Question

You work in a "planning" clinic and follow a young couple who are planning to have a first child soon. Unfortunately the couple experiences some difficulties. First of all, you help them determine the woman's fertile window. a) Knowing that his cycle is regular, lasting 24 days and that his last menstruation started on December 1st, calculate her period of fertility. (Explicitly demonstrate all the steps and parameters of your process and your calculations) b) Explain to the couple how the fertile period helps fertilization. (Explain in detail the hormonal changes specific to the period of fertility as well as their impact on the physiology of women)

Answer 1

Menstrual cycle is a natural phenomenon that occurs in every women during their reproductive period that start once they attain puberty and till the reach menopause. During this reproductive period women can give birth.

Usually menstrual cycle is considered to be 28 days, this may vary from women to women.

Menstrual cycle has to different cycles.

1.Ovarian cycle

2.Uterine cycle

1.OVARIAN CYCLE

This cycle is related to the changes that occur in ovaries. It has 2 phases

a) Follicular phase (0-14 days)

b) Luteal phase(14-28 days)

2.Uterine cycle

This cycle is related to the changes that occur in uterus,. It has 3 phases

a) Menstruation (0-5days)

b) Proliferative phase(7-14 days)

c) Secretory phase (14-28 days)

Menstrual cycle starts with the day 1 of periods.

Harmones involved in menstrual cycle includes

Estrogen and Progesterone

Follicle stimulating harmone(FSH) and Leutinizing harmone(LH), both these harmones are produced by pituitary gland.

ESTROGEN- It plays a major role in stopping the menstrual flow and preparing uterus for next phases of the cycle.

PROGESTERONE- plays a major role in preparing uterus for embryo implantation in case if fertilization takes place. It is produced by corpus luteum.

If implantation does not takes place within 2 weeks level of progesterone and estrogen drops causing uterus lining to shed and cause periods.

FOLLICLE STIMULATING HARMONE (FSH) -FSH is produced by pituitary gland and it play a role in stimulating the ovarian follicles in the ovary. Levels of FSH are more during initial days of the cycle.

LUTENIZING HARMONE (LH) -LH is also produced by pituitary gland and it's levels suddenly increases at the middle of the cycle leading to the release of ovum from matured follicle called GRAFFIAN FOLLICLE.

This takes place approximately on the 14 th day of 28 days cycle. Levels of LH are more for 24 to 36 hrs.

The period between 10 to 15 days from day 1 of mensus is considered as fertile period.

We explain this to the patient and ask as her to calculate those days and participate in intercourse during those days to increase her chances to become pregnant. And also we need to explain both the partners regarding this and make any lifestyle changes if needed like avoiding consumption of alcohol and smoking or any kind of substance abuse.