Our ancestors determined the onset of pregnancy using folk signs. Accurate diagnosis of successful conception appeared only in the early 60s of the last century. The author of the now popular rapid test that measures the level of hCG in urine was the German scientist Sondek. And what signs of pregnancy will allow the expectant mother to guess about the birth of a new life without diagnosis?
Ovulation and timing of fertilization
OVULATION (from Latin ovum - egg) - the release of a mature egg capable of fertilization from the ovarian follicle into the abdominal cavity; stage of the menstrual cycle (ovarian cycle). Ovulation in women of childbearing age occurs periodically (every 21-35 days). The frequency of ovulation is regulated by neurohumoral mechanisms, mainly by gonadotropic hormones of the anterior pituitary gland and ovarian follicular hormone. Ovulation is promoted by the accumulation of follicular fluid and the thinning of the ovarian tissue located above the protruding pole of the follicle. of ovulation, which is constant for every woman, undergoes changes within 3 months after an abortion, within a year after childbirth, and also after 40 years, when the body prepares for the premenopausal period. Ovulation stops with the onset of pregnancy and after the cessation of menstrual function. Establishing the date of ovulation is important when choosing the most effective time for fertilization, artificial insemination and in vitro fertilization.
Signs of ovulation
Subjective signs of ovulation may include short-term pain in the lower abdomen. Objective signs of ovulation are an increase in mucous discharge from the vagina and a decrease in rectal (basal) temperature on the day of ovulation with an increase in it the next day, an increase in the content of progesterone in the blood plasma, etc. Ovulation are caused by dysfunction of the hypothalamic-pituitary-ovarian system and can be caused by inflammation genitalia, dysfunction of the adrenal cortex or thyroid gland, systemic diseases, tumors of the pituitary gland and hypothalamus, stressful situations. The absence of ovulation during childbearing age (anovulation) is manifested by a disturbance in the rhythm of menstruation such as oligomenorrhea (menstruation lasting 1-2 days), amenorrhea, and dysfunctional uterine bleeding. Lack of ovulation (anovulation) is always the cause of a woman’s infertility. Methods for restoring ovulation are determined by the cause that caused anovulation and require a visit to a gynecologist and special treatment.
How do the ovaries hurt?
Based on the nature of the pain and its location, the doctor can make an initial diagnosis and preliminarily determine why a woman’s ovaries hurt, referring her for the examination necessary in this case. The pain can be constant and short-term, aching and stabbing, dull and sharp, localized in the lower abdomen or radiate to the thigh, lower back, or perineum. Often painful sensations occur on the right or left side, indicating the location of the problem organ.
However, pain in the lower abdomen can easily be confused with appendicitis, diseases of the gastrointestinal tract or genitourinary system. Especially if it is periodic and manifests itself in different localizations - in the pubic area, on the right or left side and further up to the kidney. Only a specialist will be able to determine, for example, why the ovaries hurt before menstruation or why pain occurs after sex. Therefore, you should not postpone a visit to the doctor to determine the cause of the ailment.
Ovulation and contraception
Some women experience peak sexual arousal around the days of ovulation . However, the use of a physiological method of contraception from pregnancy, based on sexual abstinence during ovulation , is especially difficult for young spouses, whose frequency of sexual intercourse reaches a fairly high level. In addition, with strong love excitement and nervous stress, additional ovulation can occur (especially with episodic, irregular intercourse) and then not one, but two eggs mature in one menstrual cycle. This should be kept in mind when choosing one or another method of contraception.
Causes of pain in the lumbar area during ovulation
You can often hear from women that they have severe pain in the lower abdomen and lower back during ovulation. This complaint of patients who have undergone childbirth or surgery is considered the most common. Similar sensations also appear in the case of inflammation in the pelvic area, which the patient is not even aware of.
All three of these factors lead to thickening of the ovarian walls. Since the ovaries play a significant role during the ovulation period, due to damage to the follicle, the lady feels sharp pain in the lower spine and abdomen.
Timing of ovulation
It should be noted that different women have a noticeable difference in the timing of ovulation . And even for the same woman, the exact timing of the onset varies from month to month. Some women have extremely irregular cycles. In other cases, cycles may be longer or shorter than the average of 14 days. In rare cases, it happens that in women with a very short cycle, ovulation occurs around the end of the menstrual bleeding period, but in most cases, ovulation occurs quite regularly.
If for one reason or another ovulation does not occur, the endometrial layer in the uterus is thrown out during menstruation. If the fusion of the egg and sperm has occurred, then the cytoplasm of the egg begins to vibrate very strongly, as if the egg is experiencing an orgasm. Sperm penetration is the final stages of egg maturation. All that remains of the sperm is its nucleus, where 23 chromosomes are tightly packed (half the set of a normal cell). The sperm nucleus now quickly approaches the egg nucleus, which also contains 23 chromosomes. The two nuclei slowly touch. Their shells dissolve and their fusion occurs, as a result of which they are divided into pairs and form 46 chromosomes. Of the 23 chromosomes of the sperm, 22 are completely similar to the chromosomes of the egg. They determine all physical characteristics of a person except gender. The remaining pair from the egg always contains an X chromosome, and from the sperm there may be an X or Y chromosome. Thus, if there are 2 XX chromosomes in this set, then a girl will be born, if XY, then a boy.
After the egg is released
When lower back pain lasts no longer than two days, there is no need to worry. This process is considered completely normal. If the pain lasts longer, there is already a reason to consult a doctor. Prolonged discomfort often indicates the presence of such ailments:
- Cystitis. This condition is an inflammation of the bladder in which the patient experiences cutting pain while urinating. All this is accompanied by unpleasant sensations in the lower back.
- Inflammatory processes in the intestines. In this case, the symptoms differ from those observed with ailments associated with the reproductive system. In addition to pain in the lumbar region, a woman also feels discomfort during bowel movements.
- Cyst rupture. This condition is considered one of the most dangerous. It is always characterized by acute pain that is not easy to relieve.
- Inflammation of one or two ovaries. The sensation of pain in the ovarian area often appears. It is also accompanied by an increase in body temperature.
When the follicle is “destructed,” the discomfort may not stop. The reason for this is a disease that affects the musculoskeletal system. This moment should not be missed, because ladies, as a rule, do not think that scoliosis also makes itself felt during ovulation. The developing pathology of the spine entails a distortion of the internal organs located near the pelvis. And their incorrect position, in turn, leads to severe spasms during the transport of the egg through the fallopian tubes. And painful sensations appear after ovulation has passed.
Ovulation, conception and gender of the child
Research conducted at the National Institute of Environmental Health Sciences (North Carolina) has shown that not only the actual conception of a child, but also its gender depends on the time of conception in relation to the time of ovulation .
The chance of conception is highest on the day of ovulation and is estimated at approximately 33%. A high probability is also noted on the day before ovulation - 31%, two days before it - 27%. Five days before ovulation the chance of conception is estimated to be 10%, four days before ovulation is 14% and three days before ovulation is 16%. Six days before ovulation and the day after ovulation, the likelihood of conception during sexual intercourse is very low.
If we consider that the average “life expectancy” of sperm is 2-3 days (in rare cases it reaches 5-7 days), and the female egg remains viable for about 12-24 hours, then the maximum duration of the “dangerous” period is 6- 9 days and the “dangerous” period correspond to the phase of slow increase (6-7 days) and rapid decline (1-2 days) before and after the day of ovulation , respectively. Ovulation , as noted above, divides the menstrual cycle into two phases: the follicle maturation phase, which with an average cycle duration is 10-16 days and the luteal phase (corpus luteum phase), which is stable, independent of the duration of the menstrual cycle and is 12- 16 days. The corpus luteum phase refers to the period of absolute infertility; it begins 1-2 days after ovulation and ends with the onset of a new menstruation.
A little theory
Ovulation is the moment when the egg leaves the corpus luteum, ready to meet the sperm. This date occurs approximately in the middle of the cycle, 4-7 days after the end of menstruation.
If a woman's reproductive system is functioning normally, unprotected intercourse during ovulation will result in conception. The event can take place several days before the expected date: the activity and viability of sperm persists for three days.
The connection between the sperm and the egg occurs inside the woman’s fallopian tubes. It leads to the appearance of a special element - a zygote. From this moment on, the woman can be considered pregnant.
The resulting zygote actively divides, creating cells of the future embryo. The fifth day is considered the date of its transformation into a blastocyte. If at first the embryo floats in the fallopian tubes, now it tries to attach itself to the endometrium of the uterus. When this moment comes, a woman’s hormonal background changes, and she feels the first symptoms.
The stages of in vitro fertilization in our center are almost exactly the same, only the zygote is formed in the laboratory, under the supervision of specialists. The formed embryos are implanted into the uterine cavity, and a few days later the success of the procedure is determined.
The sooner a woman finds out about pregnancy, the better: any disturbances in the body’s functioning, improper regimen, or stress can negatively affect the development of the baby.
Symptom of embryo implantation - bleeding
Minor bleeding often occurs at the same time as menstruation. For this reason, it is easy to confuse both processes. Bleeding can be an early sign of pregnancy and occurs in one in three women. It occurs due to a disruption of the blood vessel wall at the moment when the embryo is implanted into the wall of the uterus. A symptom mistakenly associated with menstruation causes difficulties in calculating the due date.
It is also worth keeping in mind that bleeding occurs for other reasons during pregnancy. Some of them require immediate medical consultation, as they are dangerous to the health and even the life of the pregnant woman and fetus. An example is an ectopic pregnancy, which usually ends in miscarriage or rupture of the tube.
The role of the ovaries in the female body
In size, they are no larger than a peach pit. When there are no pathologies in the body, the left one is always somewhat smaller in size compared to the right one. This organ is a composite organ and is represented by a cortex and connective tissue. Disruption of these components causes general malaise and problems with the functioning of other organs of the female body.
Reproductive function of the ovaries
This paired organ plays a major role in the process of reproduction. After all, they are the ones who produce eggs, which, after fertilization by male sperm, give rise to the birth of a new embryo. They are located on both sides of the uterus, in the pelvic region. Immediately after fertilization, the ovulation process stops and the ovaries begin to produce a temporary protective layer for the future fetus - yellow bodies. However, this layer disappears after the formation of the uterine placenta. Usually replacement occurs after the first 20 weeks of pregnancy.
How does stimulation work before IVF: how many days does it last, what consequences can there be?
How long stimulation lasts for IVF depends on what drug is used and what protocol is implemented. Prevention of premature ovulation is important. This is achieved by suppressing the secretion of the preovulatory peak of luteinizing hormone. To block this process, drugs from 2 main groups can be used - gonadotropin-releasing hormone antagonists or agonists. The type of drug and the duration of its use determines how IVF stimulation occurs.
- Protocol for the use of gonadotropin-releasing hormone ANTAGONISTS. This group of drugs allows you to immediately stop the spontaneous synthesis of luteinizing hormone. It is prescribed approximately on the 6-8th day from the start of taking gonadotropins, which stimulate the growth and maturation of several follicles at once.
- Protocols for the use of gonadotropin-releasing hormone AGONISTS. There can be 3 types depending on the duration./li>
In the case of a “long” protocol, taking hormonal medications begins 1 week before the expected menstruation. This introduces the woman’s body into a state of short-term menopause and makes it possible to ensure that in the next menstrual cycle all follicles will be the same size (this process is called “synchronization of folliculogenesis”). After a menstrual-like reaction, the administration of gonadotropins begins, which stimulate the growth of follicles. Their puncture is carried out approximately after 3-4 weeks.
The “ultra-long” protocol does not differ in technology from the “long” one, except that the administration of agonists begins at least 2-3 months before the intended artificial insemination. This stimulation scheme is recommended for severe forms of endometriosis, when it is necessary to normalize existing disorders in advance.
All events develop in the same menstrual cycle, during which both gonadotropin-releasing hormone agonists and gonadotropins are administered. It takes about 2 weeks until the follicles are received.
Treatment in Reproductive
Reproductologists approach each case individually. To select the most suitable stimulation scheme, at the first stage a detailed examination of the woman is carried out. First of all, the ovarian reserve is assessed and a forecast of the ovarian response to stimulation is made. Depending on this, a specific protocol, drug and its starting dose are selected. At the same time, possible complications are prevented. In order to create the best conditions for the development of pregnancy, the optimal number of embryos is implanted. If a couple has genetic diseases, preimplantation diagnostics is performed. All this allows us to provide treatment as effectively and safely as possible.
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Ovarian stimulation drugs
At different stages of the procedure, different groups of drugs are used. Drugs similar to gonadotropins (recombinant or menopausal hormone) promote the simultaneous growth and maturation of several follicles. At this stage, reproductive specialists may encounter an unpleasant situation when the follicles begin to grow, but may “burst” ahead of time, i.e. premature ovulation occurs. To avoid this, the peak of luteinizing hormone is blocked. It is its rise in the blood that initiates the ovulation process. For the purpose of blocking, both agonists and antagonists of gonadotropin-releasing hormone can be used.
Against the background of hormonal therapy, the follicle continues to grow. When its size reaches 18-20 mm, ovulation inducers are introduced. They will help to finally prepare him for artificial insemination. Human chorionic gonadotropin most often acts as an inducer. After ovarian stimulation has passed, gynecologists prescribe progesterone preparations to successfully achieve and maintain pregnancy. They prepare the endometrium for embryo transfer. This stage is extremely important, because The resulting corpus luteum often turns out to be defective in stimulated cycles.
How to reduce pain in the lower abdomen during IVF?
The pain syndrome that occurs after in vitro fertilization causes discomfort, so the natural desire of patients is to reduce it. To do this, doctors advise adhering to the following rules:
- Avoid overwork. After IVF, the patient should not experience physical or emotional stress. She needs to be provided with proper rest and sleep; if she feels unwell, it is recommended to adhere to bed rest.
- Take walks in the fresh air. Physical inactivity is dangerous for pregnancy to the same extent as overwork. Therefore, a woman needs to take walks in the fresh air for at least an hour in comfortable shoes without heels. It is best to do this in quiet places - for example, in a park or square. Running, jumping, bending, squats, lifting even small weights must be completely avoided.
- Eat healthy foods. After IVF, you need to follow a special diet prescribed by your doctor. As a rule, it includes natural vegetables, fruits, dietary meat (chicken, beef, venison), and seafood. It is better to completely avoid spicy, smoked, and fried foods or limit their consumption as much as possible. It is also necessary to avoid foods that can increase gas formation - for example, legumes, cabbage, etc. Often after IVF, the lower abdomen hurts not because of the procedure itself, but because of digestive disorders.
- To refuse from bad habits. Cigarettes, alcohol, and psychoactive substances have a complex negative effect on the body of mother and child. In particular, they cause chromosomal mutations in the fetus, which can lead to frozen pregnancy or miscarriage. They can also provoke uterine spasms and, as a result, spontaneous abortion. Therefore, after IVF, bad habits must be completely eliminated, and in the presence of pathological addictions, undergo a course of treatment.
- Refuse sexual activity. During the first 5 days after IVF, you are prohibited from having sex or masturbation. Sexual arousal and orgasm cause intense contraction of the uterus, which can provoke rejection of the embryo at the implantation stage. After a medical examination has established successful and reliable implantation of the embryo in the endometrium, sexual activity can be restored, subject to the restrictions prescribed for any pregnancy (both natural and artificial).
- Avoid visiting baths, saunas and swimming pools. In these places there is a risk of infection with genital tract infections, which can cause inflammatory processes in the uterine cavity, thereby disrupting the process of embryo implantation. Also, high temperatures in baths and saunas provoke an increase in blood pressure, a deterioration in general health, threatening miscarriage.
The use of painkillers and other medications after IVF requires special attention. The physiology of in vitro fertilization differs from that of natural conception, therefore the use of medicinal analgesics during this procedure is prescribed only in the most extreme cases. As a rule, only natural-based painkillers (for example, valerian) are allowed in small doses. However, the decision in this case always remains with the doctor, who bases it on the results of a medical examination of the patient. If a woman has severe stomach pain after IVF, and the situation does not improve within a few weeks, he may also prescribe synthetic medications.
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How long does it take for an embryo to implant?
The onset of implantation occurs approximately on the 6-7th day from the moment of fertilization. Implantation of the embryo into the uterus takes up to several days. For this to happen, the mucous membrane must change its structure. Under the influence of female sex hormones, it becomes looser and more blood vessels appear in it.
At the first stage, the embryo comes into contact with the mucous membrane, and at the final stage it begins to grow into it. Thus, implantation is completed. Implantation of the embryo usually occurs between the 6th and 12th day of its development.
Why can your head, chest, or ovaries hurt when stimulated?
Taking hormonal drugs affects the synthesis of vasoactive substances. They dilate blood vessels, increasing the distance between cells. As a result, fluid flows more easily into the extravascular space. This leads to changes in the general condition against the background of stimulation performed within the framework of IVF protocols.
Dilation of blood vessels in the brain causes headaches. The release of fluid into the intercellular space in the mammary glands leads to compression of the nerve endings and the appearance of chest pain. The ovaries may hurt slightly even normally, that is, when there is no hyperstimulation syndrome. This is due to a hormone-mediated increase in blood flow in these organs. They increase in volume and compress the nerve endings. Such symptoms usually do not cause significant discomfort to the woman, so they do not require pharmacological correction.
When should you take a pregnancy test?
Many women who have been trying to get pregnant for a long time cannot wait for the desired two stripes. Despite this, you should wait until about 7 days after intercourse to take your first pregnancy test. If done too early, it will show a negative result. The best time to do a home test is when your period is expected - around 14 days from ovulation.
If you have any doubts, you should contact the clinic and donate blood to the laboratory for diagnostic tests to determine the level of human chorionic gonadotropin in the blood. The concentration of beta-hCG indicates with high accuracy what week of pregnancy a woman is in. In the case of in vitro embryo transfer, gonadotropin levels are also detectable even after a week.
The most reliable transfer result is possible approximately 10-14 days after the procedure.