After ovulation the cells of the follicular shell are luteinized and constitute Corpus Luteum which becomes the main source of hormones in the luteal phase. It produces increasing amounts of progesterone and estrogen with their peaks at the mid-luteal phase.
The continued production of estrogen throughout the cycle and addition of progesterone in the luteal phase causes changes in the endometrium and the uterine cycle responds accordingly. The thick secretory endometrium favors implantation. If conception, CL continues into the first trimester of pregnancy when the hormonal function is taken over by the placenta.
If conception, does not take place CL degenerates, hormones levels are dropped, endometrium looses its support, separates and is discharged along with blood as menstruation.
Reduction in levels of ovarian hormones also results in withdrawal of inhibition of Hypothalmo-Pituitary-Ovarian axis, gonadotrophins are released and the new cycle begins.
It is evident that ovaries and uterus are important reproductive organs and their functions are needed to be coordinated. Uterine cycle is totally dependent on ovarian cycle. Duration of menstruation in fact is the duration of ovarian cycle. Women lay great emphasis to it because it is the only evidence of their reproductive capabilities. Menstrual irregularities worry them. Menstrual disturbance unless due to organic lesion indicates an ovarian disturbance. If menstrual cycle is disturbed, women are extremely worried and insist on the correction of the cycle. It is not important. Important is ovulation without which woman can not conceive. Correcting these irregularities with synthetic ovarian hormones, blocks the ovulation. Menstrual disturbances do not need corrections unless bleeding is excessive or prolonged because that results in blood loss to cause anemia. For reproduction establishment of ovulation should be the aim.
Reproduction is a complex process. Fertility is the normal physiological function of the body like any other function. Most of the people who can not conceive are not suffering from any disease or ill health. There may be unresolved of complexities of reproduction which just needed the resolution.
In many couples, these simple facts are the reasons that the wife has not been pregnant. Probably the circumstances have kept the couple separate at the desired time. It demands that a few ova, generally accepted to be 12 should be exposed before embarking on investigations. The ova and sperms need good genetic constitution to perform their function before any other factor sets in.
Husband is fertile all the time if his testes function normally. The sperms are continuously shed from testes and stored in accessory organs from where they are ejaculated into the wife through coitus.
Modern technology gives hope to every individual to own a child. Once the reason is found there is a remedy available. Medical treatments help only limited couples. ART gives hope to all.
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