47 Moleye Street, off Hughes Avenue, Alagomeji bus stop/off Herbert Macaulay Way By Total Filling Station, Yaba, Lagos, Nigeria

09060007645 08093177754

info@gcemhospital.com

Menstrual cycle/Basis of fertility..what do you know about this important cycle?

Kindly pay attension to key words as you read….

Reproductive cycle begins at puberty as the hypothalamus ( rgan within the brain) pulse Generator is activated.

Menstrual cycle are mostly irregular during the first 2yrs after first menses (Menachre) and 3yrs before cessation of menses( menopause)

Secretion from the brain( Gonadotrophin releasing Hormone (GnRH) guides secretion of Follicle stimulating hormone (FSH) and leutinizing hormone (LH)

The following hormone play vital role in maintaining regular mense/ fertility namely estrogen,progesterone norepinephrine, dopamine B- endorphin ,inhibit, Activin

GnRH must be released in pulsatile fashion( pulse like fashion)usually once between 60-90 minutes

Variation in pulse frequency of GnRH release alters the ration of FSH to LH. Increase frequency of GnRH like once in one hour is common in follicilar ( egg) development phase of menstrual cycle and result in follicular recruitment. While release of once in 2-3 hr is typical of luteal phase( second phase of menstrual cycle)

Menstrual cycle can be divided for convenience into 4 phases namely menstrual phase. .During the menses,follicular phase when follicle(eggs) are recruited ;ovulation phase..period surrounding ovulation and luteal phase ..from ovulation to onset of next mense.

Follicle(eggs) do not developed when the LH pulse decline to interval of less than 2-3 hrs. Also high and prolong GnRH exposure saturated GnRH receptors causing anovulation (no release of egg on that cycle) by down regulation.

Follicles are usually stored in a “resting pool”. Once they leave the resting state there is only two possibilities.. ovulation or altresia (dying off).Altresia account for more than 99% of follicular lost.

It takes average of 85 days ( about 3 completed menstrual cycle)for follicle to reach point of ovulation from the “resting pool”

Process of follicle (egg) generation ie folliculogenesis can be divided into 4 phases..namely recruitment selection, Dominance and ovulation phases.

Recruitment takes place between day 2,3 and 4 of mense (while you are menstruating) and by day 5,both menstrual flow( in most women) and follicular recruitment ends. In some women, this recruitment process is defective and contributes to infertility in some women

Dominant phase…Naturally except ovulation is induced( assisted)spontaneously multiple ovulation is atypical (rare) .The dorminant ( selected)follicle is selected early when it developed LH receptors while other follicles that started the journey dies off.

Selection..Usually Day 7 Mark’s the time when the influence of a single follicle creates an environment in which only it can adequately mature and be ovulated.

By Day 8,Selection end and maturation begins in preparation of ovulation.

While these are going on at the ovarian end, the Uterine lining that started 1cm will grow to a thickness of 8-10mm and by day 11,thickness will reach 16–20mm.while estradiol level( esttogen) reaches its peak of 24-36hrs before ovulation

When ovulation approaches around day 14 in a 28day menstrual cycle, blood supply to the ovary increase,the ovarian ligament contract, pulling the ovary closer to the fallopian tube ,so that when ovulated, it can enter the tube for transportation. .

Ovulation occurs 10-12hour of LH peak and 36 hours after the estradiol peak.The most reliable indicator for the timing of ovulation is the onset of the LH surge which begins 28-32 hrs before ovulation.

A defective luteal phase can contribute to infertility and early pregnancy wastage .This defect is becoming more common lately among women and greatly contributing to menstrual irregularity and infertility

After 2-3 days of tubal transport following sucessgul fertilization , the embryo enters the Uterine cavity on day 17 and will not be attached to the uterine epithelium( lining for2-3 days. The embryo is highly susceptible to injurious condition at this phase as other phase too

Implantation takes place between day 20-24 in a 28 day cycle.. Peak level of progesterone are seen between 8-9days after ovulation that corresponds to time of implantation of the fertilised embryo.

Human Chorionic Gonadotrophins (HCG)..Basis for pregnancy test is secreted from day 22 following invasion of the endometrium and HCG serves to rescue the corpus luteum and maintain function with secretion of progesterone until placenta ( tissue that is delivered after baby is delivered) start producing hormones to keep the pregnancy going..

Without fertilization and subsequent implantation,decreasing hormonal (steroidal) level leads to increasing coiling and vasoconstriction of the spiral arteries which supply the upper 2/3rd of the functional endometrium and fibrin thrombus accumulation within endometrial capillaries

Mense therefore ensures at day 28. Menstrual bleeding is controlled by the vasoconstriction of the ruptured basal arteries in the denuded basal layer. Defects in these area and clothing factors deficiency can result in heavy menstrual losses.

The basal layer is not shed and it is the from this layer that the uterus regenerates again and the cycle resumes back .

Clinical implication…All issue that relates to irregular menses, not ovulating in a menstrual cycle, infertility, prolong bleeding ,heavy flow and pregnancy wastages ( miscarriges) ,all have connection to improper functioning of the menstrual cycle and also form bases of treatments including infertility treatment

If you need further information and evaluation contact us on our various social handles facebook page: GCEM hospital,or visit wwwgcemhospital.com or follow me on Facebook Blessing Okangba; Instagram drokangba, Twitter drOkangbaBC .

I appreciate Vivian Lewis MD ; Landes Bioscience Vademecum

Dr Okangba Blessing

Consultant Obs//Gynae. GCEM Hospital

This Post Has 96 Comments

  1. Really brief yet explanatory. 👏🏿👏🏿👏🏿

  2. An insightful read!!.
    Thank you!

  3. Very brief yet explanatory.

  4. Apt and well explanatory to a layman

  5. Some really choice articles on this website , saved to favorites . Avie Meyer Adrianne

  6. Hi there! Someone in my Facebook group shared this website with us so I came to check it out. Rana Kristoforo Antonina

  7. At this time I am going to do my breakfast, after having my breakfast coming over again to read other news. Angele Sauncho Romona

  8. Hi there very cool blog!! Man .. Excellent .. Wonderful .. Vonni Rayner Koch

  9. Thanks to my father who told me on the topic of this webpage, this web site is truly amazing. Valery Murray Ulphia

  10. You have noted very interesting details ! ps decent site. Raquela Rowney Gino

  11. You made some nice points there. I looked on the internet for the subject matter and found most individuals will agree with your site.

  12. Hello! I could have sworn I’ve been to this blog before but after browsing through some of the post I realized it’s new to me. Anyways, I’m definitely happy I found it and I’ll be book-marking and checking back frequently!

  13. You made some nice points there. I looked on the internet for the subject matter and found most individuals will agree with your site.

  14. Hello! I could have sworn I’ve been to this blog before but after browsing through some of the post I realized it’s new to me. Anyways, I’m definitely happy I found it and I’ll be book-marking and checking back frequently!

  15. I conceive you have observed some very interesting points, regards for the post. Roselia Had Joete

  16. Quite informative, look forth to coming back again. Nike Jarred Kancler

  17. I think other website owners should take this internet site as an model, very clean and excellent user friendly style. Leodora Douglas Noami

  18. Piece of writing writing is also a fun, if you be familiar with then you can write otherwise it is complex to write. Shirl Randal Banky

  19. You made some nice points there. I looked on the internet for the subject matter and found most individuals will agree with your site.

  20. This is really interesting, You are a very skilled blogger.
    I have joined your rss feed and look forward to seeking
    more of your excellent post. Also, I’ve shared your website in my social networks!

  21. Thanks again for the blog post.Really looking forward to read more. Wilber Fleisher

  22. Hello, all the time i used to check web site posts here in the early
    hours in the morning, for the reason that i like to find out more and more.

  23. This is my first time pay a quick visit at here and i am in fact impressed to read all at
    one place.

  24. My spouse and I stumbled over here different web address and thought I might check things out.
    I like what I see so i am just following you. Look forward to
    looking over your web page yet again.

  25. Thanks for any other fantastic article. The place else may just anyone get that kind of information in such an ideal means of writing?
    I have a presentation next week, and I am at the search for such info.

  26. Spot on with this write-up, I absolutely believe this amazing site needs much
    more attention. I’ll probably be back again to see more, thanks for the information!

  27. What’s Taking place i am new to this, I stumbled upon this I’ve discovered It absolutely useful and it
    has helped me out loads. I am hoping to contribute & aid other users
    like its helped me. Good job.

  28. I think the admin of this website is genuinely working hard for his site, since here every
    material is quality based material.

  29. I would like to thank you for the efforts you have put in penning this blog.
    I really hope to view the same high-grade content from you later on as well.
    In fact, your creative writing abilities has inspired me to
    get my own blog now 😉

  30. I absolutely love your blog and find many of your post’s to be just what I’m looking for.
    Does one offer guest writers to write content to suit your needs?
    I wouldn’t mind creating a post or elaborating on some of the subjects you
    write with regards to here. Again, awesome web site!

  31. What’s up, I wish for to subscribe for this web site to take most recent updates, therefore where can i do it please help.

  32. Heya i am for the first time here. I found this board and I find It really useful & it helped me out much.
    I hope to give something back and help others like you aided me.

  33. Hello there I am so delighted I found your web site, I really found you
    by mistake, while I was researching on Aol for something else, Nonetheless I am here
    now and would just like to say many thanks for a fantastic post and a all round interesting blog (I also love the theme/design), I don’t have time to browse it all at the moment but I have
    bookmarked it and also added in your RSS feeds, so when I
    have time I will be back to read much more, Please do keep up the great
    job.

  34. Do you mind if I quote a couple of your posts as long as I
    provide credit and sources back to your website?
    My blog site is in the very same area of interest as yours and
    my users would truly benefit from some of the information you
    present here. Please let me know if this alright with you.

    Thanks a lot!

  35. You really make it seem really easy together with your presentation however I to
    find this topic to be actually something which I believe I’d never understand.
    It kind of feels too complex and extremely broad for me. I’m taking a look forward in your subsequent
    put up, I’ll attempt to get the dangle of it!

  36. Hello there! This article could not be written any better!
    Looking at this article reminds me of my previous roommate!
    He constantly kept preaching about this. I most certainly will forward this article to him.
    Fairly certain he will have a good read. Thanks for sharing!

  37. Excellent, what a weblog it is! This blog provides useful information to us, keep it
    up.

  38. Hello there, just became alert to your blog
    through Google, and found that it iss really informative.

    I am gonna watch out for brussels. I will be grateful if you
    contine this in future. Maany people will be benefited from your writing.
    Cheers!
    Roweer homepage cheap bed frames

  39. Hi there to every single one, it’s really a nice for me to pay a visit this web page, it contains precious Information.

  40. Hi there! Someone in my Facebook group shared this website with us so I came to
    take a look. I’m definitely loving the information. I’m bookmarking and will be
    tweeting this to my followers! Excellent blog and superb
    design.

  41. I just couldn’t go away your site prior to suggesting that I actually enjoyed the standard info a person provide to
    your visitors? Is gonna be back steadily in order to check out new posts

  42. Howdy! I simply want to give you a huge thumbs up for your excellent information you have got
    here on this post. I’ll be coming back to your web site for more soon.

  43. Good way of describing, and fastidious article to
    obtain data on the topic of my presentation topic, which
    i am going to deliver in university.

  44. I’m now not certain the place you’re getting your information, but
    good topic. I needs to spend some time studying more or working out more.
    Thanks for great information I used to be looking for this info
    for my mission.

  45. hello!,I like your writing very a lot! proportion we keep up
    a correspondence extra approximately your post on AOL?

    I require a specialist on this house to unravel my problem.

    Maybe that is you! Looking ahead to see you.

  46. Hi there I am so grateful I found your website, I really found you by accident, while I was looking on Bing for something
    else, Regardless I am here now and would just like to say kudos
    for a tremendous post and a all round exciting blog (I also love the theme/design),
    I don’t have time to read through it all at the moment but
    I have book-marked it and also included your RSS feeds, so when I have
    time I will be back to read a great deal more, Please do keep up the fantastic b.

  47. You really make it appear really easy together with
    your presentation however I in finding this topic to be actually one thing that I think I’d never understand.
    It seems too complex and very huge for me. I am looking ahead for your next publish, I’ll attempt to get the
    grasp of it!

  48. Really appreciate you sharing this blog.Thanks Again. Fantastic. Terrell Gaona

  49. I’ve learn some just right stuff here. Certainly value bookmarking for revisiting.

    I wonder how a lot attempt you put to create any
    such great informative website.

  50. Hello! I just want to offer you a big thumbs up for the great info you have got here on this post.
    I will be returning to your web site for more soon.

  51. I needed to thank you for this very good read!! I absolutely enjoyed
    every bit of it. I’ve got you book marked to check out new things you post?

  52. I just couldn’t leave your site before suggesting that I extremely loved the standard info
    an individual provide in your visitors? Is gonna be back regularly to check out
    new posts

    my web site best site

  53. Spot on with this write-up, I honestly think this website needs far more attention.
    I’ll probably be back again to read through more, thanks for the advice!

  54. My partner and I stumbled over here by a different web page and thought I should check things out.
    I like what I see so i am just following you.
    Look forward to looking into your web page yet again.

  55. I’m extremely impressed with your writing skills and also with the layout
    on your blog. Is this a paid theme or did you customize it yourself?
    Either way keep up the nice quality writing, it’s rare to see
    a great blog like this one today.

  56. What’s up, this weekend is nice designed for me, as this time i am reading this enormous informative piece of writing here at
    my home.

  57. This is really interesting, You are a very skilled blogger.

    I have joined your feed and look forward to seeking more of your
    excellent post. Also, I have shared your web site in my social networks!

  58. I’m excited to discover this page. I wanted to thank you for your time just for this wonderful read!!
    I definitely really liked every bit of it and i also have you saved to fav to see new
    things in your blog.

  59. It’s actually a cool and helpful piece of information. I
    am happy that you simply shared this useful info with
    us. Please keep us informed like this. Thanks for sharing.

  60. You should take part in a contest for one of the highest
    quality blogs online. I am going to recommend this site!

  61. I am really impressed along with your writing talents as neatly
    as with the structure for your weblog. Is that this a paid theme or did you customize it yourself?
    Anyway stay up the nice quality writing, it’s rare to peer a great
    blog like this one these days..

  62. First off I want to say excellent blog! I had a quick question in which I’d like to ask
    if you do not mind. I was curious to find out how you center yourself and clear your mind before writing.
    I’ve had a hard time clearing my thoughts in getting my ideas out.
    I truly do enjoy writing however it just seems like the first 10 to 15 minutes are usually wasted
    simply just trying to figure out how to begin. Any ideas or hints?
    Thanks!

  63. There is certainly a lot to know about this issue. I like all of the points you have made.

  64. You produce quality content, congratulations on this

  65. Just wish to say your article is as astonishing.
    The clearness in your post is just nice and that i
    could assume you are knowledgeable on this subject.
    Well together with your permission allow me to grab your RSS feed to keep updated with drawing close post.

    Thanks one million and please keep up the rewarding work.

  66. Pretty section of content. I just stumbled upon your site
    and in accession capital to assert that I acquire in fact enjoyed account your blog posts.
    Any way I’ll be subscribing to your feeds and even I achievement you access consistently quickly.

  67. Please let me know if you’re looking for a writer for your blog.
    You have some really great posts and I believe I would be a good asset.

    If you ever want to take some of the load off, I’d absolutely love to write some material for
    your blog in exchange for a link back to mine. Please shoot me an e-mail if interested.

    Many thanks!

  68. Superb post however , I was wondering if you could write a litte more on this topic?
    I’d be very grateful if you could elaborate a little
    bit more. Cheers!

  69. Thanks a bunch for sharing this with all of us you really
    understand what you are speaking about! Bookmarked.
    Please also talk over with my site =). We will have a hyperlink change arrangement between us

  70. You actually make it seem so easy with your presentation but I find this
    matter to be really something that I think I would never understand.
    It seems too complex and extremely broad for me.
    I’m looking forward for your next post, I will try to get the hang of it!

  71. Hello there, You’ve done a great job. I will definitely
    digg it and personally suggest to my friends. I am sure they will be benefited from this web site.

    Feel free to surf to my web page: 12bet

  72. Great goods from you, man. I’ve understand your stuff previous to and you’re just too magnificent.
    I really like what you have acquired here, really like what you are saying and the way
    in which you say it. You make it enjoyable and you still take care of to
    keep it wise. I cant wait to read far more from you. This is actually
    a tremendous site.

  73. Thank you, I’ve recently been looking for info about this topic for a long time and yours is the best I have found out till now.
    However, what in regards to the conclusion? Are you sure
    in regards to the source?

  74. It’s really a nice and helpful piece of info.
    I am glad that you shared this useful information with us.
    Please stay us up to date like this. Thanks for sharing.

  75. Pretty nice post. I just stumbled upon your blog and wished to say
    that I’ve truly enjoyed surfing around your blog posts.
    In any case I’ll be subscribing to your rss feed and I
    hope you write again soon!

  76. I don’t even know how I ended up here, but I thought this post was
    good. I don’t know who you are but definitely you’re going to a famous
    blogger if you are not already 😉 Cheers!

  77. My spouse and I stumbled over here from a different
    web address and thought I might check things out. I like what I see so
    now i’m following you. Look forward to looking at your web page repeatedly.

  78. I blog frequently and I truly appreciate your content.
    This article has truly peaked my interest. I am going to
    bookmark your site and keep checking for new details about once a week.

    I opted in for your RSS feed too.

  79. Amazing! Its really remarkable article, I have got much clear idea about from this article.

  80. Howdy! Would you mind if I share your blog with my facebook group?
    There’s a lot of folks that I think would really enjoy your content.
    Please let me know. Cheers

  81. May I simply just say what a relief to discover somebody who really knows what they’re talking about on the web.
    You actually realize how to bring a problem to light and make it important.
    A lot more people ought to read this and understand this side of the story.
    I can’t believe you aren’t more popular given that you surely have the gift.

  82. It’s going to be ending of mine day, except before finish I am reading this fantastic piece
    of writing to improve my know-how.

  83. We are a group of volunteers and opening a new scheme
    in our community. Your website provided us with
    valuable info to work on. You have done a formidable job and our whole community will be grateful to you.

  84. Hey! I’m at work browsing your blog from my new iphone 4!
    Just wanted to say I love reading through your blog and look forward to all your posts!
    Carry on the outstanding work!

Leave a Reply

Close Menu