When a woman wants to get pregnant, ovulation becomes a passionate matter. Something that wasn’t important, suddenly becomes a goal. “Am I certain that I ovulate? How do I know on which day I ovulate?” These are frequently asked questions.
That is why I would like to talk about some of the false beliefs we often encounter in our consultations.
Is it true that every month, ovulation happens in only one ovary?
Actually no, it isn’t, even though it is written in school text books.
The follicles go through the following stages: primordial, primary, secondary and finally tertiary, when they have become mature.
The primordial follicles, during the first stage, lie in the ovary, until three months before the cycle in which ovulation takes place several start to grow and become primary follicles. This process is called recruitment.
Of all these follicles, only a few eventually become secondary, many atrophy and are left behind. This is called atresia process. Finally, only one among the secondary ones will become tertiary, measuring at that point 2 or 3 cm in diameter. If instead of being one they are two, the result is a twin pregnancy.
Throughout this process, the dominant follicle produces substances which inhibit the development of the other follicles. This occurs in all ovary tissue, it does not matter if it is on the right or left ovary. When a woman only has an ovary she always ovulates from this ovary. If she has two this process is randomized, which means she can ovulate from one ovary for several months in a row.
What if I don’t ovulate?
Many women fear not knowing whether they ovulate. I can tell you that, if menstrual cycles are regular, which means you have your period each month, it is certain that you ovulate.
Women who do not ovulate are those who don’t get their period, have it every several months, or have irregular cycles.
To know on which days you ovulate, it is enough to observe the usual length of your cycles. We know that 14 days go by from ovulation to the following period. Thus if your cycles are of 28 days, you will ovulate most likely on the 14th day of your cycle. And if they are of 27 days, you will ovulate on day 13th.
Although it is not always exact, you don’t need an ovulation test. It is more practical to have sexual intercourse between three days before and one day after you expect to ovulate. We know that sperm can remain alive, waiting for the oocyte for up to three days on the fallopian tubes, and that the oocyte can be fertilized within 24 hours (it degenerates one day after ovulation).
Ideally you should have sexual intercourse on these days, but not necessarily on all these days. Even if you have a mission, try to keep a bit of romance!
You should know that sperm moves from the vagina to the tube with a speed of 2-3mm a minute. Therefore, from the moment ejaculation occurs until the sperm reaches the oocyte, approximately 45-60 minutes go by… Only a few hours after sexual intercourse, you may already be pregnant!
Ovulating doesn’t mean you can get pregnant
During the last years of menstruating, a woman cannot have healthy children. The physiological system which separates the chromosomes in the oocytes ages, and becomes ineffective. Thus, as time passes, the oocytes present alterations which prevent fertilization to take place, or which may lead to miscarriages.
This aging process is caused by the passing of time. Some believe that during pregnancy, or while taking contraception, oocytes are preserved, but this is not true. It is like thinking that while we sleep we do not age.
Another common misconception is believing that, if you have been taking contraceptive pills for a long time, you should wait several months before getting pregnant.
This is untrue, you can seek pregnancy from the moment you stop taking the pill. I guess this false belief is based on the fact that when ovulation does not occur over many cycles, it is frequent that it can be delayed.
What happens to the unfertilized oocytes?
The unfertilized eggs are microscopic cells that are eliminated by a type of white blood cells called macrophages, which are part of our cellular cleansing system. They are not eliminated throughout the period but recollected by these lymphocytes and brought to the blood stream.
Is fertility inherited?
We know some aspects related to fertility are genetically determined and for this reason some families are more fertile than others. Therefore, the number of oocytes and of primordial follicles when a baby girl is born can be approximately 2 to 3 million. This is related to heredity linked to the X chromosome.
Our patients often tell us: I will probably start menopause at the same age my mother had it or a bit later. In industrialized societies this is changing. Since toxic substances, which are endocrine disruptors, get collected on the fat of the mother, the number of these cells is reduced along with the fertile age. This also occurs in men and for this reason male fertility decreases in areas contaminated by environmental toxics.
Finally, it is very typical to hear: “I had my first period at a very young age so this means I will reach menopause early”. This is not true. The age of menopause is not linked to the age of the first menstruation.