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Female Reproduction

Understanding female reproduction helps us understand what needs to go right in order to become pregnant and also what can go wrong and how we can treat it.

We all learn about the “birds and the bees” as a child in school. But, we are woefully unprepared for when pregnancy doesn’t come easily. Having a deep understanding of male and female reproduction and the many things that have to go right in order to become pregnant helps us realize that getting pregnant really is a miracle.

The main factors of female fertility are:

  1. Egg quality and production
  2. Fallopian tubes
  3. Uterine condition
  4. Endocrine system

How do I know I’m ovulating?

A woman will never produce more eggs than she is born with – about 1-2 million. By the time a woman reaches menopause, she may have only a few hundred eggs left. So, age is a very important factor in female fertility. 

Eggs are referred to as oocytes, ovum or gametes. It is huge compared to the sperm that tries to fertilize it in order to produce children. If a woman is not ovulating, she will not be able to become pregnant. So, one of the first things we determine is whether a follicle is growing each month. A follicle forms around the egg each month and enlarges during the cycle until finally it releases the egg into the fallopian tube where it can be fertilized by a sperm.

How do I know my fallopian tubes are clear?


If there is an issue in the fallopian tube such as scarring or something blocking the sperm from reaching the egg, then obviously there is no chance of becoming pregnant. To determine whether both fallopian tubes are open, a fertility specialist will order a simple x-ray called a hysterosalpingogram (HSG). This is a simple test performed at an imaging center and is relatively painless and quick.

Can I be sure a fertilized egg can implant in my uterus?

Once the egg has been fertilized, it needs to implant into the lining of the uterus where it will grow into a baby. Implantation will be interfered with if the uterine lining is too thick or too thin, has abnormalities, scarring, fibroids or polyps. Medications or routine surgery can eliminate uterine issues keeping you from successfully becoming pregnant.

The Endocrine System

A woman’s endocrine system secrets hormones into the circulatory system to be carried into the appropriate destination in the body.  Specifically, the ovaries produce progesterone and estrogen, which regulate the menstrual cycle and play a crucial role during pregnancy. And, the pituitary gland regulated sex hormones through the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). FSH stimulates ovarian follicles to mature in the ovaries. LH helps in ovulation.