Month: November 2021

Natural conception is what future parents who are planning a pregnancy are striving for. It is natural: without the intervention of doctors! Fortunately, in the vast majority of cases, pregnancy occurs “by itself”, without any special manipulations. Some parents are examined before planning, and sometimes they “calculate” the necessary days to achieve the goal faster.

What should I do if I can’t get what I want? To begin with, it is worth remembering exactly how conception occurs.

Conception

During sexual intercourse, spermatozoa enter the vagina and begin to move along the reproductive tract: through the cervix, the uterine cavity, and then, through the hole in the tube corners, into the tubes. It is in one of the tubes that they meet with the egg. The embryo formed as a result of fertilization moves towards the uterus and on the 5th-6th day of development enters the uterine cavity, where implantation takes place (attachment to the uterine wall).

In other words, in order for this meeting to take place, it is necessary to comply with the mandatory conditions: the pipes must be passable, and the sperm must be capable of fertilization (as doctors say, be fertile enough).

Determining the day of ovulation

If these conditions are met, sexual intercourse should occur as close as possible to ovulation; to understand exactly when ovulation will occur, it is enough, for example, to install an application on a smartphone, and it will indicate “dangerous” days. Or, calculating the duration of the cycle, divide the number of days from menstruation to menstruation (take 30 days for convenience) by two. It is during this period (in our example, it is 15-16 days) that ovulation should be expected. It should be taken into account that phase II is usually no shorter than 13-14 days. You can use the services of a gynecologist who, with the help of ultrasound, will be able to very accurately determine the day of ovulation – doctors call such a scheme “programmed conception“.

Natural conception – Additional recommendations

A married couple planning a pregnancy should naturally adhere to some recommendations that will reduce the risk to offspring and facilitate pregnancy. This kind of advice is given to the family, bearing in mind that compliance with them is desirable for both spouses. It is recommended to give up smoking tobacco and other smoking herbs, from the use of strong alcohol, drugs; walks in clean air and the absence of inflammatory diseases are desirable (relevant during epidemics). Reception of vitamin and mineral complexes – taking into account the season and the region of residence.

The only recommendation only for a woman is taking clomid or folic acid at a dose of 400-800 mcg, which reliably prevents the pathology of the neural tube in the unborn child; admission should begin 2-3 months before the planned pregnancy.

How is the stimulation for conception carried out in a natural way

Stimulation is possible only if the patency of the tubes and the fertility of the sperm are proven, it is also necessary to make sure that there is no pathology of the uterus and appendages; in some cases, the Kurzrock-Miller test is performed (a test for compatibility of sperm and cervical mucus). With an unspecified condition of the fallopian tubes and the general condition of the reproductive organs (pelvis, uterus, appendages), stimulation can lead to extremely undesirable consequences, of which the most formidable is ectopic pregnancy. Naturally, ectopic pregnancy can occur regardless of whether there was stimulation, but unjustified stimulation creates conditions under which the occurrence of ectopic pregnancy is more likely.

For stimulation, in most cases, so-called gonadotropins are used. It is accepted to prescribe small doses from 4-6 days of the menstrual cycle. The doses and the day of the start of stimulation are selected in such a way that 2-3 follicles grow in the cycle. It is the growth of more than one follicle (and therefore an egg) that increases the chances of pregnancy in this cycle. The purpose of stimulation is jewelry work: it is important to prevent the growth of a large number of follicles, and, at the same time, to achieve synchronous growth of two or three. It is customary to prescribe a trigger drug that will help the follicles to circulate at the same time and tell you exactly when you need to try to conceive a child.

We add that by agreeing to stimulation for conception, parents should be aware that such stimulation increases the likelihood of multiple pregnancies, because mature eggs have an equal chance of fertilization.

A special situation is when stimulation is used to treat anovulation (absence of spontaneous ovulation): the purpose of treatment in this case may consist in a whole range of measures, depending on the cause of the pathology.

Hormonal stimulation of ovulation: many women who undergo infertility treatment by in vitro fertilization (IVF) are often interested in questions:

• Do hormonal drugs used during IVF reduce the ovarian reserve?
• Won’t all the follicles be taken away during ovarian puncture?
• Will hormonal stimulation bring the onset of menopause closer?

As part of this short article, we will try to answer the questions posed. And let’s start with the theoretical part.

Hormonal stimulation of ovulation

Ovarian (ovarian) reserve is an internal reserve of the ovaries, which determines their ability to develop a healthy follicle with a full-fledged egg. The ovarian reserve not only reflects the total number of follicles contained in the ovaries, but also their functional state.

The follicular reserve is laid in utero, is not replenished during a woman’s life, does not increase, is individual, and normally by the time of the formation of menstrual function, a girl has an average of 270,000- 470,000 follicles.

During one menstrual cycle, as a rule, one follicle grows and reaches the ovulation stage. On average, 400-500 follicles reach ovulation in a woman’s entire life, and the rest undergo atresia (reverse development). Thus, with each menstrual cycle, the total number of follicles decreases, and with their complete disappearance, menopause occurs. The mechanisms of atresia and apoptosis ensure the survival of the strongest follicles, in which genetically healthy oocytes are most likely to mature.

In natural conditions, by the beginning of the next menstrual cycle, a cohort of antral follicles is formed in a woman, of which one pre-ovulatory is isolated by the time of ovulation, while the rest undergo reverse development.

Hormonal drugs

Hormonal drugs used during the IVF program, the so-called “ovulation inducers”, have an effect on almost all follicles that have reached the antral stage, without affecting the entire ovarian reserve. Thus, in a stimulated cycle, it is possible to obtain high-quality eggs even from those follicles that would be “lost” to a woman under natural conditions. From this it can be concluded that stimulation does not lead to premature depletion of the follicular apparatus, does not reduce fertility and, thereby, does not bring the age of menopause closer.

All of the above confirms that the most important physiological factors determining the ovarian reserve are the genetic predisposition and age of the patient.

Studies conducted in recent years have shown that the rate of follicle disappearance doubles when the primordial pool is reduced to 25,000 follicles, which normally corresponds to the age of 37.5 years. This age is defined as critical, after which the ovarian reserve itself decreases sharply. However, there are significant individual characteristics in the time of menarche (10-16 years), the time of menopause (45-55 years), the onset of which is determined only by the individual biological age of a woman.

The correct selection of the stimulation scheme will allow you to get the optimal number of the highest quality eggs without causing any harm to health.

If pregnancy does not occur, then you should think about the lack of ovulation. Ovulation refers to the natural physiological processes that occur in the female body. It denotes the natural ability to procreate. During this period, a woman becomes pregnant, because the egg is secreted. This process falls in the middle of the menstrual period. However, if pregnancy does not occur, then it is worth considering, perhaps there is no ovulation, why? What are the reasons?

Important! This article is posted exclusively for educational purposes, the information cannot be used for self-diagnosis and self-treatment. To make a diagnosis and properly prescribe treatment, you should consult a doctor.

Ovulation may not be due to physiological reasons. For example, it is believed that if a girl has her period, then she can get pregnant. Of course, it can, but the probability of this is very low. Stable functioning of the reproductive system, regulation of hormone secretion are not established immediately, so teenage girls have irregular menstruation. Studies show that many menstrual cycles are anovulatory. This is due to the fact that the follicles do not mature normally, which improves over time.

Anovulation may also occur during pregnancy. The hormonal background of a woman is changed, there is no cyclic rhythmic release of hormones (read more here). And during lactation, prolactin increases in the blood, which also prevents ovulation, as with pathological hyperprolactinemia.

Lack of ovulation: The presence of diseases

Most often, the lack of ovulation is caused by a number of serious gynecological and endocrine diseases. Here are the main reasons why there is no ovulation:

• polycystic ovary syndrome (PCOS);
• reduced estradiol content;
• excessively high level of follicle-stimulating (FSH);
• infantilism;
• high degree of obesity;
• exhaustion (anorexia);
• hyperprolactinemia;
• violation of pituitary function;
• diseases of the thyroid gland.

If you examine patients with such diseases, you can understand why they do not ovulate. They usually have hormonal disorders that affect all stages of egg development.

Endocrine diseases play a special role. The fact is that the regulation of the secretion of certain hormones is interdependent. Therefore, women with diabetes mellitus, thyroid diseases often have problems with conception.

For example, such a pathology as insulin resistance, associated with a violation of the transfer of sugar into the cell, can cause anovulation. If glucose intake is disrupted, insulin production in the pancreas increases. The effect of insulin resistance on conception is still being studied, but it has been revealed that women with a change in the NOME index, which determines the level of disorders, more often develop polycystic ovary syndrome. It also occurs in type 2 diabetes mellitus.

Insulin resistance can be physiological and pathological in nature. Physiological is observed even in adolescent girls and if you do not adhere to proper nutrition, do not follow the regime, it can lead to the development of diabetes, PCOS and anovulation. Problems with conception can occur, even if a woman just got sick before ovulation, this can also negatively affect the process. After all, at this moment the body is involved in the fight against infection, the organs are working in stress mode, hormone production is changing, that’s the reason why ovulation is delayed and it is not. It may come later or not appear at all.

Chronic stress

Constant and increased stress is one of the essential reasons why there is no ovulation. Nervous overstrain, mental overload and chronic stress are among the most frequent causes of a delay in this process. Excessive shock can become a locking mechanism of ovulation. Moreover, with its complete absence for a very long period.

Regulation of the reproductive function of the body is called neurohumoral. This suggests that the brain controls the secretion of hormonal substances. Stress, overstrain create pathological foci in the brain tissue that affect the production of gonadotropins. Therefore, the treatment of this type of disorders can be difficult and sometimes lengthy. If external factors of influence are not eliminated in a timely manner, the process may deepen and then not only pregnancy will not occur, but also the development of diseases of other organs is possible.

Is it possible to get pregnant without ovulation?

If you do lack of ovulation, then in no case should you lose heart, but you should go to the doctor. Perhaps here, in the absence of egg maturation, there is a serious pathology that needs to be urgently treated in order to observe how the tummy grows in the near future. Most likely, the doctor will talk about hormonal failure. To identify the cause of the absence of ovulation, it is recommended to first pass the necessary tests and undergo an ultrasound examination. And this act will be the most correct, because the doctor, based on the medical results, will tell you in detail how to get pregnant without ovulation in your particular case.

And yet, what does modern medicine offer us? Is it possible to get pregnant without ovulation? If the cause of the pathological condition does not lie in serious anatomical disorders, then hormone therapy is recommended, which will provoke the proper maturation of the egg. One of the treatment options is taking medications based on progesterone (for example, Clomid).

So, if you are not sure if it is possible to get pregnant without ovulation, then in this case it is best to set yourself up for a positive outcome. All that is required is to faithfully carry out medical appointments. Remember: proper treatment contributes to the achievement of the goal – pregnancy and the birth of a child.

Stimulating egg maturation: To begin with, such a diagnosis (ovulation dysfunction) under no circumstances can be based on the results of a single examination. Such conclusions of the doctor are fraught with an absolutely useless course of treatment, and prescribed means to stimulate ovulation can cause great harm to the female body if taken unnecessarily. Remember that before thinking about treatment, you need to conduct an ultrasound examination during at least three cycles, and only then think about methods to combat the so-called anovulation.

When it comes to the ovaries, where full-fledged and ready-to-fertilize eggs do not mature, any doctor first of all thinks about the reasonableness of the use of hormonal drugs. The list of drugs used to stimulate ovulation is huge, so the appropriate treatment is prescribed on an individual basis. Nevertheless, there are a number of the most common drugs that we will now consider.

Stimulating egg maturation

Stimulation with clostilbegyt: is a drug that enhances the production of hormones through a direct effect on the pituitary gland and hypothalamus, which then gives an impetus to the maturation of follicles. Ovulation stimulation with clostilbegyt is a fairly well-established procedure – pregnancy occurs in 40% of cases.

An important factor here is a thorough medical examination, during which the doses of clostilbegyt should be established, as well as a further action plan, that is, a clear decision whether the egg will be fertilized in a natural way, or IVF will be needed.

As a rule, the reception of clostilbegyt begins on the fifth day of the menstrual cycle. Usually, the course of treatment begins with a dose of 50 g, but, again, everything is individual, and without the supervision of a doctor, it is better not to experiment even with the most proven proportions and frequencies of use of this drug. During use, increased sexual activity is recommended, which will increase the chances of a woman becoming pregnant in the shortest possible time. In the absence of visible results of the course of treatment, during the use of clostilbegyt to stimulate ovulation, the doctor may prescribe injections of chorionic gonadotropin. If such treatment is ineffective, the woman is offered to repeat the stimulation, switch to other drugs, or pay attention to surgical methods, such as ovarian cauterization and laparoscopy.

Drugs for ovulation stimulation

Nevertheless, clostilbegyt is far from the only drug used to stimulate ovulation. Among the most popular in use, it is also worth highlighting funds based on clomiphene.

One of the leaders is clomid, which, in addition to stimulating ovulation in women, is also used by men in bodybuilding. There are other names of this drug, for example, Fertomid, and other generics based on clomiphene.

Stimulating egg maturation with folk remedies

Often, the causes of prolonged female infertility cannot be established even by the most experienced doctors, which means that hopes for the appointment of an optimal course of treatment are also sent to the trash can. In such cases, desperate women often resort to “grandmother’s” advice, and, as it turned out, not in vain. Some folk remedies for stimulating egg maturation have confirmed their effectiveness after a number of successful pregnancies of women practicing certain methods, therefore, we will not ignore them either.

It should be taken into account that under no circumstances can phytotherapy be combined with the use of conventional hormonal drugs. In the opposite case, the hormonal background of a woman is at risk of being disturbed, and further medical treatment of infertility will not bring any results. Moreover, before using folk remedies to stimulate ovulation, a woman should carefully study the compatibility of herbs and infusions with her body, and prevent the incompatibility of phytopreparations with factors of her own body. For example, with polycystic ovaries, the use of sage is strictly prohibited, etc. It is strongly recommended to consult with your doctor before making your own course of treatment.

Ovulation after stimulation

In the case of a successful pregnancy after ovulation stimulation, a woman needs to be under the careful supervision of a doctor for the first few months, since at this time the risk of termination of pregnancy is significantly increased. Moreover, in order to avoid fetal hypoxia, a woman will have to periodically take blood tests to determine the level of hormones in her. A full medical examination should also become part of the routine of the expectant mother – after ovulation stimulation, the factors that negatively affect the course of pregnancy become much more than during natural pregnancy.