The female cycle
A cycle with ovulation and hormone production of oestrogen and progesterone (corpus luteum hormone) is a requirement for pregnancy. Usually, ovulation takes place on about the 14th day of the cycle. After ovulation, the ovum cell moves into the fallopian tube where fertilisation takes place. Within five to six days, the fertilised ovum passes through the fallopian tube and reaches the womb. There, the embryo can implant and develop further until birth.
Some women can feel the ovulation. But what is called “Mittelschmerz” is, however, no proof of ovulation. A lack of mittelschmerz also does not mean a lack of ovulation. In addition, around the time of ovulation, the breasts might become sensitive. The body temperature (basal temperature) increases and the mucus, which previously closed the cervix, liquefies. This helps the sperm better reach the fallopian tubes and fertilise the ova.
You can calculate the approximate time of ovulation,if your cycle is regular, through the use of an online ovulation calendar. Simply enter the first day of your last period and your cycle length. Then the calculator will show you the date of your ovulation as well as your fertile days. However, such a calendar works only in case of a regular cycle.
Infertility as a result of an illness
Polycystic ovarian syndrome (PCOS) is characterised by many small cysts (blisters filled with fluid) in the ovaries. Women who are affected by this also often have cycle irregularities (e.g. longer cycles) as well as an increased level of male hormones. PCOS patients have an increased risk of diabetes and being overweight.
If endometrial tissue grows outside of the uterus, the woman’s fertility can be impaired. This illness is called endometriosis. This can be located, for example, in the fallopian tube or on the ovaries, but also in the bladder or intestine. During the female cycle, this tissue shows the same changes as the mucous membrane in the uterus. It often leads to menstrual disorders. The cause of endometriosis is unknown. However, it is known that endometriosis can lead to reduced fertility.
How can we help?
Before the start of fertility treatment, we always perform basic diagnostics and a consultation. If there are no blockages of the fallopian tubes and a sperm quality that is not very impaired, firstly a hormonal treatment is considered.
The likelihood of a pregnancy taking place is increased through a supporting hormonal treatment. To this end, either Clomifen tablets from the 5th to the 9th day of the cycle, or injections with natural follicle-stimulating hormone (FSH) can be used. The drug and its dosage will be selected individually on the basis of the present findings.
Both FSH and Clomifen promote the growth of the follicle. The ovum maturation is monitored closely by means of ultrasound and through determining different blood values. The doctor monitors the size of the maturing follicle as well as the growth of the endometrium. If the follicle has matured, ovulation is triggered by an injection. We can inform you when ovulation takes place and therefore narrow down the best time for conception.
After ovulation you will be given natural progesterone (corpus luteum hormone) to support the implantation of the pregnancy. For this purpose, a capsule of Utrogest or Progestan is inserted into the vagina in the morning and in the evening. Two weeks after ovulation, a blood sample can be taken, to determine whether a pregnancy has occurred. This blood sample can be taken in our centre (without an appointment) or with your gynaecologist.
For many women it can be helpful to exchange information with other women who are also affected. For this reason there is a private, non-public group on our Facebook page for women dealing with infertility. To join it, simply write to us on Facebook!
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