The reproductive female system is unique. Thanks to her, a woman has the ability to bear children almost throughout her life. In order for a child to be born, the female body goes through three phases: fertilization, pregnancy and birth. The whole process can go easily, but sometimes any of the phases fails. Most often, women are faced with the inability to conceive a baby - the first phase. This is due to both external and internal physiological causes. The main problem that needs to be addressed at this stage is the lack of ovulation. There are many reasons why pregnancy does not occur during ovulation and after it. You can get rid of them by the joint efforts of the patient and the doctor.
The concept of ovulation and the monthly cycle
Ovulation is a process in the female body when an egg ready for fertilization leaves the ovarian follicle and is sent to the uterus. In the absence of fertilization, the egg leaves the uterus along with an obsolete endometrial layer - this is how menstruation begins.
The menstrual cycle in its concept is defined as the period of time from the beginning of menstruation (the first day of the cycle) to the last day when the next menstruation should begin. The average period of the menstrual cycle lasts 21-31 days. The ideal cycle is 28 days. In a healthy female body, the menstrual cycle does not go astray, and menstruation comes once during the cycle.
If you count by the calendar method, then ovulation occurs in the middle of the cycle. Often women are interested in how long ovulation occurs or why it came later. With a duration of 28 days, it is necessary to count 14 days from the start of menstruation. This will be the beginning of the ovulation period, which lasts up to 3 days. If during this period the egg meets the sperm, then the fetus will conceive.
The average life expectancy of an egg ready for fertilization is one day. If fertilization is unsuccessful, she dies and rushes out with the menstrual blood. The ovulation process takes place every month. Normally, several omissions of the onset of the ovulation period per year are allowed.
How to determine the absence of ovulation?
The reproductive function of the female body requires close observation. When controlling changes in your health, you can note the signs that appear with the onset of the ovulation period. In their absence, it can be assumed that ovulation did not occur. Symptoms of pathology, namely the absence of ovulation, are quite different:
- failure of the menstrual cycle, irregular appearance of menstruation, their complete absence;
- change in the nature of discharge during menstruation (spotting, copious);
- the absence or increase in symptoms of the onset of the menstrual cycle (headaches, drawing pain in the lower abdomen, breast hypersensitivity, jump in hormonal levels, increased taste buds and smell);
- when controlling the onset of ovulation by measuring basal temperature, a prolonged absence of changes is observed (the temperature does not increase);
- lack of vaginal discharge;
- decreased libido or a complete lack of sexual desire during the menstrual cycle.
The presence of one or a complex of signs may mean anovulation. But without accurate and professional studies, it is impossible to say for sure whether or not the woman had ovulation. Therefore, to accurately determine the period of ovulation or its absence, it is necessary to conduct comprehensive studies of the body.
Why is ovulation absent?
The main reasons why ovulation does not occur during the menstrual cycle may be the result of pathologies or physiology of a woman. An examination by a specialist will give a true reason.
The physiological reasons why ovulation does not occur suggest:
- the presence of pregnancy;
- recovery period after childbirth;
- breastfeeding a newborn;
- use of oral hormonal contraceptives;
- the beginning of puberty;
- menopause, age-related changes.
As is already clear from this list, the physiological causes are logical and proceed without any problems with the woman’s health. Anovulation can occur in the body of a healthy woman up to 3 times a year, this is considered the norm.
Pathological reasons why ovulation does not occur if menstruation is regular:
- A sharp change in weight. Sudden exhaustion, or vice versa, obesity of a woman’s body can have a direct effect on the reproductive system. Adipose tissue is an endocrine organ that produces female hormones. With a sharp weight gain, fat accumulates in the body, due to this the amount of hormones increases. Violation of the hormonal background leads to the absence of ovulation. Depletion of the female body also affects the hormonal background of a woman. But in this case, there is a deficiency of estrogen (female hormone), which leads to the disappearance of menstruation, and anovulation.
- Prolonged stressful situations, frequent overwork, psychological problems, lack of proper rest and a favorable surrounding background are also one of the reasons why ovulation does not occur if the periods are regular.
- Violation of the endocrine system of women. Diseases of the thyroid gland affect the work of the entire female body, including the work of the ovaries. The production of a large number of male hormones in the female body leads to a lack of ovulation.
- Inflammatory processes, infectious gynecological diseases lead to a deterioration in women's health, ovarian dysfunction, anovulation.
If the question is why pregnancy does not occur during ovulation, then the woman needs to eliminate the above reasons. Well, if after this conception did not occur, it is recommended to be examined by a specialist.
Careful research, timely examinations and a visit to the gynecologist help to identify anovulation at the initial stage. And the correct treatment and restoration of the body leads to the elimination of the causes of the disease.
Diagnosis of anovulation problem
Analysis of data on the duration, frequency and nature of the menstrual cycle in women is the initial stage in identifying the causes of ovulatory dysfunction. Lack of ovulation may be due to an irregular menstrual cycle. But these examinations are also needed in order to know why pregnancy does not occur during ovulation. Diagnosing a problem involves several steps, which will be described below.
Examination by a gynecologist
Gynecological examination is necessary when diagnosing a problem. With it, the doctor can determine any abnormalities in the anatomy of the ovaries, which may be the cause of a violation of their functions and, as a result, lead to anovulation.
Basal temperature measurement
The method used to detect ovulation is to measure basal temperature during the menstrual cycle. Measurement takes place daily in the morning at the same time, a table or graph with the results is compiled. Temperature can be measured both in the rectum and in the vagina. The rectal method of measurement is more accurate. It is better to conduct research over several cycles.
With the onset of ovulation, body temperature is increased. In the absence of ovulation, basal temperature does not change during the cycle, there is no division into phases.
Using test strips to determine ovulation
Pharmacy tests for ovulation are similar in appearance to pregnancy tests. But an ovulation test is necessary within a week. With a regular cycle, the start of the study is determined 17 days before the onset of menstruation. In an irregular cycle, the count is based on the duration of the shortest cycle that has been in the past six months.
The test works as follows: a strip is placed in a container with collected urine for 10 seconds, after which the results that occur within 10 minutes are removed and evaluated. The ovulation test responds to a hormone that is released into a woman’s body 1-2 days before ovulation begins.
Hormone blood test
This stage is important for determining the exact amount of hormones that are normally found in a woman's body. Deviations from the norm indicate a disease that leads to anovulation.
There is a list of hormones for the presence of which it will be necessary to donate blood:
- Follicle-stimulating hormone. He is responsible for the growth of a healthy egg and for the formation of estrogen.
- Luteinizing hormone. It is responsible for the production of progesterone and for the completion of egg maturation. Analysis for this and the previous hormone should be taken on the 3rd-7th day of the menstruation cycle.
- Prolactin is an important hormone that is responsible for the occurrence of anovulation, since a deviation from the norm negatively affects the work of the ovaries. Analyzes are given twice per cycle.
- The hormone estradiol. It helps the egg develop fully, prepares the female body for future pregnancy. Analyzes are submitted during the cycle.
- Hormone progesterone. Affects the onset and further development of pregnancy.
A gynecologist can also prescribe tests for other hormones, depending on preliminary diagnosis and possible diseases.
Ultrasound to determine ovulation
To date, ultrasound diagnosis of the reproductive organs of the female body is one of the most active. Thanks to modern technologies and the development of medicine, the doctor can determine the pathology of the genital organs, internal structure, trace the process of ovulation in the female body and give an answer to the question of why ovulation occurred earlier or later.
Treatment of the causes of anovulation
After diagnosis by a gynecologist and identifying the reasons for the lack of ovulation, treatment is prescribed. It depends on the identified pathologies and disorders.
If the absence of ovulation is due to sharp changes in the woman’s weight, then the doctor prescribes recommendations for changing the diet for weight gain or loss, as well as lifestyle recommendations.
Disorders of the thyroid gland are treated with hormonal drugs (thyroid hormones). They support and normalize the production of hormones estrogen and progesterone.
In addition, hormonal drugs are also used in violation of the amount of hormones that are inherent in the male body.
Polycystic ovary is also treated with hormone therapy. In the case when the effectiveness of such therapy is absent, surgical intervention is possible. To eliminate the causes of anovulation, a procedure called laparoscopy is performed. It involves stimulating ovulation by applying incisions to the ovaries or removing some part of the ovary. The effectiveness of laparoscopy is high and is valid for the first year after the procedure. The first ovulation after laparoscopy can occur within two weeks.
Another method of treating anovulation is the appointment of hormonal contraceptives. Oral contraception blocks the woman’s ovaries during admission (for effective treatment, the period can last several months). After canceling contraception, the ovaries begin to work again, the cycle is restored.
Artificial Ovulation Stimulation
Artificial stimulation of ovulation occurs by taking certain medications prescribed by a gynecologist. The stimulation process is as follows:
- Depending on the choice of drug, a woman is prescribed a stimulating medication on a specific day of her menstrual cycle.
- While taking a course of pills, a woman undergoes an ultrasound of the ovaries. Using ultrasound, the gynecologist monitors the creation of an egg.
- When she reaches the required level of maturity, the gynecologist determines, prescribes and injects a hCG injection into the woman’s body. HCG is a chronic human gonadotropin, the level of which contributes to the normal passage of ovulation and conception.
If all procedures are performed correctly and in a timely manner, ovulation occurs in the woman over the next two days. Its presence can also be determined using ultrasound. If ovulation has happened - it must be supported by hormonal drugs that are responsible for the production of the hormone progesterone.
Stimulating procedures help only in the case of a complete diagnosis of the female reproductive system. With artificial stimulation, certain hormonal drugs are used:
- "Klostilbegit" - tablets, the dose of which is determined by the doctor individually for each woman. Taking the medicine begins on the fifth day of the menstrual cycle and lasts 5 days. Drug treatment takes place in two cycles, after which a break is made. This medicine depletes the female ovaries, so you should not allow the drug to be taken more than five times in a lifetime.
- "Letrozole" is a drug that regulates the amount of hormones in the female body, improves the endometrial layer in the uterus, increasing the possibility of the egg connecting with it. Application is determined by the doctor. He chooses a scheme, depending on the disease and the individual characteristics of the woman.
- "Puregon" - a hormonal drug, is used from the second day of the menstrual cycle for two weeks. The medicine is available in the form of injections, the dosage of which is determined by the attending gynecologist after careful monitoring of the body's reaction to the drug.
It is important to remember that you can not use folk remedies to stimulate ovulation in conjunction with hormonal drugs. After the treatment, women wonder when pregnancy occurs after ovulation. The most common cases of pregnancy directly on the first day of ovulation.