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20110823

Getting Pregnant: Why Ovulation Cycle is More Precise Predictor of Fertility and Ability to Get Pregnant

Defining the Ovulation (Fertility) Cycle Versus the Menstrual Cycle

Most women seem to have a good understanding and timing of their menstrual cycle; many are stunned to learn that they know little or nothing about their ovulation or fertility cycle. Many infertile women have not heard or can't even tell the difference between the two.

What's the differnce between the well-known menstraul (or uterine) cycle and the mysterious ovulation (or fertility cycle)?

Menstrual cycle is the uterine cycle or monthly menses

Basically the menstruation refers to the uterine or endometrium and the cycle occurs in three stages:

1. The building stage or the proliferative phase
2. Secretory phase: Hormonal preparation stage for pregnancy
3. Shedding or mentraul phase where you have external bleeding

Ovulation Cycle is the Actual Fertility Cycle

Refers to the stages of development of ovarian follicles to the point of egg release from the ovaries and eventual formation of the corpus luteum.

In nature, this two cycles are inter-connected and run-concurrently together in harmony as in well-timed musical orchestra (all things being equal) to produce female fertility and pregnancy.

However, the subject of this discourse is focused on the less understood ovulation or actual fertility cycle.

In the beginning of a woman's reproductive life Starts in Her Mother's Womb...

A woman's reproductive life begins when she is still in her mother's womb as a fetus precisely sometime between the 14th and 20th week of gestation. At this time all the eggs or oocytes (immature eggs) a woman will ever have in her lifetime are first produced in her ovaries. The number of immature eggs created at this time are estimated to be around 7 million. From this time onward, the eggs continue to diminish in number to such extent that at birth, the baby is left with a couple of million egges in both ovaries. All things being equal, I guess one million eggs a piece for each ovary

Thus a woman is born with a finite bank account of premature eggs in her ovaries. Ovulation, therefore is not the manufacture of more oocyte (primitive eggs) but the maturing and release of already existing eggs.. This is contrary to the male where there is perpetual production and release of sperms regardless of age..

From the onset, the oocytes in the ovaries are surrounded by follicular cells which will nourish the eggs for up to 50 years or more of the womans reproductive life until she passes her menopause. Most follicles are not destined to mature and ovulate, but will die a natural death and be reabsorbed into the substance of ovarian tissue through a process called atresia. It is important to note here that the process of atresia progresses always regardless of pregnancy, use of hormonal contraceptives or menstrual regularity (amenorrhoea, dysmenorrhoea)--a woman is constantly losing her eggs. This is to such an extent that at menarche (the time of her first mentruation), she only left with about 300,000 immature eggs in both ovaries.

The first day of her menstrual period is counted as cycle Day 1.

The Female Hormone Cascade System

The maturation and release of oocyts (eggs) from the ovaries are controlled by a feedback mechanism of 3 hormones:
  • Gonadotropin Releasing Hormone (GnRH)
  • Follicle Stimulating Hormone (FSH)
  • Luteinizing Hormone (LH)

The Unexplained Mystery

The primordial follicle..

An oocyte (egg) is always surrounded by resting follicles. A group of primordial or primitive follicles will beging to grow for unexplained reasons. This growth must start from the beginning of the month of the egg's intended release or ovulation. The growth is a process as the follicles go through 4 stages: Primary follicle, Secondary follicle, Tertiary follicle and finally before release, the preovulatory Gradffian follicle estimated to be about 1.5 centimeters wide.

The interesting thing is that the number of these growing follicles is inversely co-related to the woman's age; it means that the younger the woman, the more primordial follicles will begin to mature and be released.

Enter Hormones: Estrogen

Estrogen is secreted by the growing follicular cells, causing a feedback mechanism whereby the level of FSH production is diminished. This appears to select the the strongest eggs from the growing group of follicles. In such a way that at the end of the first week, there is usually one follicle left--the dorminant follicle, much like survival of the fittest. This dorminant follicle is about 8-10 millimeters in size which is abou the size of a small cyst.

This completes what is known as the Follicular Phase of Ovulation and Begins the Luteal Phase. We are now in Cycle Day 14 (mid-cycle for those with regular 28 day cycle)

Enter Hormones: Progesterone

Elevated estrogen levels in the blood stream signal the release or LH surge. This is the same surge that is picked up and detected by your home ovulation predictor kit. LH provokes the follicular cells to start utilization of progesterone, which is being secreted by the ovary.

Approximately, ovulation takes place 36 hours after the start of the surge of LH, about 20 hours from the time of peak blood levels of LH.

Conclusion

After the ovarian follicle opens and releases the egg, a new structure forms with the remains which is now called the corpus luteum. Corpus is Latin for body and luteum means yellow in Latin; so corpus luteum means yellow body structure. The corpus luteum goes into work to produce high levels of progesterone which is necessary to sustain gestation.

Generally, progesterone blood level tend to peak around cycle day 21, and without being signalled by hCG (a hormone secreted by the growing placenta), it will fall rapidly and another follicular phase begins once more. On the other hand, if conception occurs, the corpus luteum will continue to produce progesterone until the placenta takes over.

The luteal phase of ovarian cycle tend to be between eleven to sixteen days in length.

The entire Ovulation Process takes around twenty four to thirty six days to complete.

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