Ovulation Indunction
Ovulation refers to the process in which the ovaries release the matured egg and it stays in the Fallopian tube for 12-24 hours so that it can be fertilized. But in certain cases, women are ovulating on an irregular basis. It is a bad sign as it interferes with the ability of women to get pregnant. There are multiple reasons why women are facing this issue. Some of the problems are: hormonal imbalances, over-exercise, stress, weight issues, or there might be a problem with your reproductive issues also. The issue can either be temporary or it can be a long term one. This problem is surely going to create stress among the couples. But there is nothing to worry about; Dr Suyesha is for your aid. Dr. Suyesha is one of the best Ovulation Induction specialists in Delhi and she will look after your concern and try to resolve it so that women are not devoid of the heavenly feeling of becoming a mother.
Ovulation induction is the medical term used for the therapy which a woman has to undergo because they are not able to ovulate by themselves. It uses hormonal therapy which helps in stimulating ovulation or egg development and release. The hormonal medications are used to revitalize the egg sacs or ovaries to produce an egg. The egg can then be fertilized with the help of male sperms. Women who are facing the problem of irregular menstrual cycles were induced with the drugs so that they can ovulate on their own. The motive behind this procedure is to produce a single, healthy egg. Dr. Suyesha is there to guide you with the detailed procedure so that there are no questions in your mind. Dr. Suyesha is one of the best ovulation induction doctors in Delhi. You can have a detailed conversation with her regarding this process if you are looking to get pregnant but are facing difficulty.
When the results of diagnosis are announced that the woman is unable to conceive the child, this can break her from inside. During that time she will need some extra support as she is going through a turmoil. It is important for women to communicate their emotions to their partners and their family members, and they can share their emotions with their doctor as well. Dr. Suyesha is an experienced doctor and she knows how to emotionally support her patients. That’s why she is counted among one of the best ovulation induction doctors in Delhi. You can book an appointment with her and let her treat you so that problem of infertility can be resolved.
Around 30% of females are facing the problem of infertility due to the problem of ovulation disorders. That’s why it is believed that the ovarian cycle is delicate and composite.
THE LINK BETWEEN INFERTILITY AND OVULATION
The term infertility is used when a woman loses her ability to become pregnant. The term is generally used in the situations where the women has not conceived after having regular unprotected sex for 12 months. It must be realized that fertility also depends on age as well. If any woman is planning to conceive a baby after the age of 35, they should visit the doctor after 6 months.
It is worth noticing that out of six couples, one couple faces problems in conceiving and they require medical assistance.
The main causes of female infertility are:
- Blocked fallopian tubes
- Polycystic ovary syndrome
- Fibroids (non-cancerous growth of the muscle in the uterus)
- Problems of the cervix such as mucus hostility
- Older age (>35)
- Lifestyle factors (e.g. smoking, being overweight or underweight, drug use, always tired).
The impact of age
In recent times, it has become common for women to postpone their pregnancy until their mid 30’s as they wish to focus on their financial stature and career. But unfortunately, around one-third will face the problem of becoming pregnant, and not less than half of women over 40 will have problems in conceiving.
From the age of 35 onwards, women are bound to lose their fertility. One of the reasons for infertility is age-related decline in the number of healthy eggs in a woman's ovaries
With her birth, a woman has 4,00,000 eggs and a single egg matures each month in her reproductive years. The quantity of eggs starts decreasing from their childhood and it continues into their adulthood. Around 600 eggs are lost per month due to ovulation and the majority of eggs are slowly soaked up by the body. Other age factors are various medications, decline in frequency of intercourse in a relationship, and other diseases.
Ovulation problems
Ovulation is the evolution and release of an ovum from the ovaries. It is the most fertile period of the menstrual cycle. However, the problems might arise if the period cycle of women is irregular, then the egg production and release gets affected. Absence of periods or infrequent periods are mostly caused due to deficiency in one of the controlling hormones. The problem can be cured with the help of medications.
Ovulation problems are associated with multiple reasons like being overweight, extremely low bodyweight, or drastic change in weight. Another reason being ovaries are resistant to normal levels of hormones. Damaged, absent, or diseased ovaries are also preventing ovulation.
UNDERSTANDING CONCEPTION
Conception is a complex combination of timing and factors. It is described in 5 steps:
Step 1
Stimulation of growth with the help of hormones and the development of a single follicle within one of the ovaries takes place during the first half of the menstrual cycle. Another hormone increases the growth of the uterus lining in preparation for the fertilized egg at the same time.
Step 2
The hormone levels surge and trigger the release of an egg after the egg cell matures. The woman’s individual menstrual cycle is related to the exact time of ovulation. Ovulation happens between days 13 and 15 of a 28-day cycle, with day one being the first day of menstruation.
Step 3
The egg may be fertilized as it travels from the Fallopian tube to the uterus. Sperm can survive for 48 to 72 hours inside the human body. Only one sperm can pierce the egg's protective membrane and fertilize it, out of the countless sperm that make it thus far. During fertilization, the genes of the pair come together to form an embryo.
Step 4
The embryo begins its journey toward the uterus as the first couple cells divide. It breaks from the egg's outer membrane just before implantation.
Step 5
The embryo thrusts itself into the uterus's nutrient-rich lining six days after fertilization. To distribute nutrition and gases between the mother and the embryo, a placenta grows, and necessary hormones are released to keep the pregnancy going. If fertilization happens or the embryo fails to engraft, for some reason, the uterine lining is removed, leading to menstrual bleeding (your'period') and the cycle begins again.
USE OF THE TERM 'CYCLE'
When healthcare professionals use the term 'cycle', they can either be talking about your menstrual cycle or if you are undergoing ovulation therapy or more involved treatments such as IVF, it could mean a 'cycle' of therapy. At first many of the terms relating to infertility - especially the abbreviations - can be confusing but you will soon become used to the medical lingo.
The role of hormones
Achieving a pregnancy to a large extent depends on the successful interaction of the hormones that regulate the reproductive cycle in women and sperm development in men. Some hormones are produced from two glands in the brain, the hypothalamus and the pituitary. Specific female hormones are produced in the ovaries, while men's specific reproductive hormones come from the testicles.
Follicle stimulating hormone (FSH)
In women, follicle stimulating hormone (FSH), produced by the pituitary gland, stimulates egg growth and development and contributes to the production of oestrogen.
Luteinising hormone (LH)
In women, luteinising hormone (LH), produced by the pituitary gland, is necessary for the production of oestrogens and triggers the egg's release from the ovary.
Gonadotrophin-releasing hormone (GnRH)
The release of FSH and LH into the bloodstream is triggered by another hormone known as gonadotrophin-releasing hormone (GnRH), which is produced by the hypothalamus.
Oestrogen
The female sex hormone oestrogen encourages the egg to mature and helps prepare the uterus for pregnancy. As the egg matures more oestrogen is produced reaching a peak level about two days before ovulation. There are three main types of oestrogen produced by the body: oestrone, oestradiol and oestriol. These are often collectively referred to in the singular form, as 'oestrogen.
Progesterone
This hormone prepares the lining of the female uterus for implantation of the fertilised egg. Progesterone is only produced in significant amounts after ovulation has occurred and can then be measured in the blood.
HOW DO I KNOW IF I'M OVULATING?
You are virtually certainly ovulating if you have regular menstrual periods (regardless of the length of the cycle).
Subtract 14 days from your normal cycle length to determine the day of ovulation.
So, if your cycles are 28 days long, you will ovulate on day 14, but if they are shorter, such as 25 days, you will ovulate on day 11. There are a number of ways by which you can women can try to detect their ovulation time:
This can coincide with:
Mucus: Around the time you're ready to ovulate, you could notice a shift in your vaginal secretions. The cervix, or opening of the uterus, generates mucus, or fluid, throughout the menstrual cycle. The mucus becomes transparent and slick just before ovulation, like raw egg white. This mucus aids sperm movement up the vaginal canal and past the cervix. Even when you're not ovulating, your mucus will take on a new color, such as creamy, white, or yellow.
Pre-menstrual symptoms: Symptoms such as stomach bloating, breast discomfort, and mood swings are frequently related with the menstrual cycle. Women who are experiencing trouble ovulating, like those with polycystic ovarian syndrome or endometriosis, may experience more of these symptoms.
Around the time of ovulation, there may be localized stomach pain that lasts a few hours.
Temperature: There is a significant increase in the rise of body temperature and remains high after the ovulation. It happens because the progesterone level increases with ovulation. After recording the temperature for 2-3 months, there is a dip in the temperature. It indicates that it is the correct time to have intercourse.
Clinical testing for ovulation dysfunction
There are multiple tests via which the doctors will be able to identify the reason for irregular ovulation so that they are able to recommend treatment options. Ultrasound scan- in this scan, a long, slender probe is inserted in a vagina. After this, the doctor will have a look at the following details:
- The size of the ovaries and number of follicles present
- The thickness of uterine lining and the response of uterus to hormone production
- Are ovarian cysts or endometriosis affecting your cycles?
Hormone analysis: The measurement of hormone levels will help in identifying whether the ovulation is happening or not. Exclusion of causes like polycystic ovary syndrome, thyroid disease and early menopause is required.
LH or ovulation test kits: These kits help in measuring the LH level of urine. They aid in determining when the LH spike that precedes ovulation occurs. An increase in LH, on the other hand, does not always mean an egg has been discharged.
FSH and LH: Blood tests to detect FSH and LH levels may be required in some women to ensure that the release of these two hormones is normal. This sort of blood test is commonly performed on the second day of menstruation.
Progesterone: Progesterone levels in the blood can be used to identify if ovulation has happened. It's preferable if you wait seven days following ovulation to do it. This test, however, will not help you if your cycle is irregular.
Prolactin:Prolactin, a hormone that increases the production of breast milk, is present in high amounts.
AMH:Anti Mullerian Hormone (AMH) blood tests may be used to determine how many eggs a woman has remaining (known as her ovarian reserve). Small ovarian follicles produce AMH, which can be tested at any point during the cycle. A low AMH level could suggest a lack of ovarian reserve, whereas a high amount could indicate PCOS.
TIMING OF INTERCOURSE
To increase your chances of becoming pregnant, it is advised that you have intimacy three or four days before and on the day of your ovulation.
WHY AM I NOT OVULATING?
Due to confused hormonal signals from the body, most women are not able to ovulate. It means that the ovulation process cannot happen in the usual manner. The group of disorders in which ovulation happens on an irregular basis is known as Pituitary dysfunction. The term pituitary collapse is used when the ovulation fails to happen and there are no periods. Even though there are no particular symptoms of the disorder, there might be some related features which are common among women who are not ovulating. The problems are:
- 1. Obesity
- 2. Irregular menstrual cycle
- 3. Excessive weight gain
- 4. Milk secretion from breasts
- 5. Acne
- 6. Excessive weight loss
- 7. Oligomenorrhoea (infrequent menstruation)
- 8. Hirsutism
- 9. Amenorrhoea (lack of menstruation)