I ovulated but didn't get pregnant. There was no ovulation, but pregnancy occurred

Many couples who are passionate about having children carefully plan each sexual intercourse, counting the most favorable period for conception. However, unprotected sex during ovulation does not always lead to fertilization. Some women cannot get pregnant for years, and the thing is that conception depends not only on ovulation. Reproductive function is influenced by many factors, which are discussed in more detail in this article.

How long does it take for an egg to be released?

Every healthy woman has ovulation once in the middle of her menstrual cycle, that is, the very day when the probability of pregnancy reaches its maximum peak.

reference. Ovulation is a physiological process in which the egg leaves the ovary and moves in the fallopian tube, where it meets with the sperm. This phenomenon is preceded by rupture of the follicle.

According to most doctors, ovulation lasts about a day (24 hours), after which the egg dies (if fertilization has not occurred).

In how many cases do couples manage to get pregnant during the process?

With a regular menstrual cycle, ovulation occurs about 14 days after the onset of menstruation. Often, in order to know exactly when the fertile period will begin, women resort to special calculations. Undoubtedly, this approach significantly increases the chances of fertilization, as it reduces the risk that the day of ovulation will simply be missed. However, it cannot be argued that having sex during the ovulation period is a guarantee that pregnancy will occur.

It is important to understand that fertilization depends on many factors, which include:

• the state of the female reproductive system;
• hormonal background;
• nutrition;
• presence / absence of STDs;
• the health status of a man, etc.

Thus, having sex during ovulation is one of the many conditions that are necessary for successful conception. So, according to scientists, out of 100 couples, only 20 can get pregnant during ovulation the first time.

At the same time, out of the remaining 80 pairs:

• 50 got pregnant after 6 months;
• 30 - got pregnant in a year.

Why, with the correct calculation, it is not possible to get pregnant on the part of a woman?

The female reproductive system is not very simple. Sometimes it is very difficult to explain why conception does not occur if there was ovulation and to identify the true reason for the absence of pregnancy.

However, you may encounter the following problems:

Violation of the state of cervical mucus is manifested in the following:

• during ovulation, vaginal discharge becomes too viscous, which prevents the free passage of sperm;
• insufficient amount of mucus;
• cervical mucus is too acidic, which causes the death of spermatozoa.

Such a pathology can occur as a result of chronic inflammatory processes, hormonal disruptions, and menstrual irregularities.

Causes

There are a lot of reasons why there is no pregnancy even with regular ovulation. The most common factors preventing fertilization include:

Besides, the reason for the lack of pregnancy may be associated not only with the female body. In order to establish the nature of the problem that has arisen, it is necessary to examine both partners.

Attention. A woman should remember that an anovulatory period may occur, characterized by a complete absence of ovulation during the menstrual cycle. Despite the fact that such cases are only 1-3%, nevertheless, this circumstance should also be taken into account.

Additional factors preventing conception on the day the egg is released by the man

In addition, quite often among men there is a condition in which there is low sperm motility, called asthenozoospermia. This pathology is diagnosed by examining a small amount of ejaculate under a microscope.

The main causes of asthenozoospermia are:

• low testosterone;
• varicocele;
• genital infections;
• men's food, etc.

In addition to the above, there are many more factors that can negatively affect male reproductive function (ecology, hormonal levels, congenital pathologies, bad habits, etc.).

Why does fertilization not occur if both spouses are healthy?

What is the reason for not re-fertilizing?

Sometimes a woman who wants to have a second child long time can't get pregnant. In this case, the following reasons may occur:

• age factor- in most cases, a woman decides to have a second child by the age of 30-34. At this age, there are some difficulties with the process of conception.
• Complications that arose during the first birth(for example, if surgery was performed, scars, scars that violate the patency of the fallopian tubes may remain).
• The presence of latent infections that were not detected during the first pregnancy.
• lactation period- sometimes a woman does not want to take long breaks and tries to get pregnant a few months after the birth of her first child. However, if during this period she is breastfeeding, then in this case it will not work to conceive a child.

Many women do not understand why it is not possible to get pregnant during ovulation. This question can only be answered after passing a complete medical examination. Both family members are examined. This is necessary to identify the culprit of infertility. If the patient is fertile, the cause may be a man. To determine the negative factor, you need to seek help from a reproductologist.

The fertile ability of the fair sex lies in the peculiarities of the menstrual cycle. Its formation falls on the hormonal system. To understand how ovulation occurs, you need to understand the menstrual phases.

The cycle consists of several parts. Each phase depends on the production of a particular hormone. The estrogen phase is the first stage of the menstrual cycle. The name comes from the hormone responsible for its formation. After the next menstruation, estrogen is actively formed in the body. The hormone provokes the formation of the inner layer of the uterine body. The endometrium is the basis for the introduction of a fertilized female germ cell. After menstruation, the endometrium has a thin layer with a homogeneous structure. As ovulation approaches, the layer increases in height. On microscopic examination, the tissue appears porous and stratified.

Estrogen is also needed by the body for the appearance of the activity of the egg. A large number of germ cells are located in the ovaries. The supply of each patient is individual. It depends on the onset of menopause. Under the influence of the main female hormone, the release of a follicle-stimulating substance is observed. The hormone helps the cell to get under the shell of the paired organ. A follicle forms on the surface of the ovary. Its cavity is filled with a special fluid in which the egg is freely located. FSH also helps the follicular formation to steadily increase in volume. The largest diameter of the follicle reaches the time of ovulation.

The ovulatory phase of a woman depends on the appearance of luteinizing hormone in the bloodstream. This substance causes characteristic changes in the structure of the follicular solution. The liquid becomes more fluid. Due to this, its volume increases. The follicular solution exerts strong pressure on the inner lining of the formation. She's fading fast. The liquid breaks the thinnest section of the shell. This phenomenon is called ovulation. It is easiest to get pregnant during ovulation.

The concept of male sexual function

But not always the presence of ovulation allows a woman to conceive. In this case, it is necessary to deal with the male reproductive function. Sex glands are responsible for the ability to conceive. A man has three sex glands. Each of the organs is responsible for the production of a certain component of the seminal fluid.

The basis of sperm is a peptin solution produced in the prostate gland. The body is also responsible for the formation of a small amount of testosterone. The produced fluid enters the seminal system. In the channel, mixing with spermatozoa occurs.

Sperm are formed in paired male genital organs - testicles. The main reproductive ability depends on the qualitative composition of the sperm. The seminal fluid must contain more than 50% healthy cells. Healthy spermatozoa are those that have the following qualities:

• rectilinear movement;
• the presence of all components;
• high content percentage.

When examining sperm, several groups of male cells are found. Not all sperm are suitable for conception. Cells that move in a straight line are of value. If a couple has not been able to have a baby for a long time, the reason may be the absence of such cells. Also, the problem occurs when a large number of abnormal spermatozoa appear in the semen. Each sex cell should consist of a head, tail and neck. Not all cells have this structure. The reason for infertility can be a high content of such spermatozoa.

When planning, it is necessary to take into account the quantitative content of healthy spermatozoa. Successful fertilization occurs in the presence of active correct sperm. One ejaculate sample must contain at least 70% active cells.

If one of the partners has any violation, then it is impossible to get pregnant on the day of ovulation.

Pathological factors of the female body

So why does pregnancy not occur if there is ovulation? There are many reasons for this. The main negative factor in the absence of pregnancy is hormonal imbalance. In this case, a woman releases an egg in each cycle. In this case, you should carefully study the content of progesterone in the body. Progesterone is responsible for the second stage of the menstrual cycle. It helps the zygote to gain a foothold in the endometrial layer. Also, the substance contributes to the active growth of the fetus.

Progesterone is formed in the corpus luteum, which appears instead of the follicular pocket. For successful conception, a certain amount of progesterone is necessary. In some cases, its insufficiency is observed. During the examination, such women complain that she became pregnant, but could not bear it. Establishing the cause is carried out on the 23-25th day of the cycle. During this period, the body must contain a sufficient amount of progesterone for gestation. If it is not enough, then hormonal treatment is recommended.

Also, the problem arises due to improper development of the endometrial layer. Normal mature endometrium should be at least 11 mm thick. The ideal height is 13 mm. But sometimes the tissue does not form correctly. This phenomenon requires an examination for estrogen levels. Often the cause of thin endometrium is a lack of estrogen.

There is another problem of the endometrium, which is accompanied by infertility. It's called endometritis. On the separate area the inner layer of the uterine cavity, cells that are unusual for this tissue are found. In this case, the fertilized egg cannot attach to the endometrium. This cause can only be determined with the help of an ultrasound examination. You can also detect the disease during the construction of a graph of basal temperature.

Pregnancy may be absent for other reasons. The presence of a latent bacterial infection can also interfere with normal conception. The microflora of the genital organs is attacked by pathogenic microorganisms. In this case, various disorders occur in the uterus. Bacteria often prevent sperm from entering the uterine cavity. They are also accompanied by severe inflammatory diseases. In order for the patient to get pregnant, it is necessary to pass a swab from the vagina. The sample is examined for bacteriological content in the laboratory. Only after a thorough study of the sample is an effective treatment selected for the girl.

The cause of miscarriage may be the presence of concomitant diseases. Such diseases can negatively affect the nutrition of the zygote or its fixation. Diabetes mellitus and genital herpes are considered dangerous pathologies. Diabetes mellitus disrupts the trophic nutrition of the tissues of the pelvic organs. Blood circulation in the pelvis is reduced. Organs cease to receive the necessary amount of oxygen. The fertilized cell does not receive enough blood and dies. In this case, you should look for negative reasons that there is ovulation, but pregnancy does not occur.

Negative male factors

If a woman is completely healthy, but it was not possible to get pregnant, it is necessary to examine a man. The following factors of male infertility are distinguished:

To establish the reasons for the lack of conception, a man should visit a doctor at least once every six months. Azoospermia is often thought to be the reason why a couple may not be able to get pregnant. The seminal fluid of a man contains a small amount of living healthy germ cells. Their number does not exceed 2%. In most patients with this disease, the seminal fluid is completely sterile. To avoid the development of secondary male infertility, you should contact an andrologist. It will help solve a delicate problem.

Azoospermia is observed in men due to the presence of hormonal disorders, prolonged inflammation of the testicles, or a genetic feature. But the problem can also arise against the background of bacterial chronic prostatitis. This form of the disease can be detected only during a routine examination. Because of this disease, the gland ceases to produce the normal amount of base for the seminal fluid. Healthy sperm stick together. Such a man is incapable of full fertilization. If the cause of infertility is male infertility, then you should contact an andrologist.

Fertilization of the egg is possible only at the onset of ovulation. But not always in such patients pregnancy occurs. The reproductologist should deal with the determination of the causes of infertility. He will prescribe a series of examinations that will help identify the cause of the problem. If the woman is completely healthy, then the pathology depends on the man. For this reason, prolonged absence of pregnancy should be accompanied by a medical examination of both partners.

When a couple begins planning for a baby, the first few failed attempts can raise a lot of questions - why pregnancy does not occur, because partners try to have sexual intercourse in this, the most favorable fertile female period. In fact - this normal situation, the causes of which may be quite natural. But pathological prerequisites are not excluded.

General information

Ovulation is a short period of the female menstrual cycle, when a mature egg is released from the dominant follicle into the fallopian tube. Girls have a set of germ cells in an immature state even when the baby is in the womb. Then, during life, part of the first-order oocytes dies, and part is spent on ensuring the cyclical work of the female body. Each month, one (rarely more) follicles mature, which break in the middle of the cycle under the action of hormones, releasing an oocyte ready for fertilization by a spermatozoon.

Ovulation lasts about an hour, and then for another day the egg retains the ability to be fertilized.

If during this day there is no meeting with the male germ cell, the oocyte dies, descends into the uterus and comes out with menstrual bleeding along with endometrial particles that have grown under the action of progesterone in the second phase of the female cycle in anticipation of a fertilized egg.

Female fertility (the ability to reproduce) is largely due to the ovulatory process, and the likelihood of conceiving a child on the days of ovulation is maximum. But the maximum is not 100%. According to WHO, female fertility during ovulation depends on age, her most great importance - no more than 33% in women under 25, no more than 25% in women under 30. Reproductologists argue that these figures are somewhat overestimated, and the real probability of conceiving a child the first time in one cycle in healthy women and men does not exceed 11% at the age of 20-25 years. Naturally, after 35 years the probability does not exceed 4-7%, and after 40 years - 3%.

This is due to the deterioration of the genetic material of the woman's germ cells, and if the partner is older, then his germ cells are of excellent quality, most likely, they do not differ. These statistics are nothing to worry about. About 60% of couples conceive safely within six months, and another 30% of couples see positive pregnancy test results within a year.

In about 25% of cases, even if sexual intercourse was performed exactly during the fertile window, conception does not occur, and geneticists and doctors have not yet been able to establish the reasons for this. In addition, in almost half of cases of familial infertility, the decisive role belongs to the poor quality of sperm.

Conditions for successful conception

To find the answer to the question why a woman can’t get pregnant on ovulation with her first or second baby, you need to make sure that the couple is planning correctly and meets all the conditions for successful conception

The woman is ovulating

The fact is that every lady in the course of her life has “empty” anovulatory cycles. The older a woman becomes, the greater the number of such cycles per year (compare - at the age of 20, anovulatory cycles are normally 1-2 per year, and at 35 years - up to 5-6). Ovulation can also occur late or occur earlier, and both stress and stress can trigger this scenario. colds, and trip, flight.

In order to answer the question of whether the egg is released at all, you can use home ovulation tests: when they show two stripes - it's time to take action.

The accuracy of home tests is lower than laboratory tests, and it is possible to visit a doctor to do Ultrasound of the ovaries on the 5th-6th day of the cycle immediately after menstruation. And closer to the middle of the cycle You can do a blood test for luteinizing hormone. Its sharp jump indicates the approach of ovulation.

Ovulation Calculator

Cycle duration

duration of menstruation

• Menstruation
• Ovulation
• High chance of conception

Enter the first day of your last menstrual period

Ovulation occurs 14 days before the start of the menstrual cycle (with a 28-day cycle - on the 14th day). Deviation from the mean value is frequent, so the calculation is approximate.

Also, along with the calendar method, you can measure basal temperature, examine cervical mucus, use special tests or mini-microscopes, take tests for FSH, LH, estrogen and progesterone.

You can definitely set the day of ovulation through folliculometry (ultrasound).

Sources:

1. Losos, Jonathan B.; Raven, Peter H.; Johnson, George B.; Singer, Susan R. Biology. New York: McGraw-Hill. pp. 1207-1209.
2. Campbell N. A., Reece J. B., Urry L. A. e. a. Biology. 9th ed. - Benjamin Cummings, 2011. - p. 1263
3. Tkachenko B. I., Brin V. B., Zakharov Yu. M., Nedospasov V. O., Pyatin V. F. Human Physiology. Compendium / Ed. B. I. TKACHENKO. - M.: GEOTAR-Media, 2009. - 496 p.
4. https://ru.wikipedia.org/wiki/Ovulation

The man is healthy and fertile

A simple analysis - a spermogram will help to significantly reduce the time and nerve costs when planning a baby. If the quality of a man's germ cells leaves much to be desired, the likelihood of fertilization is significantly reduced, and the risk of conceiving a child with genetic abnormalities and chromosomal errors increases.

In this case, you first need to improve the quality of sperm by taking vitamins, giving up bad habits, visiting baths and saunas. And only after three months (this is how long spermatogenesis lasts) start the fascinating process of “catching” ovulation.

Sexual intercourse occurs during the fertile window

Spermatozoa live longer than the egg (up to 3-4 days), they are quite capable of “waiting” for the egg to be released already in the fallopian tube, and therefore it is recommended to start having sex 3-4 days before ovulation and do it every other day until 2-3 days after ovulation, refusing to use contraceptives, douching, as well as lubricants, lubricants.

With moderate sexual intercourse, the sperm of a man will be of optimal quality, which will help to conceive a baby faster.

The couple is in the right mental state

Any stress increases the production of stress hormones, which partially block the production of sex hormones. That is why it is often impossible to get pregnant, even if the sperm is of normal quality and there is ovulation. Doctors have long noticed that conception occurs most quickly in the first year of a couple's life together, while feelings are fresh. If you turn sexual intercourse into a sports attraction for the sole purpose of conceiving, then the likelihood of successful conception decreases.

A woman who every month with trepidation waits for two stripes on the test, cannot be distracted by anything else, switch, is in a state of chronic stress, and the very probability of conception becomes several orders of magnitude lower.

If it didn’t work out in this cycle, nothing bad happened, it will happen later - only this approach provides a calm and harmonious state for the fair sex.

Possible reasons for the lack of conception

A variety of factors can affect the ability of male and female cells to merge, and not all of them have been studied in detail by doctors and scientists. But even those that are known are quite enough to understand that conception is a delicate matter.

The point is mainly in the state of health of partners. In a woman, the probability of conception is reduced not only by age, but also by bad habits, living in areas with adverse environmental factors, working at night, professional contact with radiation, paints and varnishes, and toxins. And even if there is ovulation, it is not at all a fact that the oocyte will good quality and fertilization will be successful.

The factor of male fertility can be affected by the habit of wearing tight underwear and trousers, which disrupt blood circulation in the scrotum and increase its temperature. The habit of steaming in a bathhouse, turning on car seat heating also affects the quality of sperm.

We can’t even imagine how many conceptions we all missed in our lives! After all, sometimes pregnancy “breaks down” at the very initial stage - the fetal egg cannot descend into the uterus, implantation does not occur, due to a genetic error, it stops developing and growing and dies. In this case, menstruation comes, perhaps with a slight delay. And the woman will never know that conception did take place.

The reason for the lack of pregnancy with strict adherence to the rules of successful conception can be any gynecological pathology - obstruction of the fallopian tubes, inflammation in the uterus, ovarian dysfunction. Often, doctors also diagnose hormonal infertility, in which the level of hormones in the female body does not allow her to be pregnant (lack of progesterone, estrogen). Often, ovulation does not occur, and if it does, then the level of natural hormonal support cannot be sufficient to ensure the survival of the embryo in the very first days after conception.

In men, the cause may be hidden in varicocele, prostatitis, in genital infections, many of which occur without pronounced symptoms, and therefore may not be immediately noticed by the carrier.

Both partners can get sick before ovulation with a viral illness, a cold, which also significantly reduces the quality of germ cells and reduces the likelihood of conception.

Separately, it is worth talking about the antisperm antibodies that the immunity of a man or woman produces. Immune protection simply perceives spermatozoa as foreign objects, and throws all its forces into destroying them as soon as possible. At the same time, sperm die even in the body of a man, if he has antisperm antibodies, or die without reaching the egg, if such immune cells are produced in a woman.

The immune system can react to sperm in this way for several reasons. For example, a man underwent surgery on the genitals, there was an injury, a bruise of the genitals, and individual germ cells, having got into the wrong place where they were supposed to be, caused an aggressive immune response. In women, this form of infertility develops due to excessive anal sex with ejaculation in the rectum, as well as swallowing sperm during oral contact. This is one of the most difficult types of infertility to treat.

What to do?

Whatever your ideas about your own fertility, it is best to start planning your pregnancy with a trip to the doctor. A woman needs to be examined by a gynecologist, put her own weight in order (even losing weight by 5% of the original body weight increases the likelihood of conception). It is also important for a man to pay attention to his diet, bad habits and make a spermogram.

A simple and quick examination will allow the couple to more constructively plan the addition to the family, to know exactly the "weak" sides of each other. Let's just say that there are almost no insurmountable situations. Even if some deviations are identified, in 96% of cases, after the right treatment, the problem is eliminated, and the couple can proceed to the successful planning of the baby.

The remaining 3% of couples will benefit from assisted reproductive medicine methods - IVF, ICSI, egg and sperm donation. Today, most of the reproductive medicine services are provided free of charge, under a compulsory health insurance policy.

Before you start tracking ovulation and planning conception, you need to do some preparation. Most couples, according to reviews, took 2-3 months to follow simple recommendations and thereby increase their chances of becoming parents:

• both partners should lead a healthy lifestyle, take vitamins with a predominant content of zinc, selenium, magnesium and folic acid;
• all diseases and infections must be treated in advance, after taking antibiotics, anti-inflammatory drugs, painkillers, antifungal agents, at least 1-2 months must pass before the start of planning;
• partners should eat in a balanced way, any diet for weight loss is contraindicated, the diet must include milk, meat, fish, greens, vegetables and fruits. It is important for a woman to refuse coffee and strong tea, and at the same time dark chocolate.

Sometimes you may need to go to the genetics. This is done if no objective causes of infertility have been identified in any of the partners, and conception still does not occur. The reason may lie in genetic incompatibility, if the male genome is very similar to the female genome. It is also recommended to visit genetics for spouses who have had cases of severe congenital diseases and syndromes in their family.

A trip to a psychotherapist is inevitable in case of psychogenic infertility, when the cause lies in severe stress, worries, and fears. Once these feelings are eliminated, the couple usually manages to conceive a baby without any problems.

About ovulation and how to get pregnant, see the following video.

Attempts to conceive a child are far from all couples give a quick result. Gynecologists give parents-to-be an average of 6-12 months of unprotected sex before they start to worry.

During the year of regular intercourse, it is recommended to track the time of ovulation in order to increase the chances of conception. But in some cases, even a favorable fertile period does not work, and pregnancy does not occur. Why is this happening and how to fix it?

Is it always possible to get pregnant during ovulation?

A successful uterine pregnancy occurs when the egg is released from the ovary (oocyte), meets the sperm, then implants in the endometrium of the uterus and begins to develop.

On the part of the woman, the main condition for the onset of pregnancy is the maturation of the dominant follicle in the ovary containing the egg. Contrary to popular belief, this does not happen to everyone. menstrual cycle(MC).

Therefore, even regular unprotected sex does not lead to the desired pregnancy in the current month. This is not considered a deviation: every woman during the year can have several cycles without ovulation.

But sometimes the reason for unsuccessful attempts to conceive a baby lies elsewhere. What other factors cause failure in future parents? Read on.

What can prevent conception - an overview of the main factors

Unsuccessful attempts to get pregnant are not a sentence yet. If you have just started trying, and the pregnancy has not yet occurred, do not rush to panic.

Perhaps the reason lies in the banal errors in the calculations of the fertile period, as well as external factors which are easy to fix.

Incorrect calculation of an auspicious day

Ovulation occurs in the middle of the menstrual cycle. For example, if menstruation occurs every 28 days, then the egg leaves the ovary on day 14. There is a lot of medical literature on how to correctly calculate the ovulatory period, but many people still make mistakes in the calculations. Most often, the main mistake is the incorrect interpretation of the beginning and end of the MC.

It is correct to consider the beginning of the cycle the first day of menstruation, the one on which the bleeding began. Some women consider the period of menstruation to be a kind of “blind zone”, and begin to count the MC from the day the menstruation ends. And this leads to an error in calculating the day of ovulation and unsuccessful attempts to get pregnant.

The first day of menstruation is considered the beginning of the follicular phase of MC, when, under the influence of sex hormones, a new follicle begins to mature in the ovary.

This phase lasts two weeks and ends with ovulation. Different women may have different cycle lengths, and in each case, you need to make an individual calculation of the day of ovulation.

This is a simple task: we divide the number of days in the MC by two, and determine the end date of the first half of the cycle in the calendar. You need to retreat from it for two days in both directions - these five days are the fertile period when the probability of conception is highest.

For example, the MC lasts 26 days. Dividing 26 by 2, we get 13. Therefore, on the 13th day after the start of menstruation, ovulation should occur. It is advisable to have an active sexual life with a partner from 11 to 15 days, because. the egg may leave the follicle a little earlier or later.

Fallopian tube obstruction

It also happens that the egg leaves the follicle, but cannot get into the uterus to meet with the sperm because of the mechanical obstruction of the fallopian tube.

In healthy women, a mature egg leaves the ovary and is captured by the so-called. cilia of the fallopian tube, which move inward in the rhythm of the heartbeat. The egg makes its way through the fallopian tube into the uterine cavity in a few hours.

Due to chronic inflammatory or adhesive processes in the appendages, obstruction of the fallopian tubes occurs, and the egg cannot get from the ovary to the uterus. Under these conditions, the chances of pregnancy are low.

There is also a danger ectopic pregnancy when the spermatozoon manages to penetrate the fallopian tube, and the fertilized egg is delayed and attached to the wall of the tube. This is an unfavorable scenario for the development of events, which poses a threat of rupture of the tube and severe blood loss.

endometriosis and endometritis

Inflammation of the uterine mucosa - endometritis, as well as pathological proliferation of endometrial epithelial cells - endometriosis - are considered one of the most common causes of female infertility. Under these conditions, the uterine mucosa is not able to accept the egg, even if it is fertilized by a sperm.

Another option for the development of events in endometritis and endometriosis is spontaneous abortion (miscarriage) during the first weeks after conception. The inflammatory process provokes the rejection of the endometrium along with the fetal egg.

Progesterone deficiency of the second phase of the cycle

The menstrual cycle is divided into two phases. The first is follicular, during which the dominant follicle containing the egg matures. After the ovulatory peak, lasting 24 hours, the second phase of MC begins - progesterone.

At this time, in place of the bursting follicle, the so-called. The corpus luteum is a temporary gland that produces the hormone progesterone. Under its influence, the proliferation of the endometrium occurs, which thickens and fills with blood to receive a fertilized egg.

If, for some reason, an insufficient amount of progesterone is produced, the uterus becomes unable to accept a fertilized egg, and pregnancy does not occur.

Medications taken by partners

In gynecology, there is a method of stimulating ovulation, when the ovaries are first put into "hibernation" mode using conventional hormonal contraceptives for several months.

After the abolition of COCs (combined oral contraceptives) comes the so-called. rebound effect, when the ovaries "wake up" and give out several eggs at once. While taking the pills, ovulation does not occur under the influence of the progestin component in the preparation. After stopping the reception, it takes several months to resume their work.

Some drugs can also reduce fertility in both partners. Various antidepressants, ulcer medications, antibiotics, and antihypertensive drugs reduce fertility by affecting sperm quality and ovarian function.

sexually transmitted infections

Sexually transmitted infections are another reason why partners have difficulty conceiving. Syphilis, gonorrhea, chlamydia, and even banal herpes often cause latent chronic inflammation of the uterine mucosa, which makes pregnancy impossible.

Varicocele in men

Varicocele - an expansion of the veins of the spermatic cord - is one of the most common urological pathologies in men that impair reproductive function. This is a process similar to varicose veins veins of the lower extremities: the veins in the male genital organs are pathologically dilated.

The blood vessels supplying the testicles are a continuation of the great vena cava and the renal vein located in the abdominal cavity. Increased blood pressure in them leads to the expansion of the veins of the spermatic cord - varicocele.

As a result of this pathological process, the blood supply to the testicles is disturbed and, as a result, the quality of seminal fluid deteriorates. The chances of an egg being fertilized naturally decrease.

Bad spermogram

On the part of a man, the main factor in successful conception is the quality of seminal fluid. The semen must contain a sufficient number of healthy, mobile spermatozoa that can move along the female genital tract towards the egg.

Sometimes, as a result of a laboratory analysis of seminal fluid - spermograms - doctors find:

• a small amount of spermatozoa in a portion of semen;
• complete absence of spermatozoa in the ejaculate;
• sluggish, inactive spermatozoa;
• violation of the shape of the heads and flagella of germ cells.

All these factors do not allow sperm to fertilize the egg, which makes pregnancy impossible in principle.

From this video you can learn more about the reasons why the desired pregnancy does not occur:

Anovulatory female cycle

During the year, the girl has several anovulatory menstrual cycles, when the follicle does not mature in the ovary. In this case, menstrual bleeding occurs as usual.

In healthy women, 1-2 anovulatory MC during the year is not a pathology. Lack of ovulation is often due to hormonal changes. The female reproductive system is a delicate and complex mechanism, sensitive to external factors.

For example, various factors can slow down ovulation:

• stress;
• past illnesses and surgeries;
• taking medications;
• flight to another climatic zone;
• abuse of cigarettes and alcohol.

Because of them, the process of maturation of the follicle slows down in the current month, which will successfully end in the next MC. But if several cycles in a row occur without ovulation, you need to contact a gynecologist.

He will prescribe a hormonal examination and folliculometry - ultrasound monitoring of the ovaries for several MCs. If a violation is detected, the specialist will prescribe hormonal drugs that normalize the functioning of the ovaries.

Why re-pregnancy does not occur

Sometimes women who get pregnant easily and have a successful first child are unable to conceive a second child. At the same time, both spouses are healthy, so for doctors and for the parents themselves, the reason for the failures becomes a mystery.

Gynecologists name several possible factors why a woman fails to conceive a second baby:

1. Ovarian exhaustion (especially if the first child was given with difficulty or with the use of assisted reproductive technologies).
2. General exhaustion of the body, especially if 6-9 months have not passed after the first birth.
3. Non-recovered menstrual cycle after childbirth.
4. Mother's age after 35 years.
5. New spouse.
6. Genital tract infections as a consequence of pathological childbirth.
7. Hormonal disorders after childbirth.

If a woman wants to have another child almost immediately after the first birth, this will be problematic due to natural hormonal processes. Within 6-12 months after childbirth, the reproductive system is restored, including the work of the hypothalamic-pituitary system and the ovaries.

Important! Regular breastfeeding after childbirth causes the so-called. lactational amenorrhea, when the ovaries are in "standby mode" for 6-9 months after childbirth. Weaning the baby from the breast will make them “turn on” again.

Conscious parenthood, when spouses take a responsible approach to the issue of conceiving a future baby, can reduce many negative factors that prevent the conception, bearing and birth of a healthy child. Future mom and dad should have their health checked at the planning stage to rule out possible problems.

A year before the intended conception, parents must undergo a complete medical examination. The future father needs to be tested for sexual infections and spermogram, as well as undergo a urological examination to rule out testicular pathologies. The expectant mother should be tested for a hormonal mirror and checked for the absence of inflammatory and adhesive processes in the uterus and appendages.

One more important point– Examination of partners for genetic and chromosomal diseases. In practice, it happens that one or both spouses are carriers of hereditary diseases that are transmitted to the child (for example, hemophilia, Leber's congenital amaurosis).

If there are no factors preventing the conception of a child, spouses can safely have sex without protection. According to statistics, pregnancy occurs within 2-12 months.

In parallel with medical examinations, the husband and wife should give up bad habits, exclude smoking and alcohol, and adjust their diet.

The expectant mother especially needs to take special vitamin and mineral complexes containing folic acid, vitamins A, B, E and D, calcium, phosphorus, iron and other micro and macro elements. This will prepare the body for conception and childbearing, as well as reduce the likelihood of complications during pregnancy.

What to do if you can't get pregnant

If attempts to conceive a child fail one after another, parents, especially the expectant mother, need to remain calm.

Firstly, stress and anxiety only exacerbate possible problems and further reduce the likelihood of conception.

Secondly, excitement is always unproductive and takes a lot of mental energy that spouses could direct in a constructive way.

If pregnancy does not occur within 6-12 months of regular intercourse without contraception, it is necessary to consult a doctor and undergo an examination for hormones, as well as examine the reproductive organs on ultrasound. This needs to be done by both a woman and a man, because. in half of the cases, the cause of infertility in a married couple is problems on the part of the man.

should not be written off and psychological reasons failure when trying to conceive a child. It happens that a woman or both spouses are not yet mentally ready for parenthood, which triggers psychosomatic processes that block reproductive function.

It often happens that after working with a psychologist, people solve their problems and become parents.

All folk advice based on herbal treatment, conspiracies, reconciliations with the horoscope and other methods are not recognized by official medicine.

But no one will forbid future parents to use the advice of "grandmothers" if it increases confidence and helps reduce emotional stress. In psychology, this is called the anchor method, when a person, through various rituals and other illogical actions, creates for himself the illusion of controlling the situation and thereby relieves nervous tension.

But the most rational and effective strategy for the behavior of future parents who have difficulty conceiving remains timely seeking medical help, a full medical examination and following the recommendations of the attending physician.

Conclusion

Ovulation does not occur every menstrual cycle, so spouses do not need to be upset if conception did not occur in the current month.

If you correctly calculate the fertile period, the chances of getting pregnant will increase, provided there are no hormonal disorders, as well as inflammatory, adhesive and infectious diseases sexual organs of both spouses. It never hurts to undergo a medical examination to exclude possible pathologies in the reproductive sphere.

Most a simple explanation why it was not possible to get pregnant during ovulation is that the period of fertility was incorrectly determined. Think about it, are you right? Does the moment match? intimacy c is two days before, the day of ovulation and the day after it?

If there is ovulation, but no pregnancy, then 9 reasons for the absence of pregnancy are possible:

1. A healthy couple takes TIME to successfully conceive, up to about 12 months;
2. There is a mechanical obstacle in the way of spermatozoa;
3. Poor sperm quality(number, activity, developmental anomalies, etc.);
4. Inflammation of the genitourinary system;
5. Hormonal imbalance(including diseases of the endocrine system, NK-VDKN and others);
6. Physiological and other pathologies of the uterus;
7. Psychological factor(burning desire or, conversely, NOT wanting to have a child);
8. Immunological factor when the spermatozoa are destroyed immune system women or men;
9. Chromosomal pathology(especially when there have been unsuccessful pregnancies in the past).

I've been on my period for a while now, and my tests are negative. Are you starting to worry? This article describes the most likely reasons why pregnancy does not occur when there is ovulation. You will learn what must be done to speed up conception. Continue reading.

Why you can't get pregnant on the day of ovulation

In addition to a mature egg, for the successful conception and attachment of the embryo, many more happy coincidences are needed. It is not enough to actively plan only on the day of ovulation. According to statistics, only 21.2% of pregnancies began on this day.

To get pregnant (!)To significantly increase your chances of conception, open sexual contact is required three days before, the day before, or the day after ovulation. If there is no desire to calculate ovulation, PA should be repeated every 2-3 days during the entire cycle.

Step one: Visit to the doctor and tests

So, when pregnancy does not occur during normal ovulation, it is quite natural that you have doubts of this nature:

1. Are you unable to conceive due to health problems?
2. Or is everything in order with the body and you just need to wait?

The second option is supported by official statistics (!) According to WHO data across the European Region, only one in six couples fail to conceive after a year of active planning. Think about it, that's over 83% successful families, which means you also have a very high chance of having a baby within 12 months of active planning!

Diagnosis BEFORE you start planning will save you time

Was there pre-conception preparation (preparation for pregnancy) for both partners? The sooner you start asking the question: “Can something prevent me from getting pregnant?” The better.

Before starting active actions, both partners should visit a family planning center, gynecologist, urologist / andrologist and undergo an examination.

Medical examination and diagnostics are needed here for what: with the help of a series of tests, it will be possible to identify factors that can prevent you from becoming pregnant, as well as those that are potentially dangerous for the fetus.

Here are the main obstacles:

• Poor sperm fertility . All major pathologies on the part of the partner the spermogram will show (the male factor is always excluded first!). According to statistics, about 40% of failures in planning a child happen precisely because of the poor quality of sperm. A good spermogram has the following characteristics (according to WHO data): the number of spermatozoa is 15 million / ml, actively motile - from 35%, the correct form - from 4%.

Advice: making a spermogram is inexpensive and easy. Imagine how much time you will save if you find the problem in time and improve performance quickly.

• Irregular shape of the uterus, the presence of polyps and other formations, as well as inflammatory processes of the OMT. They are used to diagnose Ultrasound and gynecological smears. Ultrasound monitoring will help diagnose many different diseases: endometriosis, PCOS, cysts, hydrosalpings and others.

Note(!) Unfortunately, ultrasound does not show how passable the tubes are, as well as the sufficiency of estrogen and progesterone. Hormonal imbalances, when there is too little or too much of a certain hormone, are usually indicated by specific diseases.

• Analysis forTORCH will help to detect and treat infections in time, which (in the acute period) can harm the embryo.

What are all these procedures for? To identify and eliminate as many potential obstacles to a successful pregnancy as possible. The sooner you find out - the sooner you start treatment - the sooner you get pregnant.

The first thing you should do today(!) Are there potential barriers to your future pregnancy? If you have not already done so, visit the specialized specialists and eliminate problems #3, 4, 6 and partially 5.

Step Two: Track Your Cycle

Continue further attempts to conceive a child if there is a doctor's permission to have sex without contraception.

Now you know for sure that the egg matures and releases normally, but does the reproductive system function correctly after ovulation? Does the corpus luteum produce enough progesterone?

You can check this in several reliable ways:

• do a blood test for progesterone in the second phase of the cycle, 7-10 days after ovulation. Normal level 16.2–85.9 nmol/L (directed by a physician) ;
• for three cycles (in our opinion, this is the most convenient and affordable way self-diagnosis).

How long does the corpus luteum function?

This temporary gland plays a very important role in the onset and maintenance of pregnancy. You can determine the normal functioning of the corpus luteum without tests and ultrasound at home, using the basal temperature chart.

Here are the two most telling signs that everything is in order in the second phase:

1. Immediately after ovulation, BBT rises and in 3 days the indicators reach a level that is on average 0.3-0.5 ° higher than phase I marks.
2. The temperature remains elevated for more than 10 days (a one-day drop does not count).

BT schedule - determination of a sufficient level of progesterone. The temperature rises by 0.3-0.5 gr. for three days and keeps like this for more than 10 days

If you observe such a trend on several charts in a row, then you should not worry, you are doing well with maintaining the pregnancy.

Rule out hormonal disorders

Working with your doctor is very important. Based on the results of blood tests or BT schedules, the doctor will conclude how things are going with your hormonal background (we have this reason number 5 of unsuccessful attempts to get pregnant).

If abnormalities are detected, treatment is prescribed for an average of 3-6 months.

Important(!) During the use of drugs of the progesterone group (Dufaston / Utrozhestan), active planning can be continued. If - at the time of intimacy, it will be necessary to use contraceptives. In the final recommendations, the gynecologist will write like this: sex life -condom.

Step three: Eliminate psychological barriers

It is better to work on psychological barriers early, as soon as you start preconceptual diagnostics.

The thought is material! Do you think like this all the time:

• Why can not I get pregnant?
• This is not life until I get pregnant!
• Why does everyone give birth without problems, but I don’t?
• As I already got tired of everything - I want to give birth and rest!
• That's when I'm in position, he/they/she/everything will change for the better!
• I'm already so many years old, but there are no children!

If yes, then here is a psychological fact for you: the subconscious mind reads such attitudes and brings them to life. BUT, it understands them approximately as follows:

• I am unable to get pregnant!
• I `m not happy!
• I'm a loser!
• I'm tired and twitchy man!
• Everything is bad!
• I'm incomplete!

The situation is not changing. There is no child, you are an unhappy woman.

Changing our attitude to reality

As I described in my happy pregnancies - nothing will change until you start thinking and acting like you are already there, in a happy future.

Try to imagine in detail, in detail, your feeling when you look at a test with two strips, see a small heart on an ultrasound ... Have you imagined? And now remember this vivid sensation and try to reproduce it mentally again and again.

If you can't get pregnant, work on your thoughts. Thoughts shape behavior and feelings. And they in the future embody the dream

From practice: Under the influence of happy feelings and experiences, the attitude towards life and oneself changes. A woman becomes 100% sure of a successful outcome and acts as if everything has already happened. And the subconscious, seeing this new reality, quickly brings it to life.

Replace the original, negative settings with the following:

• I get pregnant quickly and have healthy babies easily!
• I'm happy!
• How wonderful that it is so easy for me and other women to get pregnant!
• I love myself and do what I love!
• I am glad that everything in my life is arranged in the best way!
• I'm at the right age to have a healthy baby!

Feel like everything has already happened. As if in advance, thank yourself and everyone around you. Your desired pregnancy will definitely come!

Internal stops

This is the opposite side of the burning desire to have children. A woman, for some reason, is afraid of getting pregnant because of one old case, a sad story.

The experience is so deeply rooted in the subconscious that any mention of the conception of a child causes stress and fear. It blocks the normal functioning of the reproductive system, contributes to the development of diseases that interfere with the onset and normal development of pregnancy.

It is better to deal with the development of internal barriers with a psychologist. You can help yourself only by finding (and this is difficult!) And replacing negative programs with positive ones. If you have any negative associations related to pregnancy, childbirth and children, try to create new memories that are good and happy.

Read more about methods to help you not get hung up on pregnancy.

Step Four: Check the patency of the pipes

The tubal factor is problem number 2 on our list of 9 possible causes of failure to conceive during normal ovulation.

Adhesions (constrictions, adhesions) pinch the tubes and other organs of the small pelvis, soldering the walls together and do not allow the spermatozoa to meet the egg.

Note(!) Partial fusion of the tube is possible, when a small sperm cell can overcome the lumen, but a large fertilized egg cannot - this is one of the causes of an ectopic pregnancy.

How to understand if there are spikes?

It happens that the gynecologist literally gropes for them when examining them on the chair (they wrote to me: take into account adhesions on the left), but this is not always noticeable. Please note, with a high degree of probability, adhesions have formed in the abdominal cavity and OMT:

• if you have had surgery in the past;
• if there were inflammations, especially chronic ones;
• if you have been treated for an STD.

Usually doctors turn their attention to the tubal factor after a year of unsuccessful planning. When should you start worrying about tubal obstruction?

I advise you to discuss with your doctor the possibility of an earlier diagnosis of tubal patency if the likelihood of adhesions is high for you. For example, if you are already over 35 or when ultrasound shows formations in the pelvis:

Obstruction of the fallopian tubes may be indicated by formations in the small pelvis - a cyst, hydrosalpings, etc.

Methods for checking the patency of the fallopian tubes

If adhesions in the pelvis are unlikely, that is, none of the above three factors apply to you - the HSG method is optimal for you.

Hysterosalpingography is an x-ray of the tubes with a contrast agent injected into them.

Another option is ultrasonic HSG. Screening is done with a contrast agent visible on ultrasound.

Based on the results of the procedure, the doctor will only say whether there is patency or not. HSG does not eliminate the problem, but only diagnoses its presence.

When, when the likelihood of adhesions is high, the most successful option is diagnostic laparoscopy. This is a minimally invasive surgical procedure performed under anesthesia. It will be possible to go home in 3 days and with three small incisions on the abdomen.

This is interesting(!) There are cases when, due to the adhesive process, the tubes are strongly displaced, moving away from the ovary, although formally they are passable. As a result, even with good ovulation, the egg does not enter the fallopian tube, but remains in the abdominal cavity and fertilization does not occur. During laparoscopy, the doctor restores the normal position of the tube by removing adhesions.

I myself was afraid to do laparoscopy for a long time. And in vain - I became pregnant already in the eighth month after it (three of which I took OK to allow the ovaries to rest).

My second successful pregnancy also happened after this procedure. During the operation, the doctor not only checked, but also restored the patency of the left fallopian tube. She was literally soldered into a lump and strongly shifted to the left (ovulation was on the left during my second pregnancy!)

Step Five: We do an analysis for anti-sperm antibodies

When all other obstacles to the birth of a child are excluded, and there has been no pregnancy for a year (half a year for women 35+), it is the turn of the study of the immunological factor. This is a situation when the antisperm antibodies of a woman or the man himself destroy spermatozoa and conception does not occur.

Who is at risk for antisperm antibodies?

Most often, the appearance of male antisperm antibodies (ASAT) stimulates the destruction of the barrier between sperm and the body (blood-testicular barrier). This happens in such cases:

• inflammation of the genitourinary system, prostatitis;
• injury to the scrotum or testicles;
• surgical operations, including varicocele;
• hydrocele and other diseases;
• oncology;
• intimate relationships by oral or rectal way without a condom.

If the spermogram is good, the immunological male factor is ruled out in most cases, since the spermatozoa affected by the antibodies are immobile and easily detected in this basic study.

However, in some cases: injuries, operations and diseases, it is recommended to do MAR test to determine what percentage of sperm cells are covered with antibodies. The best result is less than 10%.

Another diagnostic option is the postcoital test. when sexual intercourse is carried out a day or two before ovulation. 4 hours later, the doctor takes and examines a sample of cervical mucus for the presence of motile sperm in the cervical canal. A positive result is 25 or more actively mobile male germ cells.

When do ASAT appear in the female body?

The immune system of a woman produces antibodies in response to foreign bodies (sperm) entering the bloodstream. This occurs as a result of microdamages of the mucous membranes during intimacy (including rectally and orally) without contraception. There is also a high probability of the appearance of ASA in inflammation and STDs, especially aggressive in this regard, chlamydia.

Important(!) Preliminary examination and treatment of infections and inflammatory diseases is a prerequisite for pregnancy. Antibodies can be detected in blood, cervical mucus, or follicular fluid.

After establishing the diagnosis, the doctor will prescribe treatment. In parallel with this, the use of condoms is recommended to reduce the contact of seminal fluid with the mucous membranes of a woman 3-6 months old.

What to do if the treatment does not help

In difficult cases of immunological infertility:

• after a year of unsuccessful planning;
• detection in the blood, mucous membranes, seminal fluid ASA;
• unsuccessful surgical or conservative treatment, –

In case of poor activity of spermatozoa due to ASAT adhering to them, the doctor selects the best, purifies it and introduces it into the egg

VMI will help sperm cells bypass the cervical barrier and immediately get into a more favorable environment for existence.

ECO will ensure the selection of the most active and correct units capable of self-fertilization of the egg.

ICSI It is used in cases where a spermatozoon alone is not able to penetrate into the female germ cell due to damage by antisperm antibodies. To increase the likelihood of successful fertilization, the embryologist independently releases the spermatozoa from ASAT and injects the sperm into the egg.

Step six: We go through PGD / PGS before insemination, IVF and ICSI

You will definitely become a mother if you want! Thanks to assistive technologies, it is possible to give birth to a healthy child even after 40 years.

So, all the previous steps have been taken and the last possible ninth reason remains - chromosomal pathologies.

Determined that at least 20% of childless couples have various chromosomal pathologies. The help of a geneticist is required in such situations:

• woman's age 35+;
• very poor spermogram (100% of sperm with poor morphology, less than 10 million sperm per 1 ml, etc.);
• in the history of the disease there were several unsuccessful pregnancies (especially those that were interrupted before 12 weeks);
• 3 or more failed IVF attempts.

PGD ​​or PGS?

To begin with, the Karyotype is determined - whether the chromosome set in the parents is normal. If violations are detected, PGD is performed. Pre-implantation genetic diagnosis (PGD) is necessary to identify abnormalities and select healthy embryos for replanting.

If both parents have normal chromosome set (karyotype), then PGS is performed - pre-implantation genetic screening. It aims to detect spontaneous anomalies in the genome of the embryo.

Evaluation of the results of the analysis

Based on the diagnostic/screening results, the most healthy and suitable embryos are selected.

The procedure is carried out in this cycle (if three days were analyzed) or in the next cryocycle (when five days were checked with their subsequent freezing).

Attention(!) No one can give a 100% guarantee of the accuracy of the result of the embryo study. According to statistics, when analyzing three-day days using the FISH method, an error was detected in 0.1-0.6% of all cases. Violations were not established and the embryo was transferred. Science does not stand still, perhaps soon genetic and chromosomal anomalies will be determined accurately.

According to practitioners from reproductive centers, PGD and PGS are very effective procedures.

With the use of PGS in women over 35 years old, for example, the number of pregnancies increased by 1.5 times, cases of embryo development after implantation decreased by 2 times, the number of births of children with Down syndrome and other chromosomal and genetic diseases decreased by 1.5 times .

Advice to help you get pregnant

Start loving and praising yourself now! Most health problems arise due to psychological factors. When a woman is unhappy, unloved and stressed, this leads to the development of diseases.

Doctors will help identify and cure most of the consequences of experiences and stress, but will not be able to eliminate the root cause!

Guided by these steps, you will surely see your cherished two stripes. For example, I got pregnant twice after taking only the first four of six steps. Act boldly and confidently.

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Obstetrician-gynecologist Olga Pryadukhina

Obstetrician-gynecologist, doctor of ultrasound diagnostics.
Certified operating doctor obstetrician-gynecologist.
Book author :"How to Get Pregnant Fast"
Participant scientific research associated with pregnancy complications. Has a number of publications in scientific journals.

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