Understanding Your Menstrual Cycle: A Guide To Conception

Phases of the Menstrual Cycle

Menstrual phase (Days 1-5)

• The menstrual phase begins with the uterus shedding its lining. This results in menstrual bleeding.
• The shedding process is triggered by a drop in both oestrogen and progesterone.
• Symptoms like cramping, bloating, mood swings and fatigue are common during this phase.
• While this is not the most fertile phase, understanding the symptoms and your cycle begins here.

Follicular phase (Days 1-13)

• The follicular phase starts on the first day of menstrual bleeding and continues till ovulation.
• The pituitary gland releases follicle-stimulating hormone, which stimulates the ovarian follicles to grow.
• Oestrogen levels continue to rise during this phase, thickening the uterine lining for a potential pregnancy.
• In most cases, only one follicle becomes dominant and prepares for ovulation.
• This phase is variable and the length of this phase directly determines the cycle length of each woman.
• Fertility is not at its highest during this phase, however, conception can occur, especially in the five days leading up to ovulation.

Ovulation phase ( Around day 14 for a 28-day cycle)

• The dominant follicle releases a mature egg due to a surge in luteinising hormone.
• Ovulation typically lasts anywhere from 12 to 24 hours and is the most fertile phase in your cycle.
• Common signs you can watch out for to tell if you are ovulating include: an increase in cervical mucus, with a stretchy, egg-white consistency, a slight increase in basal body temperature, an increase in libido, mild pelvic pain (mittelschmerz) and breast tenderness. It is not important for all of these symptoms to be present, however, it is likely that you will notice a few.
• The egg travels down the fallopian tube where fertilisation may occur if it meets a sperm cell.

Luteal phase (Days 15-28 in an average cycle)

• The fertilised egg implants itself into the uterine lining around 6-12 days after ovulation, if conception occurs.
• If conception does not occur, progesterone and oestrogen levels drop again, leading to the start of the next menstrual cycle.
• Symptoms of this phase include bloating, intense fatigue, breast soreness, lack of energy and motivation, mood swings and an increase in appetite. It is important to note that symptoms can vary for every woman.
• The luteal phase is not particularly fertile, however, the first five days can be considered fertile and conception can occur during this time.

Tracking Your Cycle For Conception

• Calendar method: The calendar method requires you to track your menstrual cycle for several months so that you can identify ovulation and its symptoms and patterns. This method works best for women who have regular cycles. It may be less effective if your periods are irregular.
• Basal Body Temperature method (BBT): This method involves taking your temperature every morning before getting out of bed. A slight increase (0.2–0.5°C) indicates that ovulation has occurred. This method is most effective if used consistently over multiple cycles.
• Ovulation predictor kits: These tests detect the surge of luteinising hormone in urine within 24-36 hours. They are very useful for predicting the most fertile days with the highest accuracy.
• Observing cervical mucus: Cervical mucus is stretchy, slippery and clear right before ovulation. This texture is ideal for sperm movement. The mucus becomes thick and less fertile.

Factors Influencing Menstrual Cycle and Fertility

Age and ovarian reserve:

• Fertility declines with age, especially after the age of 35 since women are born with a finite number of eggs.
• Ovarian reserve tests like AMH, FSH, and antral follicle count can help determine the egg supply.

Lifestyle factors:

• Diet: A balanced diet rich in essential nutrients like vitamins, minerals and healthy fats promotes fertility.
• Exercise: Moderate exercise done regularly can promote hormonal balance, but excessive exercise can disrupt hormonal balance and pause ovulation.
• Stress: Chronic stress can disrupt ovulation and hamper fertility.
• Sleep: Poor sleeping habits can impact hormonal balance and fertility.

Medical conditions:

• Polycystic Ovary Syndrome (PCOS): PCOS can cause irregular ovulation and hormonal imbalances.
• Endometriosis: Endometriosis might affect egg quality and implantation.
• Thyroid disorders: Thyroid disorders such as hypothyroidism and hyperthyroidism may disrupt menstrual cycles.
• Luteal phase defects: Inadequate amounts of progesterone produced in the luteal phase might prevent implantation.

Birth control history:

• Irregular periods: Some women can experience irregular periods after stopping birth control.
• Taking time: It might take some time before the periods normalise.

When to Seek Medical Help

• Irregular or absent periods: If your cycles are consistently shorter than 21 days or longer than 35 days, they can be considered irregular. Additionally, if your periods are heavy, painful or absent, you must consult your doctor.
• Difficulty conceiving: If you have been trying to conceive without any success and are under 35, you should seek medical advice within twelve months of trying. If you are over 35, consult a doctor after six months of trying. For women who are 40 or above, it is best to seek medical help immediately.
• Signs of underlying reproductive issues: Symptoms like severe pelvic pain, unexplained weight loss or gain, abnormal hair growth or a history of miscarriages can often be a sign of an underlying reproductive condition. If you have any of these, it is important to consult your doctor immediately.

FAQs on Understanding Your Menstrual Cycle: A Guide To Conception

1. Can I get pregnant during the follicular phase?
   The last few days of the follicular phase can be fertile, however, the ovulation phase has the highest fertility.
2. Can I get pregnant if my periods are absent or irregular?
   It is possible to conceive with irregular periods, as long as you consult your doctor on time. With absent periods, you may need to consult a fertility specialist and undergo some treatments.