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Fertility and various aspects associated with it is an important knowledge that everyone should know about. Whether you are a young girl stepping into adulthood or a woman trying to get pregnant, knowing how a woman’s reproductive system works can be immensely helpful.
Not just for women, an understanding of the fundamentals of fertility can be useful for men as well, as this can help them take care of the women in their lives in a better way.
In this article, we will provide you with an overview of three important aspects related to fertility – ovulation, conception and infertility.
The process of the release of a mature egg from one of the ovaries and its movement along the fallopian tube towards the uterus so that it can be fertilized is known as ovulation. It is a part of a woman’s menstrual cycle.
As an egg reaches maturity, it is released from the ovary. It then moves along the fallopian tube and reaches the uterus where it waits for a sperm to get fertilized. During this waiting period, the lining of the uterus gets thickened to prepare for the fertilized egg.
In case of no conception, the uterine lining and the unfertilized egg are shed along with blood. This is known as menstruation. Ovulation usually happens once a month, about two weeks before the next period. Usually, ovulation lasts from 16 to 32 hours.
Conception is the process of a sperm and egg joining together. This happens when a sperm swims up through the vagina and fertilizes an egg in the fallopian tube. This can happen after hours of having unprotected sex. The fertilized egg then gets implanted into the uterus leading to conception. This is the first step of pregnancy.
Once an egg is fertilized, it moves down the fallopian tube, dividing into multiple cells in the process. A fertilized egg is known as a zygote. Around a week after the sperm has fertilized an egg and the zygote reaches the uterus, the zygote grows into a cluster of about 100 cells, called a blastocyst. The blastocyst attaches itself to the lining of the uterus, a process known as implantation.
However, it is essential to remember that all conception does not lead to implantation. Sometimes implantation can be unsuccessful leading to the fertilized egg being flushed out during the next menstrual period.
In case of successful implantation, the cells continue to divide with some cells developing into a baby and others forming the placenta. During this time, women release hormones that signal the body that a baby is growing inside the uterus. These hormones also inform the body not to shed the lining of the uterus. This is why during pregnancy women do not experience menstrual periods. This is also the first way of knowing that someone is pregnant.
The menstrual cycle is closely linked to conception and ovulation. Usually, menstrual cycles are 28 days long, but the length can vary from one woman to another. The exact time of ovulation of a woman is dependent on the menstrual cycle.
Let’s break down the timelines to understand this clearly:
So what triggers a positive pregnancy test?
A fertilized egg travels through the fallopian tube to the uterus after conception. The fertilized egg, known as an embryo, gets attached to the wall of the uterus, which triggers the formation of the placenta. The placenta produces and releases a hormone called human chorionic gonadotropin (hCG) into your blood and urine. This is the hormone that’s captured in pregnancy tests. hCG starts appearing in a person’s blood after 11 days after conception, however, it may take longer to show up on an at-home pregnancy test.
Now that we have a better idea about ovulation and conception, let’s take a deeper look into the ovulation cycle. The ovulation cycle can be roughly divided into two parts:
The phase starting from the first day of the last menstrual cycle till ovulation. This can be different for different women, lasting from 7 days up to even 40 days.
The second half of the cycle that lasts from the day of ovulation until the beginning of the next period. This period has a more precise timeline and usually lasts for only 12 to 16 days.
So, all in all, ovulation is what decides how long a woman’s cycle is. External factors such as illness, stress, and disruption to the normal routine can mess up your ovulation cycle, thus, in turn, messing up the time when your period will start.
If you’ve been trying to get pregnant, tracking the ovulation cycle can be immensely helpful. This can ensure that your efforts are fruitful. Here are some of the things that you can try:
Let’s now talk about the third issue in question – Infertility.
Infertility is defined as a condition where a woman can’t get pregnant after one year of trying to conceive. Infertility can be caused by various reasons such as endometriosis, ovulatory disorders, low sperm count or low testosterone. Age can be a major factor in infertility.
However, today, many treatments are available to treat a woman’s infertility.
Infertility is primarily of three types:
Infertility has become more common than before. The WHO has classified infertility as an acute disease. In Malaysia, infertility rates range between 10 to 15%.
Infertility can be caused due to a variety of reasons. The causes can concern any one of the partners or sometimes both the partners. Some of the common causes of infertility include:
While the above symptoms can be experienced by both men and women, some causes can be specific to only women such as:
Treatment of infertility is dependent on the cause of infertility and the goals one wants to achieve. Both the partner’s age, how long they have been trying to conceive and their personal preferences are important factors in deciding the course of treatment. One or both partners may need infertility treatment.
The most common treatments for women include:
If the male partner is infertile, treatments are done to address issues related to the penis and/or testes:
A woman’s reproductive system is complex and is susceptible to health issues which can range from simple period problems to complex infertility issues. No issue is minor, when it comes to the reproductive system of a woman as a small issue can lead to a major problem if left untreated.
The care should start right after a girl gets her first period. Speaking to a gynaecologist on time can go a long way in avoiding bigger issues in the future.
Dr Siti Maisarah Ahmad
Consultant Obstetrician, Gynaecologist & Reproductive Medicine (Visiting)
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