Understanding Fertility

Understand infertility & its underlying causes with Dr Rhythm Gupta, infertility specialist in Delhi.

Fertility is the natural ability of a couple to parent a child. Most of the couples around 80% would achieve pregnancy within one year of trying more so in the earlier months, another 10 percent would conceive in subsequent 1 year. However, the remaining may not be able to and would need an expert opinion to find out the causes and possible interventions needed to conceive.

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Fertile Window

The days of women’s cycle with maximum chances of pregnancy around the time of egg release (ovulation) is the fertile window. Although a frequency of 2-3 acts of intercourse are adequate to get pregnant but more sexual activity around the time of ovulation in the fertile period would increase chances.

Ovulation is release of an egg from the follicle into the fallopian tube where it waits for sperm for fertilization. Once released egg can survive for 12 – 24 hrs in the female body to fertilize and result in pregnancy. If the pregnancy doesn’t happen the egg disintegrates and is later followed by menses.

Sperms survive for 24 to 48 hrs in the female tract, however, pregnancy can even occur by intercourse as long as 5 days preceding the ovulation. This is probably because of entrapment of sperms in the secretions of female tract. But the best probabilities of pregnancy is with intercourse around the ovulation time.

How to determine Fertile Window?

It is important for the couple to identify Fertile Window so as to time intercourse well. This can be determined by many methods but the most commonly used by my patients are

Cervical mucous test:

Due to the formation of the egg, a hormone called estradiol is released in the body, this liquifies the normal discharge from female tract which maximises the penetration and travel of sperm to reach the egg. Women can notice this change in consistency of the discharge and time intercourse accordingly. But this is not very reliable. Better and more accurate methods are also available.

LH kits:

These are kits like pregnancy test kits available by a different manufacturer which help to predict egg rupture 12- 24 hrs before. All you need to do is start using the kit from day 11 of the cycle in afternoon. Put 2-3 drops of urine in the marked area on the kit and wait of a minute for the result, a single line would indicate negative result and two pink lines positive, indicating impending egg release in next 12- 24 hrs and hence the couple should have intercourse on the day of positive LH test and the subsequent day. Usually egg is released on day 14 in a regular 28 day cycle and on day 16 in a 30 day cycle.

Ultrasound for Follicle Monitoring:

This is is the surest of all modalities helping in predicting egg release prospectively. Usually used in stimulated cycles wherein some medicine in given to the women for initial 5 days of the cycle to help egg formation or to time intrauterine insemination. In regularly menstruating women, follicle monitoring started from day 10/12 of the cycle, a healthy follicle grows at a rate of 2mm/day and endometrial lining at 1 mm/day and it reaches a size of 18-20 mm before rupture and releases egg. A trigger injection can also be given at this mature size to rupture the follicle artificially and time intercourse or intrauterine insemination accordingly. The couple should have intercourse around the time of rupture while trying for pregnancy.

What Is Infertility?

Infertility is a condition that affects the reproductive system impairing the ability of a couple to conceive despite having unprotected intercourse for more than a year. Conception is a complicated process happens when there is production of healthy sperm by male partner, healthy eggs by the female partner, open or patent fallopian tubes that allow transfer of egg to its middle portion wherein the sperm reach the egg, the sperm’s ability to fertilize the egg when they meet, the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus which depends on good embryo quality and healthy endometrium (lining of the uterus). And once conception happens the inherent growth potential and the physical & hormonal environment in mother’s body affects its continuity till full term to result in live birth.

Infertility cause?

About one-third cases of infertility can be attributed to male factors, about one-third female factors and remaining one-third by combination of problems in both partners or, in about 20 percent of cases, is unexplained- wherein the female is forming an egg, the sperms in husband semen are of good quality and the fallopian tubes are open but still the couple is infertile.

To find out the cause it is important that both the partners are subjected to some tests. For the female, some hormonal blood tests, ultrasound, and tubal status evaluation is need for men semen analysis is desirable.

To understand more about the procedure, consult Dr. Rhythm Gupta, IVF & Infertility specialist in Delhi. Excel IVF is a top IVF clinic in Delhi with a great success rate. To book an appointment, call: +91-9868040808 or email: drrhythmgupta@gmail.com