Expert guide on ovulation: What is pre-mature menopause or pre-mature ovarian failure? Signs you should watch out for

There are six days throughout a woman's menstrual cycle when intercourse can result in pregnancy and ovulation is a part of this cycle when the egg is released from ovary of the dominant follicle into the fallopian tube. It is important to track ovulation since it opens for a fertile window where the chances of conception are higher and his fertile window includes the five days leading up to ovulation and the day of ovulation.

Expert guide on ovulation:

Every woman possesses millions of eggs from menarche or the first period, through menopause or the last period but only one egg ripens each month so the menstrual cycle begins with the first day of the period, which is the formation of the uterine lining. The brain then releases the hormone FSH, which stimulates only one egg to develop despite the fact that we have millions of eggs and during the first 14 days, the egg generates the hormone oestrogen that works on the uterine lining, thickening it.

When the egg is ready to burst, another hormone called luteinizing hormone, or LH, is produced. In an interview with HT Lifestyle, Dr Kiran Coelho, Consultant, Gynaecology and Obstetrics at PD Hinduja Hospital and Medical Research Centre, Khar Facility, explained, “The egg ruptures and is picked up by the fallopian tube as a result of the LH surge. It will remain the following 24 hours in the fallopian tube. This is known as ovulation. For 72 hours, the sperms are capable of impregnating the egg. So, if the couple has previously had intercourse and the sperms are waiting, or if the couple has intercourse within the next 24 hours the egg will then be fertilised in the fallopian tube, resulting in pregnancy. However, in most cycles, the egg dies within 24 hours and the lining comes out in the form of the monthly period within the next 14 days. This is the menstrual cycle.”

She advised, “If the couple wants to conceive, they must know when ovulation occurs so that they do not miss the critical 24 hours. So, assuming one has regular cycles, ovulation normally happens 14 days before the next period. In a 28-day cycle, this equates to 10 to 14 days. This is the calendar method. Another way is determining the basal body temperature. There is a fertility thermometer that takes rectal temperature on a daily basis. Because of the LH impact, there is a one-degree increase in temperature following ovulation. So, when the temperature rises by one degree, it indicates that ovulation has happened.”

Dr Kiran Coelho added, “Then the third way is with ovulation induction kits which are very reliable and available in the market. One can test every day the urine for when the LH surge is detected. When the LH surge is detected, that’s the day ovulation will occur and the couple can have intercourse on that day. The fourth method is to do a follicular study using sonography. So one conducts the sonography on the 10th day of your cycle every other day after that, and the actual development and rupture of the ovulation is targeted by the follicle study. So these are the numerous methods for determining whether one is ovulating and, if so, when one is ovulating. Most women have a reproductive life span of 20 to 40 years. So, after the age of 30 to 35, ovulation becomes irregular, and beyond the age of 35 to 40, ovulation I t is quite irregular, and one may require ovulation induction medicine, in which medicines are administered to produce the egg to ripen it and to rupture.”

There is a test known as anti Mullerian hormone or AMH that may determine the amount of fertilisable eggs a female has or the ovarian reserve, which is the number of eggs capable of being fertilise. Dr Kiran Coelho elaborated, “With that test, a female can find out how fertile she is and how many eggs does she have. If a woman wishes to postpone pregnancy, she might undergo an egg freezing procedure. Younger women who do not wish to have children might undergo egg freezing, in which several eggs are simulated and then extracted and frozen. Embryos are created and IVF can be performed as and when a woman wishes to conceive.”

Bringing his expertise to the same, Dr Kshitiz Murdia, CEO and Co-Founder of Indira IVF, highlighted, “Ovulation usually occurs 13-15 days prior to the start of each cycle. However, much like menstruation, the timing of ovulation varies from person to person and cycle to cycle. If a menstrual cycle lasts 28 days, the ideal day for ovulation is around day 14. In order to track ovulation one can maintain a tracking calendar, take help of ovulation prediction kits and also look out for symptoms of ovulation like mild pain, increased libido, tender breasts and amount of vaginal discharge.”

He added, “With age at around 40 years of age, the consistency of ovulation and the risk of infertility gets impacted. As such, under such circumstances for a successful pregnancy one would have to undergo medical supervision. Depending on the diagnosis they may be advised egg freezing, cryopreservation, PGTA embryo preservation, IVF and IUI and other such infertility treatment procedures.”

Pre-mature menopause or pre-mature ovarian failure - Signs you should watch out for:

Though many individuals confuse the two, pre-mature menopause and pre-mature ovarian failure are not the same conditions. Dr Kiran Coelho shared, “When the ovaries stop functioning before the age of 40, this is referred to as premature menopause. In premature ovarian failure too, the ovaries cease to function. However, in premature menopause, a woman cannot become pregnant and has no ovulation, but in premature ovarian failure, she can be made to ovulate with medication.”

She pointed out, “Both conditions have the same symptoms. Oestrogen deprivation, hot flashes, irritability, irregular periods, lack of sleep, bloating, dryness of skin, frequent vaginal infections, loss of libido, dryness of vagina, painful intercourse, mood swings, frequent urinary tract infections, and, of course, infertility and irregular periods are among them.”