The FEMALE Reproductive System
So many things have to go just right in a woman’s body in order to achieve fertilization, successful implantation, and a sustained pregnancy. It’s a wonder any of us are here at all! We can correct many aspects of the female cycle that may not be functioning properly. Sometimes this is all a couple needs to become and stay pregnant.
Problems with the fallopian tubes are very common. Blockages of the fallopian tubes can prevent the egg from entering the tube after ovulation, or prevent sperm from ascending into the tube to reach the egg. Fallopian tubes can also become swollen and accumulate fluid (also known as a Hydrosalpinx) which is unhealthy for a developing embryo. Tubal abnormalities also increase the risk of having an ectopic pregnancy, where an embryo implants inside the fallopian tube, which is not viable and also dangerous because the tube can rupture. The tubes are evaluated by the hysterosalpingogram (HSG) test. Women with endometriosis, pelvic adhesions, and prior sexually transmitted infections are at increased risk of having tubal abnormalities.
There are both congenital and acquired problems of the uterus. Approximately 2% of women are born with a uterine malformation that can cause problems with either conception or miscarriage. Other problems of the uterus can develop over time, such as polyps, fibroids, or scar tissue (Asherman’s syndrome). Polyps and fibroids are benign growths of the inner lining of the uterine cavity or muscle cells within the walls of the uterus, respectively. Scar tissue within the uterine cavity can develop from prior infections or surgeries in the uterus, such as a D&C. The HSG test or saline ultrasound (sonohysterogram) is used to reveal structural abnormalities of the uterus.
Many women who experience infertility have hormones that are not functioning properly, are not ovulating at the right time, or are not ovulating at all.
Understanding how your own body works becomes even more essential when you start trying to build your family.
There are two phases to your menstrual cycle:
Begins on cycle day 1, the first day of your period. While your body is shedding the lining and nutrients of uterus that were not used to sustain a pregnancy last month, it also begins to develop follicles (each containing an egg) in the ovaries when the pituitary gland releases the hormone FSH, follicle stimulating hormone. As the days pass, one follicle becomes dominant and prepares to release one mature egg, ready for fertilization. The developing follicle makes estrogen, which causes the lining of the uterus (endometrium) to grow.
This occurs after a surge in the level of luteinizing hormone (LH) – which tells the dominant follicle to release its mature egg into the fallopian tube. This part of the cycle begins around cycle day 14, typically lasts for 16-32 hours, and ends after the egg has been released. Properly timed intercourse needs to occur here or just prior to ovulation in order to achieve pregnancy.
This phase begins around day 15 and lasts until pregnancy occurs or the next period begins (around 14 days later). The egg that has been released will stay in the fallopian tube for around 24 hours awaiting fertilization. Once fertilization occurs, the fertilized egg develops into an embryo and travels down the tube to the uterus over the next 4-5 days. An unfertilized egg will disintegrate quickly if it does not become fertilized. The ovary makes a combination of estrogen and progesterone during the luteal phase. These hormones cause the lining to undergo changes, and become prepared to have an embryo implant. If pregnancy does not occur, the ovary stops making hormones which causes the lining to become unstable and menses begins.