What needs to be done for ovulation to occur. Is it possible to get pregnant if there is no ovulation? If there is no ovulation, you can get pregnant: treatment

The main task of a woman on Earth is considered to be procreation. Of course, both a woman and a man participate in the process of conception, but whether a representative of the fairer sex endures a pregnancy and gives birth to a healthy child depends only on herself. Ovulation is necessary for fertilization to occur. Ovulation and conception are two interrelated conditions, because in the absence of ovulation, fertilization is impossible. Signs of ovulation are almost always noticed by a woman (consciously or not), so knowing them is necessary not only for planning a long-awaited pregnancy, but also for preventing an unwanted one.

Menstrual cycle and its phases

To define the term “ovulation”, you should understand the concept of “menstrual cycle”.

During the menstrual cycle, functional and structural transformations successively occur in the female body, which affect not only the reproductive system, but also the rest (nervous, endocrine and others).

The formation of the menstrual cycle, which is physiological for female body, begins during puberty. The first menstruation or menarche occurs at the age of 12 - 14 years of girls and draws a line under the first period of puberty. The menstrual cycle is finally established after a year to a year and a half and is characterized by the regularity of menstrual bleeding and a relatively stable duration. During the specified time (1 - 1.5 years), the cycles of a teenage girl are anovulatory, that is, there is no ovulation, and the cycles themselves consist of two phases: follicular and luteal. Anovulation during the formation of a cycle is considered an absolutely normal phenomenon and is associated with insufficient production of hormones necessary for ovulation. By approximately 16 years of age, the menstrual cycle acquires its own individual characteristics, which persist throughout life and regular ovulation appears.

Physiology of the menstrual cycle

The average duration of the menstrual cycle ranges from 21 to 35 days. The duration of menstrual bleeding is 3–7 days. For most women, the total cycle length is 28 days (75% of the population).

It is customary to divide the menstrual cycle into two phases, the boundary between which is ovulation (in some sources a separate ovulatory phase is distinguished). All changes that occur periodically and are repeated approximately every month in a woman’s body, in particular in the reproductive system, are aimed at ensuring complete ovulation. If this process does not occur, the cycle is called anovulatory, and the woman is, accordingly, infertile.

Phases of the “female” cycle:

First phase

In the first phase (another name is follicular), the pituitary gland begins to produce follicle-stimulating hormone, under the influence of which the process of proliferation (maturation) of follicles or folliculogenesis starts in the ovaries. At the same time, over the course of one month, about 10–15 follicles begin to actively grow in the ovary (either in the right or in the left), which become proliferating or maturing. The maturing follicles, in turn, synthesize estrogens necessary for the final completion of the process of maturation of the dominant follicle, that is, they are temporary glands. Under the influence of estrogen, the main (dominant) follicle forms a cavity around itself, which is filled with follicular fluid and where the egg “ripens”. As the dominant follicle grows and a cavity forms around it (now called the Graafian vesicle), follicle-stimulating hormone and estrogens accumulate in the follicular fluid. As soon as the process of maturation of the egg is completed, the dominant follicle sends a signal to the pituitary gland, and it stops producing FSH, as a result of which the Graafian vesicle ruptures and a mature, full-fledged egg is released into the “light.”

Second phase

So what is ovulation? The second phase (conventionally) is called ovulatory, that is, the period when the Graafian vesicle ruptures and the egg appears in the free space (in this case, in abdominal cavity, often on the surface of the ovary). Ovulation is the process of direct release of an egg from the ovary. The rupture of the main follicle occurs under the “banner” of luteinizing hormone, which begins to be secreted by the pituitary gland after a signal is given to it by the follicle itself.

Third phase

This phase is called the luteal phase, as it occurs with the participation of luteinizing hormone. As soon as the follicle bursts and “releases” the egg, the corpus luteum begins to form from the granulosa cells of the Graafian vesicle. During the process of granulosa cell division and formation of the corpus luteum, progesterone begins to be synthesized along with the pituitary gland secreting LH. The corpus luteum and the production of progesterone are designed to preserve the egg in case of fertilization, ensure its implantation into the uterine wall and maintain pregnancy until the placenta is formed. The formation of the placenta is completed by approximately 16 weeks of pregnancy and one of its functions includes the synthesis of progesterone. So, if fertilization has occurred, then the corpus luteum is called the corpus luteum of pregnancy, and if the egg does not meet the sperm, then the corpus luteum undergoes reverse changes (involution) by the end of the cycle and disappears. In this case, it is called the corpus luteum of menstruation.

All the described changes affect only the ovaries and are therefore called the ovarian cycle.

Uterine cycle

Speaking about the physiology of the menstrual cycle and the ovulation cycle, it should be noted the structural changes that occur in the uterus under the influence of certain hormones:

Desquamation phase

The first day of the menstrual cycle is considered to be the first day of menstruation. Menstruation is the rejection of the overgrown functional layer of the uterine mucosa, which was ready to receive (implant) a fertilized egg. If fertilization does not occur, then desquamation of the uterine mucosa occurs along with blood - menstrual bleeding.

Regeneration phase

Follows the desquamation phase and is accompanied by restoration of the functional layer with the help of reserve epithelium. This phase begins during bleeding (at the same time the epithelium is rejected and restored) and ends on the 6th day of the cycle.

Proliferation phase

It is characterized by the proliferation of stroma and glands and coincides in time with the follicular phase. With a 28-day cycle, it lasts up to 14 days and ends when the follicle matures and is ready to rupture.

Secretion phase

The secretory phase corresponds to the phase of the corpus luteum. At this stage, thickening and loosening of the functional layer of the uterine mucosa occurs, which is necessary for the successful introduction of a fertilized egg into its thickness (implantation).

Signs of ovulation

Knowing its signs will help determine the day of ovulation, for which you need to pay great attention to your body. Of course, ovulation cannot always be suspected, because its manifestations are very subjective and sometimes go unnoticed by a woman. But the changes hormonal levels, occurring every month, allow you to “calculate” and remember the sensations during ovulation and compare them with those that occur again.

Subjective signs

Subjective signs of ovulation include those that the woman herself feels and which only she can tell about. Another name for subjective signs is sensations:

Stomach ache

One of the first signs of ovulation is pain in the lower abdomen. On the eve of follicle rupture, a woman may, but not necessarily, feel a slight tingling in the lower abdomen, usually on the right or left. This indicates a maximally enlarged and tense dominant follicle, which is about to burst. After its rupture, a small wound, a few millimeters in size, remains on the lining of the ovary, which also bothers the woman. This is manifested by minor aching or nagging pain or discomfort in the lower abdomen. Such sensations disappear after a couple of days, but if the pain does not go away or is so acute that it disrupts your usual way of life, you should consult a doctor (ovarian apoplexy is possible).

Mammary gland

There may be pain or increased sensitivity in the mammary glands, which is associated with hormonal changes. The production of FSH stops and the synthesis of LH begins, which is reflected in the chest. It becomes swollen and rough and becomes very sensitive to touch.

Libido

Another characteristic subjective sign of approaching and occurring ovulation is increased libido (sexual desire), which is also due to hormonal changes. It is so predetermined by nature that it ensures procreation - since the egg is ready for fertilization, it means that sexual desire needs to be strengthened to increase the likelihood of sexual intercourse and subsequent pregnancy.

Increased sensations

On the eve and during the period of ovulation, a woman notes an aggravation of all sensations (increased sensitivity to smells, changes in color perception and taste), which is also explained by hormonal changes. Emotional lability and sudden changes in mood (from irritability to joy, from tears to laughter) cannot be ruled out.

Objective signs

Objective signs (symptoms of ovulation) are those that are seen by the examining person, for example, a doctor:

Cervix

During a gynecological examination during the ovulatory phase, the doctor may note that the cervix has softened somewhat, the cervical canal has opened slightly, and the cervix itself has risen upward.

Edema

Swelling of the extremities, most often the legs, indicates a change in the production of FSH to the production of LH and is visible not only to the woman herself, but also to her relatives and the doctor.

Discharge

During ovulation, vaginal discharge also changes in nature. If in the first phase of the cycle a woman does not notice spots on her underwear, which is due to a thick plug that clogs the cervical canal and prevents infectious agents from entering the uterine cavity, then during the ovulatory stage the discharge changes. The mucus in the cervical canal dilutes and becomes viscous and viscous, which is necessary to facilitate the penetration of sperm into the uterine cavity. In appearance, cervical mucus resembles egg white, stretches up to 7–10 cm and leaves noticeable stains on the underwear.

Blood in the discharge

Another characteristic objective, but optional, sign of ovulation. Blood in the discharge appears in very small quantities, so the woman may not notice this symptom. One or two drops of blood enter the fallopian tube, then into the uterus and into the cervical canal after the dominant follicle ruptures. Rupture of the follicle is always accompanied by damage to the tunica albuginea of ​​the ovary and the release of a small amount of blood into the abdominal cavity.

Basal temperature

This symptom can only be identified by a woman who regularly keeps a basal temperature chart. On the eve of ovulation, a slight (0.1 - 0.2 degrees) drop in temperature occurs, and during the rupture of the follicle and after the temperature rises and remains above 37 degrees.

Ultrasound data

An increase in the size of the dominant follicle and its subsequent rupture are reliably determined using ultrasound.

After ovulation

Some women, especially those who use the calendar method of birth control, are interested in symptoms after ovulation has occurred. In this way, women calculate “safe” days regarding unwanted pregnancy. These signs are very uncharacteristic and may coincide with early symptoms pregnancy:

Vaginal discharge

As soon as the egg is released from the main follicle and dies (its lifespan is 24, maximum 48 hours), the discharge from the genital tract also changes. Vaginal leucorrhoea loses its transparency, becomes milky, possibly interspersed with small lumps, sticky and does not stretch well (see).

Pain

Within one to two days after ovulation, discomfort and minor pain in the lower abdomen disappear.

Libido

Sexual desire gradually fades away, since now there is no point in sperm meeting the egg, it has already died.

Basal temperature

If at the moment of rupture of the Graafian vesicle the basal temperature is significantly higher than 37 degrees, then after ovulation it decreases by several tenths of a degree, although it remains above 37 degrees. This sign is unreliable, since even after conception has occurred, the basal temperature will be above 37 degrees. The only difference is that by the end of the second phase (before the start of menstruation), the temperature will drop to 37 degrees or below.

Acne

On the eve and at the moment of ovulation, hormonal changes occur in the body, which affects the condition of the facial skin - acne appears. Once ovulation is complete, the rash gradually disappears.

Ultrasound data

An ultrasound allows one to dislocate a dominant follicle that has collapsed due to a rupture, without a large number of fluid in the retrouterine space, and later the developing corpus luteum. Ultrasound data are most indicative in the case of dynamic research (maturation of follicles, determination of the dominant follicle and its subsequent rupture).

Signs of conception

Before talking about the signs of pregnancy after ovulation, it is worth understanding the terms “fertilization” and “conception.” Fertilization, that is, the meeting of the egg with the sperm, occurs in the fallopian tube, from where the fertilized egg is sent to the uterus. In the uterine cavity, the fertilized egg chooses the most convenient place and attaches to the uterine wall, that is, it is implanted. After implantation has occurred, a close connection is established between the maternal body and the zygote (future embryo), which is supported by changes in hormonal levels. The process of securely fixing the zygote in the uterine cavity is called conception. That is, if fertilization has taken place, but implantation has not yet occurred, this is not called pregnancy, and some sources indicate a term such as “biological pregnancy.” Until the zygote is firmly established in the thickness of the endometrium, it can be expelled from the uterus simultaneously with menstrual flow, which is called a very early miscarriage or termination of biological pregnancy.

Signs of conception are very difficult to determine, especially for an inexperienced woman, and appear approximately 10 to 14 days after ovulation:

Basal temperature

At possible pregnancy basal temperature remains high, about 37.5 degrees, and does not decrease before the expected menstruation.

Implantation retraction

If in the second phase of the cycle after ovulation the basal temperature remains elevated (more than 37) almost until the onset of menstruation, then at the moment the zygote implants into the uterine mucosa, it slightly decreases, which is called implantation retraction. Such a drop is characterized by a mark below 37 degrees, and the next day by a sharp jump in temperature (more than 37 and higher than it was after ovulation).

Implantation bleeding

When a fertilized egg tries to settle in the thickness of the uterine mucosa, it somewhat destroys it and damages nearby small vessels. Therefore, the implantation process, but not necessarily, is accompanied by slight bleeding, which can be seen in the form of pinkish spots on the underwear, or one or two drops of blood.

Change in well-being

From the moment of implantation, a shift in hormonal levels occurs, which is manifested by lethargy, apathy, possibly irritability and tearfulness, increased appetite, changes in taste and olfactory sensations. Also on early stages During pregnancy, a slightly elevated body temperature can be noted, which is associated with the influence of hormones (progesterone) on the thermoregulation center. This phenomenon absolutely normal for pregnancy and is aimed at suppressing the mother’s body’s immunity and preventing miscarriage. Many women take a rise in temperature and deterioration in well-being as the first signs of ARVI.

Discomfort in the lower abdomen

Somewhat unpleasant sensations or even cramps in the lower abdomen for one, maximum two days are also associated with implantation of the zygote and are absolutely physiological.

Mammary gland

Increased sensitivity, swelling and soreness in the mammary glands persists after ovulation. The possibility of conception is indicated by a slight increase in these symptoms.

Delayed menstruation

If menstruation has not started, it’s time to take a pregnancy test and make sure you’re right.

When does ovulation occur and how long does it last?

All women are interested in when ovulation occurs, because this is important for calculating favorable days for conception or for preventing unwanted pregnancy. As already indicated, the ovulatory period is the time that lasts from the moment the main follicle ruptures until a full-fledged egg enters the fallopian tube, where it has every chance of being fertilized.

It is impossible to determine the exact duration of the ovulatory period, due to the fact that even for a particular woman it can change in each cycle (lengthen or shorten). On average, the entire process takes 16 – 32 hours. It is the process, not the viability of the egg. But the lifespan of a released egg is simpler, and this time is 12 – 48 hours.

But if the lifespan of an egg is quite short, then sperm, on the contrary, remain active for up to 7 days. That is, if sexual intercourse took place on the eve of ovulation (a day or two before), then it is quite possible for the “fresh” egg to be fertilized by sperm that were “waiting” for it in the tube and have not lost their activity at all. It is on this fact that the calendar method of contraception is based, that is, the calculation of dangerous days (3 days before ovulation and 3 days after).

When it comes

A simple calculation will help determine the days of ovulation, but approximately. Ovulation occurs at the end of the first phase of the cycle (follicular). To know on what day a certain woman ovulates, she needs to know the duration of her cycle (we are talking about regular cycles).

The duration of the follicular phase is different for everyone and ranges from 10 to 18 days. But the duration of the second phase is always the same for all women and corresponds to 14 days. To determine ovulation, it is enough to subtract 14 days from the entire length of the menstrual cycle. As a result, it turns out that if the cycle lasts 28 days (minus 14), we get the 14th day of the cycle, which will mean the approximate day the egg is released from the follicle.

Or the cycle lasts 32 days, minus 14 - we get the approximate 18th day of the cycle - the day of ovulation. Why, when talking about such a simple calculation, is it called approximate? Because the menstrual cycle, and especially the ongoing ovulation, are very sensitive processes and depend on many factors. For example, ovulation may occur prematurely (early) or late (late).

The onset of early rupture of the follicle and release of the egg can be triggered by the following factors:

• significant stress;
• lifting weights;
• significant sports loads;
• frequent coitus;
• hazardous production;
• a common cold;
• change in climate, lifestyle or diet;
• excessive smoking or drinking alcohol;
• sleep disturbance;
• hormonal imbalance;
• taking medications.

Late ovulation is said to occur if it occurs (with a 28-day cycle) on days 18–20. The reasons for this process are the same as the factors that provoke the early rupture of the main follicle.

How to calculate ovulation

All women need to know how to calculate ovulation, especially those who have tried for a long time and unsuccessfully to get pregnant. For this purpose, there are several developed methods for determining ovulation. All methods can be conditionally divided into “biological” and “official”, that is, laboratory and instrumental.

Calendar method

• duration of the cycle (it should not be too short, for example, 21 days and not very long, 35 days) - the optimal duration is 28 - 30 days;
• regularity - ideally, menstruation should come “day after day”, but a deviation of +/- 2 days is allowed;
• the nature of menstrual flow - menstruation should be moderate, without clots and no more than 5 - 6 days, and the nature of the flow should not change from cycle to cycle.

We subtract 14 from the length of the cycle (the length of the luteal phase) and conditionally take the day of ovulation (it can shift). We mark the calculated date on the calendar and add 2 days to 2 days after - these days are also considered favorable for fertilization.

Basal temperature

A more reliable method is the method of calculating ovulation using a basal temperature chart. To calculate favorable days To conceive, the following conditions must be met:

• measurement of basal, that is, in the rectum, temperature for at least three months;
• drawing up a schedule (this item is required) of basal temperature;
• measurements should be taken in the morning, after a night's sleep, at the same time and without getting out of bed.

According to the compiled schedule, we mark the first phase of the cycle, during which the temperature will remain below 37 degrees, then a pre-ovulatory decrease during the day (by 0.1 - 0.2 degrees), a sharp rise in temperature (by 0.4 - 0.5 degrees) and subsequent temperature stay above 37 degrees (second phase). A sharp jump will be considered the day the egg leaves the Graafian vesicle. We mark this day on the calendar and also do not forget about 2 days before 2 days after.

Tests to determine ovulation

Special tests for identifying the ovulatory process can be easily purchased at any pharmacy (see). The tests are based on detecting high levels of luteinizing hormone in any biological fluid (blood, urine or saliva). Positive test indicates the release of a mature egg from the ovary and its readiness for conception.

Gynecological examination

When conducting a gynecological examination, the doctor can quite reliably identify signs of ovulation using functional diagnostic tests. The first is a method for determining the distensibility of cervical mucus. The forceps captures mucus from the external pharynx of the cervix, and then its branches are separated. If the mucus is viscous and the separation of the jaws reaches 10 cm or more, this is considered one of the symptoms of ovulation. The second is the “pupil method”. The increasing mucus in the cervical canal stretches it, including the external pharynx, and it becomes slightly open and round, like a pupil. If the external pharynx is narrowed and there is practically no mucus in it (“dry” neck), then this indicates the absence of ovulation (it has already passed).

Ultrasound – follicle measurement

This method allows you to determine with a 100% guarantee whether ovulation has occurred or not. In addition, using ultrasound folliculometry, you can create your own menstrual cycle schedule and ovulation calendar and find out whether it is approaching or completed. Characteristic ultrasound signs of upcoming ovulation:

• growth of the main follicle plus expansion of the cervical canal;
• identification of the main follicle that is ready to rupture;
• control of the corpus luteum, which forms at the site of the burst follicle, detection of fluid in the retrouterine space, which indicates ovulation has occurred.

Hormonal method

This method is based on determining the amount of estrogen and progesterone in the blood. The latter begins to be released in the second phase of the cycle, when the resulting corpus luteum begins to function. About 7 days after the egg is released from the ovary, progesterone in the blood increases, which confirms that ovulation has occurred. And the day before and on the day of ovulation, estrogen levels decrease significantly. The method is labor-intensive and requires repeated blood donations and finances.

Lack of ovulation

If there is no ovulation, this phenomenon is called anovulation. It is clear that in the absence of ovulation, pregnancy becomes impossible. It should be noted that a healthy woman of childbearing age experiences up to two to three anovulatory cycles per year, which is considered normal. But if there is no ovulation all the time, then they talk about chronic anovulation and one should look for the causes of this condition, since the woman is diagnosed with “Infertility.” Causes of chronic anovulation include:

• thyroid diseases;
• overweight or obesity;
• polycystic ovary disease;
• diabetes;
• lack of weight;
• hyperprolactinemia;
• ovarian dysfunction;
• chronic inflammation of the ovaries;
• endometriosis of the ovaries and uterus (hormonal imbalance in general);
• constant stress;
• excessive physical exercise(sports, household);
• harmful working conditions;
• pathology of the adrenal glands;
• tumors of the pituitary gland or hypothalamus and other pathologies.

The following factors can lead to temporary (transient) anovulation:

• pregnancy, which is natural, no menstrual cycle, no ovulation;
• breastfeeding (most often during lactation there are no menstruation, but there may be, but the cycle is usually anovulatory);
• premenopause (ovarian function is fading, so the cycles will be anovulatory rather than ovulatory);
• taking contraceptive pills;
• stress;
• following a specific diet for weight loss;
• increase in body weight or its sharp decrease;
• change of usual environment;
• climate change;
• change of usual working conditions.

If there is no ovulation, what should you do? First of all, you should consult a doctor who will determine what caused this condition and how serious it is (chronic or temporary anovulation). If anovulation is temporary, the doctor will recommend adjusting your diet, stopping worrying and avoiding stress, changing your job (for example, one involving night shifts to day shifts), and taking vitamins.

In case of chronic anovulation, the gynecologist will definitely prescribe additional examination:

• sex hormones (estrogens, progesterone, prolactin, testosterone, FSH and LH) and adrenal and thyroid hormones;
• Ultrasound of the pelvic organs;
• colposcopy (according to indications);
• hysteroscopy (according to indications);
• diagnostic laparoscopy.

Depending on the identified cause, appropriate treatment is prescribed, the final stage of which is stimulation of ovulation. Basically, clostilbegit or clomiphene are used to stimulate ovulation, usually in combination with gonadotropic hormones (Menopur, Gonal-F). Ovulation stimulation is carried out during three menstrual cycles, and if there is no effect, the stimulation cycle is repeated after three cycles.

Question answer

Yes, such online calendars are quite suitable for calculating ovulation days, but their effectiveness reaches only 30%, which is based on the calendar method for determining ovulation.

Question:
With an irregular cycle, will chronic anovulation necessarily occur?

Yes, irregular cycles are more often anovulatory, although this is controversial. Even if your periods “jump” every month, ovulation may occur, but, as a rule, not in the middle of the cycle, but at the beginning or end.

This method is unreliable and has not been scientifically confirmed, but there is a hypothesis that “female” sperm, that is, those that contain the X chromosome, are more tenacious, but slower. Therefore, in order to give birth to a girl, it is necessary to have sexual intercourse two to three days before expected ovulation. It is during this time that the slow X sperm will reach the released egg and fertilize it. If you have sexual intercourse at the peak of ovulation, then the fast “male” sperm will outstrip the female ones and you will have a boy.

I repeat, the method is unreliable. Spermatozoa containing the Y chromosome or “male” are more nimble and mobile, but are very sensitive to the acidic environment in the vagina, so sexual intercourse should take place on the day of ovulation, which must be confirmed by ultrasound. “Male” sperm, despite their activity, die very quickly, but if coitus took place on the day of ovulation, their death will not yet occur, and “male” sperm will reach the egg faster than “female” ones and fertilize it.

Question:
I play professional sports. Could this cause a lack of ovulation?

Certainly. Professional sports loads are very significant, which not only leads to persistent anovulation, but also to disruptions in the functioning of the hypothalamic-pituitary-adrenal-ovarian system. Therefore, you have to choose, either professional sports and fame, or the birth of a child.

A woman’s ability to become pregnant and bear a child is associated with many factors. This complex process is regulated not only by the ovaries or uterus, but also by the brain, adrenal glands, and thyroid gland.

The preparation of the female body for pregnancy is repeated monthly and is called the menstrual cycle.

Menstrual cycle

Cyclic changes in a woman’s reproductive system last from the first day of menstruation until the onset of the next menstruation. Ovulation occurs in the middle of the menstrual cycle. It represents the release of a mature germ cell from a ruptured follicle in the ovary and further movement into the fallopian tube through the abdominal cavity.

What happens after ovulation? If healthy sperm are present in the fallopian tubes, it means that after ovulation, fertilization is highly likely to occur.

Typically, the release of the egg occurs on days 12–14 of the menstrual cycle. But this is only possible if it is done regularly. If the cycle is irregular, or too short or long, ovulation may occur on other days.

If for some reason the egg is unable to leave the follicle, ovulation does not occur and fertilization is impossible. This situation in gynecology is called anovulation, and the cycle is anovulatory.

Anovulatory cycles

Anovulatory cycles can lead to permanent infertility. They can be periodic, rare or constant. Constant anovulation is called chronic, and it is almost always based on a pathological process in the female body.

Sometimes the lack of ovulation is due to external factors. In this case, after they stop, the normal cycle is restored on its own.

But there are also physiological anovulatory cycles, which are a kind of protective reaction of the body.

Physiological anovulation

The physiological absence of ovulation prevents pregnancy that is currently unwanted for a woman and protects the body from excess stress.

Normally, anovulatory cycles occur when:

• pregnancy;
• lactation;
• menopause.

Pregnancy and lactation

Since the simultaneous coexistence of two pregnancies is impossible, the female body is reliably protected from re-fertilization due to changes in hormonal balance. Physiological anovulation occurs after conception and continues until childbirth. It also protects a woman from pregnancy and breastfeeding.

But this method of contraception should be used with caution.

Physiological anovulation continues only with frequent and regular feeding - at least every 2-3 hours. Night breastfeeding is mandatory. But even in this situation there is no guarantee of reliable contraception.

The menstrual cycle can resume at any time. Moreover, you can get pregnant in the absence of menstruation, after ovulation, which precedes their appearance.

Climax

After 50 years, women experience postmenopause, which is manifested by constant age-related anovulation. The period from the last regular menstruation to its persistent absence is accompanied by periodic anovulatory cycles.

Their number gradually increases, and after 12 months the ability to ovulate is completely lost.

Anovulation associated with external factors

The absence of ovulation when exposed to external factors is usually reversible. This process is partly compensatory and protects the body from pregnancy under conditions of excessive stress or exhaustion. Typically, intense exercise and fasting lead to reversible anovulation:

1. Anovulatory cycles in female athletes are not uncommon. If physical activity continues to increase, menstruation also stops - amenorrhea develops. Pregnancy in this situation is impossible.
2. During fasting - forced, associated with fasting or illness - a similar process occurs. Periodic absence of ovulation is replaced by persistent absence and is accompanied by amenorrhea. When adequate nutrition is restored, the ability to release an egg is restored.

There is also artificially induced anovulation.

It occurs when using certain hormonal and contraceptive drugs. At the same time, the woman retains menstrual-like the reaction is monthly bleeding, but the ability to become pregnant is reliably blocked. When discontinuing hormonal contraceptives reproductive function the female reproductive system is restored.

Pathological anovulation

Pathological reasons for the lack of ovulation are most often associated with diseases of the genital organs or brain. Disruption of the interaction of these two structures also leads to blocking the release of the egg from the ovaries.

Most common diseases leading to pathological anovulation are:

1. Hyperprolactinemia.
2. Polycystic ovary syndrome.
3. Luteinization syndrome unovulated follicle.

In addition, many endocrine diseases lead to suppression of the release of a mature egg. These include low thyroid function, disease or Itsenko-Cushing syndrome, disruption of the hypothalamus and pituitary gland.

Hyperprolactinemia

Prolactin is a lactation hormone. Blocking the release of the egg is one of its functions. Exactly hyperprolactinemia explains why ovulation does not occur during lactation. An increase in the level of this hormone outside of breastfeeding is often the cause of female infertility.

Lead to hyperprolactinemia various reasons.

Some of them are secreted by stress, thyroid diseases, disorders hypothalamic-pituitary interactions, taking certain medications. Sometimes hyperprolactinemia is a symptom of a pituitary tumor - prolactinoma.

For this reason, all women with increased level prolactin levels are sent for brain examination.

Polycystic ovary syndrome

This is a neuroendocrine disease characterized by increased production of sex hormones and prolactin. With polycystic ovary syndrome, the following symptoms will be present:

• Scanty periods, even their absence.
• Anovulation.
• Obesity.
• Excessive body hair growth.
• Infertility.

The exact cause of polycystic ovary syndrome is unknown. But the probability of anovulatory infertility with it approaches 80–90%.

Luteinization syndrome unovulated follicle

This is a hormonal disease in which the normal menstrual cycle is imitated. On days 12–14, an increase in rectal temperature and a change in vaginal discharge.

But after “ovulation,” fertilization does not occur, because the direct release of the germ cell from the ovary does not occur. Due to normal level hormones, ovulation and a two-phase cycle are only simulated.

It is believed that luteinization syndrome unovulated follicle is a consequence of endometriosis.

Signs of an anovulatory cycle

The release of the female reproductive cell from the ovary on the 14th day of the menstrual cycle may be accompanied by abdominal pain and poor health. Also, on days 12–14, many women notice a change in vaginal discharge and an increase in rectal temperature.

If no changes occur within a month, an anovulatory cycle can be suspected. Signs of lack of ovulation:

1. Vaginal discharge is the same throughout the month.
2. When measuring rectal temperature on the 12th–14th day of the cycle, there is no rise.
3. There is no pain in the abdomen on days 12–14, if there was any before.

Also, signs of lack of ovulation include a sudden change in the nature of menstruation. Scanty or too copious discharge, their untimely onset allows one to suspect an anovulatory cycle.

Tactics for anovulation

Women often ask their gynecologist how to get pregnant if there is no ovulation. Without treatment this is impossible. Fertilization can occur only after ovulation, usually on days 12–16 of the cycle, since the lifespan of the egg is short.

Anovulatory cycles today are common cause of female infertility.

If pregnancy does not occur within a year, and there is suspicion of this pathology, a consultation with a gynecologist is necessary. It is he who will determine what to do if there is no ovulation.

With anovulatory cycles, it is very important to determine the cause of the disease. In most cases, such infertility is treatable.

Treatment

Treatment is selected only after the cause of this condition has been established. Main directions:

1. When exposed to external factors, you need to change your lifestyle - normalize your diet, reduce stress, stop taking contraceptives. Usually, after a couple of months, the menstrual cycle is restored, and after ovulation you can become pregnant.
2. At hyperprolactinemia medications are prescribed that suppress hormone production. If it is due to a pituitary tumor, surgery is sometimes recommended. At dishormonal diseases, corrective or hormone replacement therapy is prescribed.
3. Surgical treatment is also indicated in the case of polycystic ovary syndrome. After surgical intervention the likelihood of pregnancy increases sharply.
4. If anovulatory cycles are associated with endocrine diseases, then treatment should be carried out by a gynecologist-endocrinologist. With adequate selection of medications, the normal cycle is quickly restored.
5. If the cause of the disease cannot be influenced, gynecologists perform ovarian stimulation - Clomiphene, Puregon and other similar drugs. The probability of pregnancy after ovulation stimulated by drugs is quite high.

IN modern medicine lack of ovulation - no sentence. This is only a reason for a comprehensive examination. If the cause of anovulation is identified and adequately treated, pregnancy occurs within one to two years.

The word "ovulation" comes from the Latin "ovum" - "egg". Essentially, this is the release of a mature egg capable of fertilization from the ovarian follicle into the abdominal cavity.

In women of childbearing age, ovulation is periodic and occurs in the middle of the menstrual cycle, on days 12-18. The established rhythm of ovulation can change in certain cases: within three months after an abortion, within a year after childbirth and after forty years, when the female body is preparing for the premenopausal period. Knowing your ovulation date is important when choosing the most appropriate time for insemination, artificial insemination or in vitro fertilization.

Signs of ovulation

In some women, signs of ovulation may include short-term, menstrual-like pain in the lower abdomen. The main objective signs of ovulation are considered to be an increase in mucous discharge from the vagina, a decrease in rectal (basal) temperature on the day of ovulation followed by an increase the next day, an increase in progesterone in the blood plasma and a possible increase in sexual desire.

Timing of ovulation

The timing of ovulation is different for every woman. And even for the same woman, the exact timing of ovulation can vary from month to month. But in most cases, ovulation occurs in the middle of the menstrual cycle. In rare cases, women with very short menstrual cycles may ovulate at the end of their menstrual bleeding period.

How does ovulation occur?

In the female body, on both sides of the uterus, there are ovaries that produce the hormones estrogen and progesterone. Even at the stage of intrauterine development, the girl’s ovaries contain eggs. Thus, in the two ovaries of a newborn there are hundreds of thousands of eggs. But they all remain inactive until approximately 12 years of age, that is, until the moment of the first menstruation. By this time, despite the large number of dead cells, 300,000-400,000 full-fledged eggs remain in the girl’s body. From the moment of the first ovulation until menopause, a woman will have from 300 to 400 menstrual cycles, during which the same number of eggs will mature and are capable of fertilization.

During one menstrual cycle, one egg matures in the ovaries. The duration of maturation of the egg until its release from the ovary can last up to 90 days. The main factor in this process is the time it takes for the body to reach its estrogen threshold. Maximum estrogen stimulates a sharp increase in luteal stimulating hormone (LH), which causes the egg to break through the ovarian wall within one to two days after the sharp rise in LH. In the middle of the cycle, approximately 12 days after the first day of menstruation, the pituitary gland releases large amounts of luteinizing hormone and ovulation occurs approximately 36 hours later.

The next two weeks after ovulation (the second part of the cycle) are spent preparing the uterine mucosa to receive the fertilized egg. The whole procedure is useless if conception has not occurred, and the biological consequences of the preparation will pass along with menstrual bleeding. But at this time, in one of the ovaries a new egg is already preparing for “release”.

Lack of ovulation

Ovulation disorders are caused by dysfunction of the hypothalamic-pituitary-ovarian system and can be caused by many reasons, ranging from inflammation of the genitals to stress, and can sometimes be hereditary. Anovulation in medicine refers to the absence of ovulation during childbearing years.

Causes of ovulation disorders:

• Disease. Some diseases, inflammatory or infectious, can dramatically affect your menstrual cycle and ovulation. In this case, it is important in what phase of the cycle you got sick. If the disease occurs before ovulation, it may be delayed or not occur. If you get sick in the second phase of the cycle, then this will not affect ovulation in any way, since the egg has already been formed.
• Journey. Although most trips bring joy, sometimes the stress endured during the trip can increase the time it takes for ovulation to occur, or it may not happen at all.
• Weight gain or loss. It has been scientifically proven that in order for a woman to ovulate during her menstrual cycle, she needs to have at least 18% fat of her total body weight. The fact is that it is in fat that estrogen accumulates and androgen is converted, both of these hormones are necessary for ovulation. Very skinny women often stop menstruating, possibly because there is not enough estrogen in their body for the egg to mature and be released. Overweight also disrupts ovulation.
• Stress. Most common cause the increase or disappearance of the menstrual cycle becomes stressful. By affecting the cycle, stress delays ovulation and, as a result, prolongs the entire cycle as a whole. Under extreme stress, ovulation and menstruation may disappear altogether.

In a healthy woman, ovulation does not occur in every menstrual cycle, and the frequency of anovulatory cycles increases with age. So, for example, at the age of up to 30 years, 2-3 cycles per year without ovulation are possible; after 38 years, there are more anovulatory cycles, from 4 to 8.

Ovulation and pregnancy

The probability of conception is highest on the day of ovulation and is about 33%. On the day before ovulation - 31%, two days before it - 27%. Five days before ovulation, the probability of becoming pregnant is only 10%, four days - 14%, three days - 16%, six days before ovulation and the day after it, the probability of pregnancy is very low. Thus, in order for fertilization to occur, the sperm must enter the female body at approximately the same time that the egg leaves the follicle.

At first glance, it seems that this is easy to achieve, but the fact is that the average “life expectancy” of a sperm is 2-3 days, in rare cases – 5-7 days, a female egg is viable for about 12-24 hours, thus the maximum duration of the fertile period is only 5-6 days.

Methods for determining ovulation

There are several methods that allow you to accurately determine the moment of ovulation. The most reliable of them is ultrasound follicle monitoring (ultrasound), which allows you to monitor the growth and development of the follicle and determine the moment of its rupture. An ultrasound is performed approximately 8-9 days from the first day of menstruation to determine the dominant follicle, then on days 12-13 and 16-17.

Dynamic determination of luteinizing hormone (LH level) in urine. This method can be done at home using special ovulation tests. These tests are carried out 2 times a day 5-6 days before expected ovulation.

To effectively use the calendar method for determining the fertile phase or day of ovulation, it is necessary to observe at least 6-12 menstrual cycles. To calculate the “dangerous” period, it is necessary to identify the shortest and longest cycles over 6-12 menstrual cycles. From the total number of days of the shortest cycle, subtract 18 and get the day of the beginning of the “dangerous” period, and subtract 11 from the number of the longest cycle and find out the last day of the “dangerous” period.

The temperature method for determining the day of ovulation is based on daily measurement of basal (rectal) temperature. The fact is that at the time of ovulation, the temperature in the rectum decreases, and the next day it increases. To obtain accurate data, temperature measurement must take place for at least three months, and it is necessary to abstain from sexual intercourse in the first phase of the menstrual cycle, including the first three days of temperature rise after ovulation. The effectiveness of this method depends on the accuracy of determining the date of ovulation.

Cervical (cervical) mucus, located in the cervix, differs in quantity and consistency in different phases of the menstrual cycle. It is by this that the onset of ovulation is judged.

Lactational amenorrhea, or physiological infertility, is based on the physiological effect: while the baby is sucking at the mother’s breast, ovulation does not occur.

Julia Kim
Consultant: Lyudmila Arkadyevna Badelbaeva, gynecologist-reproductologist of the IVF Center Magazine "40 weeks. Pregnancy Calendar" No. 11 (42) November 2011

Lack of ovulation (anovulation) 2-3 cycles per year and not in a row is normal. Menstruation occurs as usual or with a slight delay. It will be possible to get pregnant only in the next ovulatory cycle. When planning, if there is no ovulation, others are first excluded possible problems with conception, and only after that drug stimulation is prescribed.

Signs of lack of ovulation

There are signs that there was no release of a mature egg in this monthly cycle.

• negative;
• the level of progesterone in the blood does not increase;
• The dominant follicle and corpus luteum are not visible on ultrasound;
• the consistency and amount of cervical fluid does not change;
• no jump three or more cycles in a row;
• no engorgement of the mammary glands, pain in the lower abdomen or ovaries;
• there is no increased sexual desire and brightness of sensations during sexual intercourse.

No increase in sexual desire in the middle of the cycle in the absence of ovulation

Do you have periods without ovulation?

If the maturation of eggs is disrupted, they are not released from the follicle, but menstrual-like bleeding persists. And although the growth of the endometrium in the uterus occurs as usual, the corpus luteum does not form during anovulatory cycles.

If the menstrual cycle lasts from 24 to 30 days and the period comes on time, the woman probably does not have problems with egg maturation. If menstruation has become more scanty, irregular, the cycle becomes shorter or longer, most likely these are anovulatory cycles.

In some women with ovulatory pathology, cycles not only become irregular, but also disappear completely. It is imperative to consult a gynecologist.

If ovulation does not occur: reasons for the absence

If a woman has lost ovulation, the reasons can be both physiological and psychological. Usually they are complex and require a delicate approach and mandatory examination and treatment by a gynecologist and psychotherapist.

Lack of ovulation during regular periods can be caused by:

• hormonal imbalances;
• acute mental trauma;
• physical overload;
• rapid weight loss or gain;
• poor nutrition, fad to diets;
• change of place of residence, work, study;
• climate change when moving to another country.

No ovulation due to excess weight loss

Healthy and young women may experience anovulatory cycles for reasons psychological nature. These could be financial, housing difficulties or family problems.

Disorders of the process of maturation and release of the egg are quite widespreadcommon, about 40% of married couples experience it. Some of these cases are related toindividual characteristics of the body and is of a variable nature. This phenomenon is temporary and should not cause any concern.

Ovulation disorders also occur due to gynecological diseases, hormonal disorders or congenital pathologies of the reproductive system.

Menstrual cycle without ovulation on basal temperature charts

A cycle in which a mature egg is not released due to hormonal imbalance - increased prolactin:

Below is a graph of the basal temperature of a woman on a strict diet:

Basal temperature chart - no ovulation due to excess weight loss

And this is the schedule for a woman with normal ovulation. During this cycle, the ovaries rested and there was no release of an egg. If repeated two to three times a year, it is considered normal and does not require treatment:

Anovulatory graph of basal temperature in a healthy woman

If there is no ovulation: what to do to get pregnant?

According to WHO, successful conception in a healthy couple should occur within a year of regular sexual activity without contraception. If pregnancy does not occur, a comprehensive examination of the husband and wife is necessary.

Anovulation is not always the root cause of infertility; perhaps it is, for example, the husband’s sperm has low rates of fertilizing ability of sperm. If the spouse’s spermogram is within the normal range, you need to look for the cause in a violation of female reproduction.

To determine the reasons for the lack of ovulation, a woman is diagnosed

Diagnosis of ovulatory function disorders:

1. The content of thyroid hormones, FSH, LH, progesterone and androgen on certain days of the cycle is determined;
2. On the 10th-14th day of the cycle, an ultrasound examination is performed to monitor whether the dominant follicle is maturing (folliculometry).
3. The doctor prescribes an ultrasound of the uterus and ovaries to determine the shape, size, condition of the uterine cervix and exclude polycystic disease. With successful ovulation on ultrasound, which is performed in the second phase of the cycle, one of the ovaries is visualized corpus luteum and free fluid in the retrouterine/retrocervical space.
4. The patency of the fallopian tubes must be determined (x-ray with the introduction of a contrast agent or laparoscopy);
5. Control measurements of basal temperature are prescribed within six months.

Problems with ovulation and their solutions

Restoration of ovulatory function is carried out as follows:

• if the cause is obesity or, conversely, very low body weight, then normalizing weight or changing the physical training regimen restarts the ovulatory process. BMI - from 18 to 29 (ideally up to 25) is a good indicator and ovulation is theoretically possible. A BMI of 30 or more must be reduced in order to become able to give birth to a child;

Norms for the percentage of fat in a woman’s body to normalize the menstrual cycle and restore ovulation

• correction and restoration of normal functioning of the thyroid gland and adrenal glands is carried out;

• according to indications, hormone therapy is prescribed aimed at reducing the amount of prolactin and the concentration of androgens in the blood plasma;

• a course of OK is prescribed most often for three months to give the ovaries the opportunity to rest and recover;
• a special diet and lifestyle changes are involved, which helps regulate ovarian function and promotes pregnancy naturally.
• Diagnostic laparoscopy helps not only to accurately determine the cause of anovulation, but also to correct the situation right on the spot (it was thanks to it that I became pregnant twice).

Often after withdrawal oral contraceptives ovulates two ovaries at once, which, under favorable conditions, leads to the birth of twins.

It often happens that a woman’s menstrual cycle proceeds without the maturation and release of the egg, that is, without ovulation, but bleeding still occurs on time. Menstruation without ovulation is not that uncommon. In healthy girls, not every cycle occurs with an ovulatory period.

According to statistics, in women after 35 years of age every second cycle occurs without ovulation, and by the age of 45, in almost all cycles, egg maturation does not occur, since their supply in the ovaries is depleted over the years.

If you have problems conceiving, you should consult a gynecologist.

The concept of ovulation is especially difficult for girls who have for a long time I can't conceive a child. It is during the period when the egg is released that a woman can conceive a baby. If ovulation does not happen, then there will be problems with pregnancy, even with regular sexual intercourse. The vital supply of eggs is stored in the ovaries. When the first menstruation arrives, female reproductive cells begin to mature, one per month, and sometimes 2-3. The mature cell ruptures the ovary and comes out to meet the male sperm.

The period of maturation and release of the female cell occurs approximately in the middle of the cycle, approximately 14 days before the arrival of menstruation. The day the cell is released is considered the most favorable for conception, so girls who want to get pregnant try to calculate this secret date as accurately as possible, because the viability of the egg remains throughout the day.

After leaving the ovary, the cell travels through the tube into the uterine cavity. Usually, sperm meets in the tubes and fertilization occurs. If this does not happen, the cell dies and then leaves the uterus along with menstrual blood. Sometimes double ovulation occurs, when both ovaries release an egg, but these are rather exceptional cases.

Anovulatory cycle

But it also happens that the onset of menstruation occurs, but there is no ovulation. In fact, the egg does not mature and is not released from the ovary in such cycles, which are also called anovulatory. Moreover, every month the patient’s periods come on time, i.e. their regularity and abundance do not change. Typically, anovulatory cycles are a consequence of hormonal dysfunction, which is characterized by loss of female cycle physiological rhythm due to the lack of an ovulatory period. It’s sad, but in most cases, infertility in girls occurs precisely against the background of a lack of ovulation. But it cannot be said that the lack of ovulation is associated specifically with pathology.

The length of each woman's cycle is individual.

The monthly cycle is formed by hormonal processes occurring in the ovaries, which mature along with the woman. When puberty occurs, the ovaries begin secretory activity, which ensures the maturation of eggs. Inside, the ovary is filled with small follicles containing an egg, which mature sequentially. During one menstrual cycle, only one (at most 2) egg has time to mature, although at the same time there are many cells in the ovary that are at different phases of maturity.

When the cell finally completes development, it loses the need for nutrition, so it destroys the wall and leaves the ovary to fulfill its purpose - to meet with sperm, be fertilized and form into an embryo, and then into a fetus. The period when a female cell is released is called ovulation. After release, the egg remains viable for one and a half to two days.

Signs of lack of ovulation

Women know that their periods should come regularly and monthly. At the same time, menstrual bleeding is always accompanied by painful sensations, unstable psycho-emotionality and weakness. But not only menstruation has a specific pattern, ovulation also has special signs.

1. During the ovulatory period, the nature of vaginal discharge changes, becoming viscous and transparent. They can come for three days, and then also suddenly disappear along with unpleasant discomfort. If these signs are absent, then it means there was no ovulation.
2. Uneven and jumping cycles may also indicate the development of pathology. If menstruation occurs twice a month or is absent for several months, then there is a real risk that the girl has anovulatory cycles.
3. Sometimes anovulatory cycles are characterized by unusual menstrual flow. The unusual nature may lie in the excessive profuseness or scarcity of bleeding, its duration (more than a week) or, conversely, its short duration (less than three days).
4. Basal values ​​are below 37°C. This sign is relevant for those patients who measure rectal temperature every day. Typically, gynecologists recommend performing such procedures on girls if they cannot conceive a baby for a long time. Measurements are taken at the same time, with one thermometer, immediately after waking up in the morning. A similar temperature jump during ovulation (above 37 degrees) is explained by the release of a female cell from the ovary; normally, the basal temperature is 36.6-36.8 ° C.

Well, a characteristic sign of anovulation is the absence of pregnancy even with regular sexual intercourse, which is caused by hormonal infertility. It is this factor that usually prompts girls to turn to a specialist in order to find out the reason for the absence of children.

I didn't ovulate, will I get my period?

You can’t take any medications yourself, it’s dangerous.

With a condition such as anovulation, there is usually an absolute absence of menstruation (amenorrhea) or scanty discharge (oligomenorrhea) lasting 2-48 hours. Also likely long delays followed by scanty bleeding. For some girls, their periods come as before, so they don’t notice any changes, which seriously complicates identifying the problem. In such situations, it is possible to establish the absence of ovulation only when planning conception, when the woman tries in vain to become pregnant.

The presence of menstrual bleeding depends on the thickness of the endometrial uterine layer. It is to this that the female cell is attached upon fertilization. If conception does not occur, the endometrial layer is rejected and leaves the uterus in the form of menstruation. The thickness of this layer is regulated by the hormone estradiol, with a deficiency of which the endometrium does not grow to the required size. As a result, periods become suspiciously scanty or absent altogether. It is considered quite normal if a woman has anovulatory cycles a couple of times a year.

Causes of anovulation

Female monthly cycle develops under the guidance of complex immune and endocrine, neuropsychic and cardiovascular processes, therefore, the factors leading to the absence of ovulation can be caused not only by abnormalities in the patient’s reproductive system and her genital structures. Anovulation is considered absolutely natural in menopausal patients, when the appendages stop functioning, and in adolescents, when ovarian function is just beginning to function fully.

Experts divide the factors for the development of anovulation into pathological and physiological. Pathological causes usually always cause a chronic absence of ovulatory processes and are caused by the development of some disease. And physiological factors are associated with natural events inside or outside the female body.

Physiological factors

Even intense physical activity or climate change, long travel and overwork can provoke disturbances in ovulatory processes. The absence of ovulation in patients taking contraceptive drugs is considered normal, since they suppress the processes of egg maturation. At long-term use Many girls experience a characteristic complication of oral contraception; after stopping these drugs, they live for another six months without menstruation and ovulation, unable to get pregnant.

Pathological causes

Anovulation is also caused by pathological factors, to which experts include various kinds of ovarian diseases such as tumor processes, congenital anomalies, inflammatory lesions, polycystic diseases, etc. Also provoked by the absence of ovulatory processes are hypothalamic-pituitary pathologies, accompanied by disturbances in hormonal secretion.

Thyroid diseases can also cause ovulatory disorders. The thyroid gland produces hormones that are important for the female body and regulate the reproductive activity of the body. In this case, regularity of the cycle may occur, however, ovulation will be absent. Typically, problems with the thyroid gland are caused by iodine deficiency, so girls planning to conceive need to take potassium iodide and add iodized salt to their food.

Pathologies of the adrenal glands can also serve as a factor provoking anovulation. After all, the adrenal glands synthesize sex hormones, therefore, when their functions are disrupted, a shift in hormonal levels occurs, leading to disruption of ovarian activity.

In the absence of the desired conception, it is necessary to undergo an examination to identify the origin of infertility. Depending on the reason for the absence of children, the doctor will select the necessary therapy.