WHAT DOES A NATURAL CYCLE MEAN?
If a given couple has unprotected intercourse for 12 months or longer without achieving pregnancy, or the female partner has an irregular menstrual cycle or anovulation, a timely visit to the fertility specialist is strongly recommended.
At ReproART, infertility is not always treated with assisted reproductive technology. Instead, it is sometimes enough to identify favorable days when the woman’s body is ready for pregnancy. These days are identified by the fertility specialist after ultrasound monitoring or certain hormonal testing. Next, pregnancy is planned within a natural cycle.
WHAT DOES A NATURAL CYCLE MEAN?
Natural menstrual cycle is the cycle of maturation for one ovulated egg in the woman’s body: an egg matures in the female reproductive system, namely ovaries, and starts ovulating (release into fallopian tubes), which may result in pregnancy after fertilization. Without fertilization, the uterus discharges tissue, known as menstruation.
Menstruation is a part of the regular process preparing a woman for pregnancy from month to month. The menstrual cycle differs: as a rule, its duration is between 21 to 35 days, while menstrual discharge lasts 3-6/7 days. However, every cycle is individual, and even in the case of the same woman, it may vary from month to month.
Menstrual cycle phases
A menstrual cycle consists of the following phases:
- Follicular phase;
- Ovulation;
- Luteal phase.
The follicular phase starts with menstrual bleeding. At this time, the amount of follicle stimulating hormones (FSH) released from the pituitary gland increases, causing the follicle to expand. In parallel, the ovaries produce rising levels of estrogen that stimulate “the renewal” of the lining of the uterus. The end of the follicular phase is triggered by a decrease of the concentration of follicle-stimulating hormone to a critical low and the increased release from the pituitary of luteinizing hormone, followed by the next stage, ovulation.
Ovulation refers to the release of an egg from the greatly-enlarged follicle. The production of high levels of luteinizing hormone intensifies. The follicle ruptures and the egg is funneled through the fallopian tube ready for fertilization. An egg lasts only 12-48 hours. What happens next depends on the fertilization of the given egg.
The fertilized egg begins undergoing cell divisions as it travels through the fallopian tube. Roughly 3 days later, the embryo (~8 dividing cells) enters the uterine cavity. Several days later, the embryo (if it continues to develop well) may implant in the uterine lining. When implantation fails to occur, the embryo disappears and the menstrual cycle (luteal phase) continues until the next menstrual cycle begins with menstrual bleeding. In the cases of implantation, no further menstrual cycle occurs and the follicle remains evident on the ovary as a corpus luteum (yellow body). The corpus luteum continues to produce a limited amount of estrogen and produces increased amounts of progesterone – the progestational or pregnancy-supporting hormone).
If no fertilization occurs, or the fertilized egg develops poorly or the embryo fails to implant, the corpus luteum undergoes involution (diminishes and then disappears). This is why the levels of progesterone and estrogen in the blood drop drastically. The decline of estrogen and progesteron leads to shedding of the uterine lining known as menstruation.
PLANNING PREGNANCY AT REPROART
The natural cycle is monitored by the ReproART Clinic in line with modern standards. ReproART’s obstetrician/gynecologist/fertility specialist conducts an individual study of menstrual cycle phase-related changes in the uterus and ovaries. Consequently, the specialist:
- Assesses anatomical quality;
- Monitors follicular growth and development;
- Studies the process of ovulation;
- Assesses the endometrium;
- Monitors the quality of the second phase in the menstrual cycle;
- Identifies favorable days for conception;
- Instructs the patients when to have intercourse or an insemination.