dominant follicle, some important processes begin:
- The production of the LH hormone (lutenizing hormone rises in the blood).
- A few hours before ovulation, the primary oocyte undergoes a cell division process (meiosis) which results in an egg that contains 23 chromosomes
- The follicle cells surrounding the oocyte secrete mucous, forming a circular barrier (the cumulus) around the oocyte. Beneath the cumulus is a glassy looking membrane the zona pellucida. Sperm must be able to go through the cumulus and the zona pellucida of the egg in order to fertilize it.
- The egg is released and is picked up by the fimbriated ends of the fallopian tube.
- Fertilization usually occurs in the fallopian tube 12-24 hours after ovulation.
Tracking Your Fertile Time
Tracking Your Basal Body Temperature (BBT)
Keeping track of your Basal Body Temperature (BBT) is a way to document whether you have ovulated. A specific hormonal change during your cycle triggers a rise in basal body temperature. By taking your temperature every day you can chart the rise of your temperature and the day you ovulate. The BBT chart will not predict when you are going to ovulate, but can serve as a record of your patterns. This will be helpful information for your physician. Ovulation predictor kits are designed to help you predict the time you will ovulate.
Using Ovulation Predictor Kits
Urine test kits to monitor lutenizing hormone (LH) are called ovulation predictor kits. They are designed to help you predict the time you will ovulate so that you can maximize your chances of getting pregnant. Most kits typically require you to perform a simple urine test. When you urinate on a special stick from this kit, it will document the surge of LH released by the pituitary just before ovulation, usually 24-38 hours before the egg is released. Most kits offer clear instructions for use and a toll-free number to call if you have questions.
Am I Ovulating
here are only about 2 days a month when are you most likely to get pregnant. Identify the most fertile days within your cycle and then plan intercourse to correspond with these times of peak fertility.
- Every month an egg matures, leaves the ovary and travels down one of your fallopian tubes. This is called “ovulation”.
- Ovulation is primarily triggered by a monthly surge in a hormone referred to as “LH” (Luteinizing Hormone). The level of LH rises during the 24-36 hours before ovulation this is the “LH Surge”.
- Your best chance to become pregnant occurs when you have intercourse within 24-36 hours after the LH surge.
- Women’s menstrual cycles can vary from 20-44 days. This means the day of the month you ovulate can vary significantly. Most women do not ovulate mid-cycle. With so much variability, it may be difficult for a woman to find her peak fertility.
- Become familiar with your cycle by using ovulation tests before you’re actually ready to get pregnant. Ovulation Tests help you to identify the timing of your “LH Surge”: †
† Certain medical conditions and drugs can adversely affect the reliability of tests for predicting ovulation.
Source: Resolve.org
Source: ClevelandClinic.org
What are the types of infertility?
Types of infertility include:
- Primary: A woman who was never pregnant and who can’t conceive after one year of not using birth control.
- Secondary: Secondary infertility occurs when a woman can’t get pregnant again after having at least one successful pregnancy.
Source: ClevelandClinic.org
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