Fertility

Fertility—in its broadest sense—for women means being able to become pregnant and to deliver a baby.Too often in thinking of fertility we ignore men’s important part in this process; problems with a man, although less well documented, likely account for half of all infertility.Fertility in women requires a lot of things to be optimal—we require normal anatomy (ovaries, open and working fallopian tubes, uterus, cervix and vagina), regular menstrual cycles (having enough estrogen) and ovulation (egg release) providing an egg that can be fertilized. In addition, the corpus luteum from which the egg is released needs to provide enough progesterone and keep providing it for at least 12 days (so that the endometrium will be prepared for the fertilized egg to implant). Obviously we have to be interested in and have sex at the right time in the cycle. We are usually most fertile from the start to the end of stretchy midcycle mucus. It is essential also to have normal immune function that is compatible with the sperm so that the egg doesn’t block sperm fertilization and so that the fertilized egg is not blocked from implanting into the uterus. After all that, the corpus luteum needs to continue to make enough progesterone to support the implanted egg until about 12 weeks into the pregnancy at which time the placenta takes over making progesterone.Thus fertility is a multi-organ, multi-system complex process that usually works quite normally.