The Menstrual Cycle -full of clues

Being aware of your menstrual cycle and the changes in your body that happen during this time can be key to helping you plan a pregnancy, or avoid pregnancy. During the menstrual cycle (a total average of 28 days), there are two parts: before ovulation and after ovulation.

Charting Your Fertility Pattern

To help you plan or prevent pregnancy, it is helpful to know when you're most fertile.  There are three ways you can keep track of your fertile times

Basal body temperature method
Basal body temperature is your temperature at rest as soon as you awake in the morning. A woman's basal body temperature rises slightly with ovulation. So by recording this temperature daily for several months you'll be able to predict your most fertile days. (MORE ON BASAL BODY TEMPERATURE METHOD)

Calendar  method
Basal body temperature is your temperature at rest as soon as you awake in the morning. A woman's basal body temperature rises slightly with ovulation. So by recording this temperature daily for several months you'll be able to predict your most fertile days. (MORE...)

Ovulation method (Cervical mucus method)
Cervical mucus method (also known as the ovulation method) - This involves being aware of the changes in your cervical mucus throughout the month. The hormones that control the menstrual cycle also change the kind and amount of mucus you have before and during ovulation. Right after your period, there are usually few days when there is no mucus present or "dry days." As the egg starts to mature, mucus increases in the vagina, appears at the vaginal opening, and is white or yellow and cloudy and sticky. The greatest amount of mucus appears just before ovulation (MORE...)

To most accurately track your fertility, use a combination of all three methods. This is called the symptothermal method.  

How Is "Age" A Factor?

Women today are often delaying having children until later in life, when they are in their 30s and 40s. A couple of things add to this trend. Birth control is easy to obtain and use, more women are in the work force, women are marrying at an older age, the divorce rate remains high, and married couples are delaying pregnancy until they are more financially secure. But the older you are, the harder it is to become pregnant.

Women generally have some decrease in fertility starting in their early 30s. And while many women in their 30s and 40s have no problems getting pregnant, fertility especially declines after age 35.

As a woman ages, there are normal changes that occur in her ovaries and eggs. All women are born with over a million eggs in their ovaries (all the eggs that they will ever have), but only have about 300,000 left by puberty. Then of these, only about 300 eggs will be ovulated during the reproductive years. Even though menstrual cycles continue to be regular in a woman's 30s and 40s, the eggs that ovulate each month are of poorer quality than those from her 20s. It is harder to get pregnant when the eggs are poorer in quality.

Ovarian reserve is the number and quality of eggs in your ovaries and how well the ovarian follicles respond to hormones in your body. As you approach menopause, your ovaries don't respond as well to your hormones, and in time they may not release an egg each month. A reduced ovarian reserve is natural as a woman ages, but young women might have reduced ovarian reserves due to smoking, a prior surgery on their ovaries, or a family history of early menopause. Also, as a woman and her eggs age, if she becomes pregnant, there is a greater chance of having genetic problems, such as having a baby with Down Syndrome. Embryos formed from eggs in older women also are less likely to fully develop, a main reason for miscarriage (early pregnancy loss).

 

Certain Health Conditions Can decrease the Likelihood of Pregnancy

Couples also can have fertility problems because of health problems, in either the woman or the man. Common problems with a woman's reproductive organs, like uterine fibroids, endometriosis, and pelvic inflammatory disease can worsen with age and also affect fertility. These conditions might cause the fallopian tubes to be blocked, so the egg can't travel through the tubes into the uterus.

Some people also have diseases or conditions that affect their hormone levels, which can cause infertility in women and impotence and infertility in men. Polycystic Ovarian syndrome (PCOS) is one such hormonal condition that affects many women, and is the most common cause of anovulation, or when a woman rarely or never ovulates. Another hormonal condition that is a common cause of infertility is when a woman has a luteal phase defect (LPD). A luteal phase is the time in the menstrual cycle between ovulation and the start of the next menstrual period. LPD is a failure of the uterine lining to be fully prepared for a fertilized egg to implant there. This happens either because a woman's body is not producing enough progesterone, or the uterine lining isn't responding to progesterone levels at some point in the menstrual cycle. Since pregnancy depends on a fertilized egg implanting in the uterine lining, LPD can interfere with a woman getting pregnant and with carrying a pregnancy successfully.

Certain lifestyle choices also can have a negative effect on a woman's fertility, such as smoking, alcohol use, weighing much more or much less than an ideal body weight, a lot of strenuous exercise, and having an eating disorder.

Unlike women, some men remain fertile into their 60s and 70s. But as men age, they might begin to have problems with the shape and movement of their sperm, and have a slightly higher risk of sperm gene defects. They also might produce no sperm, or too few sperm. Lifestyle choices also can affect the number and quality of a man's sperm. Alcohol and drugs can temporarily reduce sperm quality. And researchers are looking at whether environmental toxins, such as pesticides and lead, also may be to blame for some cases of infertility. Men also can have health problems that affect their sexual and reproductive function. These can include sexually transmitted diseases (STDs), diabetes, surgery on the prostate gland, or a severe testicle injury or problem.

If you or your partner has a problem with sexual function or libido, don't delay seeing your doctor for help. 

In Summary  | Female Infertility

For a conception to occur, a woman’s ovaries must be able to release a viable egg, which then must be able to travel down the fallopian tube. The man must be able to ejaculate, and his sperm must be able to travel to the fallopian tube.  The sperm and egg must unite to fertilize the egg. The fertilized egg must attach to the inside of a receptive uterus (or implant) and be nurtured by the body to allow the fetus to develop and grow until it is ready for birth.

Problems with any of these steps can lead to infertility. The cause of infertility can rest in the woman or the man, or can be from unknown factors or a combination of factors.  In some cases, environmental factors can contribute to infertility.  In other cases, genetic conditions or other health problems are the main cause of infertility.Most cases of infertility in women result from problems with ovulation.  Some conditions affecting ovulation include premature ovarian failure, in which the ovaries stop functioning before natural menopause, and polycystic ovary syndrome (PCOS), in which the ovaries may not release an egg regularly or may not release a viable, healthy egg.  Among women who have PCOS, even when a healthy egg is released and fertilized, the uterus may not be receptive to implantation of a fertilized egg, which results in infertility.

Other causes of infertility might include: (1) Blocked fallopian tubes due to endometriosis, pelvic inflammatory disease, or surgery; (2)  Physical problems with the uterine wall;  (3)  Uterine fibroids

A woman’s risk for infertility can also be affected by:
Age | Stress | Poor diet  |  Being overweight or underweight  | Smoking, drugs, and alcohol |  Medication  | Environmental toxins | Genetic conditions, such as being a carrier of Fragile X syndrome  | Other health problems, such as sexually transmitted diseases 

In Summary - Male Infertility

The male fertility process involves the production of mature sperm and getting the sperm to reach and fertilize the egg.  Although it may seem to be a simpler process than female fertility, male fertility also requires many conditions to be met: the ability to have and sustain an erection, having enough sperm, having enough semen to carry the sperm to the egg, and having sperm of the right shape that move in the right way.  A problem meeting any of these conditions contributes to infertility.

Like female infertility, male infertility can result from physical problems, such as testes that don’t make enough normal sperm, hormonal problems, and lifestyle or environmental factors, including (but not limited to):

• Age

• Stress

• Exposing the testes to high temperatures, which can affect the ability of the sperm to move and to fertilize an egg.  For instance:  

• Cryptorchism is a condition where the testes do not descend into the scrotum.  Although it does not usually affect the ability to have and sustain an erection, cryptorchism means that the testes are still inside the body cavity, which has a higher temperature than the external scrotum.
• Tight underwear—For some men, wearing tight underwear can also increase the temperature of the testes.

• Smoking, drugs, and alcohol

• Medications

• Environmental toxins

• Genetic conditions, such as Klinefelter syndrome

• Other health problems