QuestionHi,
I am writing from Malaysia.
My wife, age 31, has been experiencing irregular cycles for the past 2 years. After further consultation with a fertility expert here, she was placed on Chlomid and another hormon based medication (I can't recall the name)to regularize her cycles and also spur ovulation as initial tests and scans seemed to suggest that the ovaries were not ovulating. The medications seem to be effective and for the past 2 months, we had gone through 2 cycles where follicles were present and based on scans and measurement of the follicles, our doctor would advise on the fertile day(s). My questions are:
Is this method of approximating the fertile day accurate?
How long can the sperms last in the cervix?
How long does the fertile window last once the follicles are "riped"?
My apologies if my terminologies are inaccurate. Appreciate your feedback. Thanks.
Rgrds
Andrew
AnswerHello Andrew,
It sounds like your wife has an ovulatory disorder, whereby ovulation does not occur. The most common disorder in this regard is called "polycystic ovarian disease". The appropriate first line treatment is a medication called Clomid, which causes the brain (pituitary) to stimulate the ovary harder and induce ovulation.
Your doctor is treating you appropriately by doing serial ultrasounds to see if you are responding to the medication and to time ovulation. Basically, when the dominant follicle (s) become 18-22 mms in average diameter, it is time to trigger ovulation. We usually use a medication called HCG (ovidrel) to trigger the ovulation. I then have my patients have intercourse for four consecutive days (once only per day). This is your fertile period, which ranges from 24-50 hrs. There is no way to know exactly when ovulation is going to occur, and that is the reason for the serial intercourse. (By the way, you should have stopped having routine intercourse on cycle day # 10, until the fertile period). Once ejaculation occurs, the sperm last for less than 24 hours i.e. it only has this amount of time to fertilize the egg. In addition, it is known that the sperm needs to be present prior to ovulation for pregnancy to occur. Once ovulation occurs, there is only a 12 hour window for the sperm to fertilize the egg.
I hope this answers your questions.
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
