Understanding The Connection Between Ovulation, Fertility, and Pregnancy: A Case Study

Understanding The Connection Between Ovulation, Fertility, and Pregnancy: A Case Study


The process of childbirth is undoubtedly the wonder of nature. However, as our lives become more intricate, the process of childbirth has also become more complicated. According to recent data, lifestyle changes have made pregnancy a more challenging journey for many women. With infertility rates on the rise and many opting to start a family later in life, conceiving has become very difficult. Furthermore, certain diseases and genetic disorders can affect the process of conception, which makes ovulation tracking an essential tool in the modern age. Now the question arises: what is ovulation and how to track it? This case study discusses all the topics related to ovulation, women fertility, and pregnancy.  


What is ovulation? 


Ovulation involves the release of an egg or ovum from one of the ovaries, which is a critical phase of the female menstrual cycle. By tracking ovulation, women can better understand and optimize their chances of conceiving, leading to increased success rates and a more fulfilling journey towards motherhood. If a woman has regular menstrual cycles, then she is likely to be ovulating each month. The female reproductive system undergoes a cyclical preparation for pregnancy every month. The pituitary gland secretes a hormone that signals the ovaries to produce follicles, which are fluid-filled cysts that release oestrogen, a sex hormone that thickens the uterus walls, making it more conducive to pregnancy. On the seventh day of the menstrual cycle, the follicles cease growth, save for one, which nurtures the developing egg or oocyte. On the twelfth day, the growing follicle secretes a large amount of oestrogen, which travels through the bloodstream, reaching the pituitary gland, which releases luteinizing hormone (LH). This hormone further supports the growth of the follicle. Before ovulation, the egg detaches itself from the follicle, and the follicle releases chemicals that prompt the fallopian tube to move closer and engulf the follicle. The follicle expands until it ruptures, expelling the egg and fluid into the abdominal cavity. The fimbriae, small finger-like protrusions at the end of the fallopian tube, sweep across the ruptured follicle and collect the egg. The egg is then transported to the entrance of the fallopian tube, whereby muscle contractions gently push it toward the uterus. The egg will either encounter sperm on its journey through the fallopian tube, resulting in fertilization or arrive unfertilized in the uterus and be reabsorbed by the body.  


Irregular periods are tricky. But, women who have irregular periods, still ovulate. They are just not regular. They even don't have predictable schedules. Women who have irregular periods can ovulate at different points from cycle to cycle. Therefore, it is very hard to tell what their most fertile period is. There are some women, who do not ovulate regularly. While this usually happens at the first 2-3 years after periods start. If a woman is close to menopause, then too it happens. According to Eminent Obstetrician-Gynaecologist Dr. Indranil Saha said, "If your periods are regular, it means that ovulation is taking place, and your body is ready for pregnancy. However, if your periods are irregular and occur within 1.5 or 2 months, you may have polycystic ovary syndrome. In this scenario, your ovary may have many eggs, but the ovulation process is not proper. In such cases, we must give medication to make ovulation regular.” He adds, “If a woman's thyroid level is low (hypothyroid) or her prolactin level is high, ovulation may not happen. If a woman is not getting her period regularly or is having it after one and a half or two months, we generally recommend an ultrasound (USG). If we find polycystic ovaries, then we prescribe medication. Polycystic ovaries are nothing but an excess of eggs. One in five women has polycystic ovaries, and tailored medication usually helps them get pregnant. After this treatment, if a woman still doesn't get pregnant, we go for thyroid or other tests to find out the reason."  

What happens after ovulation?

If a woman wants to get pregnant, she must fertilise the egg within the 12 to 24 hours that follow ovulation. The protein-rich clear jelly that covers the top of the vagina during intercourse is made inside the cervix, the neck of the uterus, by the surge of oestrogen that occurs right before ovulation. This produces an acidic vagina, preventing infections such as thrush. Additionally, the conditions here are favourable for sperm survival. Before an egg is released, the sperm can live in the mucus in the cervix for up to five days as they swim quickly up and into it. Sticky cells cover the egg as it is released during ovulation, making it easier for the fallopian tube to capture it. The fallopian tube is where the sperm and egg connect, and this is where the sperm begin to break down the sticking cells. Although a single sperm is all that is needed to fertilise an egg, many sperm must first connect to the membrane and outer shell of the egg.


How to test fertility at home?

But how someone can track their fertility at home? Next-generation technology made that easy. One can easily track their fertility rate through an ovulation calculator or ovulation calendar. It can help you map your most fertile time. However, apps are not accurate. Therefore, if a woman wants to track the ovulation process to make getting pregnant easier, then she can use an ovulation kit. These strap-like devices will indicate if the subject is fertile or not. Most kits work by measuring the level of luteinizing hormone (LH) present in urine. These tests are like pregnancy tests. The process is almost the same. The subject needs to provide the sample (urine) in the indicated area. A positive result means the subject is likely to ovulate within the next 24 to 36 hours.  


How can one know if she is ovulating or not? If a woman is ovulating, then her vaginal discharge or mucus will be slick and slippery just like egg white. Abdominal pain will occur on usually one side. Premenstrual symptoms like breast enlargement and tenderness, bloating, and mood swings will occur.  


What is the best time to get pregnant? 

If you want to get pregnant, the best time to try is three to six days before and during ovulation. Your cycle length will determine when you are most fertile. If you want to get pregnant, you need to stop using contraception. However, it's unclear when to stop taking oral contraception to increase your chances of pregnancy. Some doctors recommend stopping the Pill and waiting for three regular menstrual cycles to allow your body to return to normal. Every woman is different and may take a different amount of time for fertility to return. Although, it's possible to get pregnant while on the Pill. This situation is rare and doesn't harm the baby. Dr. Indranil Saha says, "If a woman tracks her fertile period and has intercourse 3 to 4 times a week, she can get pregnant easily. Even 70% of women who have polycystic ovaries get pregnant easily with proper medication. In other cases, we may opt for intrauterine insemination (IUI), in vitro fertilization (IVF), or laparoscopy. After testing hormones, we decide which process is suitable for whom."