Essentially, the female reproductive system includes the organs in the body that make it possible for a person to conceive and deliver a baby. These organs include the vagina, cervix, uterus, fallopian tubes and ovaries. Working together, these organs help women menstruate.
From puberty to menopause, most women experience monthly menstrual cycles where an egg is released from a follicle in the ovaries each month. This occurs on average every 28 days but can be anywhere between 21 to 35 days. Around halfway through your cycle, an egg is released from your ovaries, known as ovulation. It occurs around 14 days before your period starts. This also marks your most fertile time.
Menstruation occurs if the egg isn’t fertilised, where the lining of your uterus, along with blood, mucus and tissue, sheds through your vagina.
During your cycle, you’ll go through a follicular phase, which starts on the first day of your period and ends the day you ovulate. A hormone called follicle-stimulating hormone (FSH) stimulates your ovaries to produce follicles of immature eggs. During a normal cycle, only one or two eggs will mature, which sets a surge of oestrogen that thickens the uterine lining, creating a nutrient-rich environment for an embryo to grow.
The rise in oestrogen levels triggers your pituitary gland to release a luteinising hormone (LH), which starts the ovulation phase. Ovulation lasts about 24 hours and is the process whereby your ovary releases a mature egg that travels down the fallopian tube, where it can be fertilised by sperm.
The last phase in the menstrual cycle is the luteal phase. After the follicle releases its egg, it becomes the corpus luteum. The primary purpose of the corpus luteum is to pulse out hormones, including progesterone, which is required for a viable pregnancy to occur and to continue. If your egg is fertilised by sperm, your body will produce human chorionic gonadotropin (hCG), which is the hormone that pregnancy tests detect.
If you are not planning a pregnancy, or if you were unsuccessful in conceiving, the whole process starts again.
The rise in oestrogen levels triggers your pituitary gland to release a luteinising hormone (LH), which starts the ovulation phase. Ovulation lasts about 24 hours and is the process whereby your ovary releases a mature egg that travels down the fallopian tube, where it can be fertilised by sperm.
The last phase in the menstrual cycle is the luteal phase. After the follicle releases its egg, it becomes the corpus luteum. The primary purpose of the corpus luteum is to pulse out hormones, including progesterone, which is required for a viable pregnancy to occur and to continue. If your egg is fertilised by sperm, your body will produce human chorionic gonadotropin (hCG), which is the hormone that pregnancy tests detect.
If you are not planning a pregnancy, or if you were unsuccessful in conceiving, the whole process starts again.
You can come off birth control any time you’re ready and you don’t need to wait to start trying to conceive.
It’s normal for your periods to vary slightly once you’ve stopped contraception, however it is still possible to conceive during this time. Tracking your ovulation may be a little challenging due to the changes in hormones but this should settle over the following few months.
By tracking your ovulation cycle, you can better understand your fertile window.
To do this, first work out the length of your menstrual cycle – this is from the first day of your period to (but not including) the first day of your next period. Next, subtract 14 from the total number of days in your cycle. This will be your average ovulation day. There are also apps you can use to help track your cycle.
Another way you can keep track of your ovulation is by being aware of the physical cues. These can be breast tenderness, increased temperature, or by your vaginal mucus. Just before ovulation, you’ll notice a change in your vaginal discharge where it becomes clear and slippery, almost like egg whites. This is your body’s way of telling you it’s in prime fertilisation mode. And after ovulation, you’ll notice another change where it becomes thicker and off-white in colour.
Your ‘fertile window’ depends on the length of your menstrual cycle, which varies among women. It includes the five days leading up to, and the day an egg is released from your ovary.
This is the time when you’re most likely to conceive, which is good to know so you can time sexual intercourse on the days surrounding. It’s recommended to have sex every two days during ovulation. After intercourse, sperm can survive and fertilise for two to three days in the fallopian tubes.
Everyone is different, and it’s a personal choice when you feel ready to seek help.
For some guidance, the technical definition of infertility is being unable to fall pregnant after:
Whenever you feel ready to talk about your fertility health, we’re here for you.
Around 1 in 6 couples experience fertility issues, so it’s more common than you may think, and about 40% of infertility amongst couples is from female-related factors.
A woman’s age plays an important part when it comes to your chances of conceiving.
You’re born with all the eggs you’ll have in your lifetime, and your eggs will age as you do. This means that as you age, the quality and quantity of your eggs decreases, meaning your chances of getting pregnant declines.
On average, a woman in her early to mid-20s has a 25-30% chance of getting pregnant in a monthly cycle. Fertility will start to decline in her early 30s. From 35 to 40, this decline speeds up, and by the age of 41, the chances of getting pregnant in a monthly cycle is only 4%.
While your health and fitness can improve your chances of getting pregnant and having a healthy baby, it doesn’t override the effects that age has on female fertility.
The fallopian tubes connect the ovaries to the uterus. These can become blocked from issues such as infections, a sexually transmitted infection (like chlamydia), previous surgery, or endometriosis.
Blocked fallopian tubes can prevent sperm from meeting an egg and fertilising it, and is a common cause of female infertility.
Performing laparoscopic surgery to remove the blockage may allow for a natural pregnancy. If surgery is not viable, then IVF is an option as this bypasses the fallopian tubes, allowing pregnancy to occur.
Endometriosis is a progressive and chronic condition, meaning it gets worse over time. 1 in 7 women live with endometriosis and it’s often not diagnosed until you struggle to conceive.
Endometriosis is when body tissue like the lining of the uterus grows in other parts of the body where it is not meant to. It can affect the ovaries, pelvic lining, uterus and fallopian tubes. Tissues can become irritated and form scar tissue and bands of fibrous tissues can form and cause organs to stick together. It can also cause fertility problems.
Treatments for endometriosis can be as simple as medication, however, if you are trying to fall pregnant, we may possibly recommend laparoscopic surgery to remove as much of the disease as possible, increasing your ability to conceive.
Up to 80% of women of reproductive age experience fibroids, and certain types can affect fertility.
Fibroids are benign growths that can form in your uterus. While generally they are non-threatening, they can impact your ability to conceive.
The type, location and size of your fibroid will determine your treatment. You may not require any treatment, however, if it is affecting your fertility, you may require a hysteroscopy or laparoscopy for it to be removed.
PCOS is a complex hormonal condition that affects around 10% of women. It can cause small cysts to grow in the ovaries preventing follicles from growing and maturing.
PCOS affects ovulation which can result in irregular or absent periods. It can also cause dark, thick hair growth, acne, issues with sugar metabolism and often weight gain.
Treatments include insulin-sensitising agents, ovulation-inducing medications, FSH injections and weight reduction.
Polyps are abnormal tissue growths. There are two types that relate to female fertility, Uterine Polyps; which can be found in the lining of the uterus, and Cervical Polyps; which occur on the cervix.
Polyps can affect fertility by obstructing your fallopian tubes, interfering with a fertilised egg implanting in the uterus, and it can affect the uterine environment, which can influence embryo implantation and foetal development.
Removal of polyps is commonly done via a hysteroscopy, polypectomy or by medication.
PID is an infection of the reproductive organs, including the uterus, fallopian tubes and ovaries, that can cause inflammation, scarring and damage to the organs. It is often caused by sexually transmitted infections (STIs) like chlamydia and gonorrhoea, as well as bacterial vaginosis.
Along with damaging the organs, PID can also raise the risk of ectopic pregnancies, where a fertilised egg implants outside of the uterus, often in the fallopian tubes. It also causes chronic pelvic pain.
Early treatment for PID is crucial to prevent long-term complications and generally involves antibiotics to treat the infection. If undiagnosed, scarring and damage may impact your ability to fall pregnant and fertility treatments like IVF may be required.
While the average age of menopause is 51 years, there are a number of women who start experiencing menopause symptoms in the late 30s and early 40s. If a woman’s ovaries stop working properly before the age of 40, it’s known as premature ovarian failure.
Perimenopause is the lead up to menopause where your body’s getting ready for the next ‘phase’, causing periods to become less frequent, ovulation to be erratic and oestrogen levels to decline.
While it is still possible to get pregnant during this stage, it’s less likely, may take longer, and often requires the help of fertility treatments.
There are various medical conditions that can impact your fertility, from issues with your reproductive system to the effects of cancer.
There are cancer treatments that can cause problems with female fertility or carrying a pregnancy. It’s advisable to speak with your oncologist to understand the risks and effects your cancer treatment can have on your fertility.
The effect your cancer treatment may have on your fertility depends on factors including the age at the time of your treatment, the type of cancer you had, the treatment you underwent, the duration and dose of your treatment and the amount of time that’s passed since your treatment. Cancer treatments may harm your reproductive organs and the hormones that control fertility.
For example, chemotherapy can affect the ovaries, causing them to stop releasing eggs and producing oestrogen. Hormone therapy to treat cancer can disrupt your menstrual cycle.
Radiation therapy, specifically around the abdomen, pelvis or spine, can harm reproductive organs. Radiation therapy to the ovaries can cause ovarian insufficiency, to the uterus can affect blood flow, or to the brain can harm the pituitary gland, which signals the ovaries to make the hormones needed for ovulation. These can be temporary or permanent symptoms of your treatment.
We strongly advise women who have been diagnosed with cancer to consider egg freezing before they start treatment. This form of fertility preservation means that after your treatment, you still have the chance to create a family with your healthy, preserved eggs.
There are everyday lifestyle factors to take into consideration that may affect fertility health as well as your overall health.
Smoking & vaping
Drug use
Excessive alcohol
Being overweight
Being underweight
Having a fertility test is a good place to start when you’re venturing into your fertility journey.
A fertility test can help you make informed decisions and understand your fertility health. It may include several tests, from assessing your medical history to testing for genetic diseases.
It’s an important part of the process to create a personalised treatment plan that suits your specific female fertility needs.
Fertility treatments can range from simple interventions like medications to help ovulation to assisted reproductive technologies (ART), where medical and scientific methods are used to help you get pregnant.
There are different reasons why fertility treatments may be used, including:
Your treatment plan is tailored to you depending on your specific needs.
If you’re having issues with your ovulation, you may need an ovulation induction (OI) treatment, which will stimulate follicle growth.
If you’re struggling to get pregnant through sexual intercourse, there are ART treatments that can be used. These treatments include intra-uterine insemination (IUI) and in-vitro fertilisation (IVF) with or without intracytoplasmic sperm injection (ICSI) – sperm injection directly into the egg.
Because ARTs are done in a clinical setting, there are ways we can pick and choose eggs and sperm that are the best quality and most likely to fertilise.
Induced ovulation involves medication to create a more certain ovulation period, giving you a better chance of conceiving.
IUI is a simple option that involves placing sperm directly into the uterus around the time of ovulation.
After a course of hormone stimulation, eggs are collected and combined with a sperm sample in our lab in an attempt at fertilisation.
ICSI uses a more technical and delicate procedure to inject a single sperm directly into an egg.
PRP is used in fertility to improve the ability to produce healthy eggs or to increase uterine lining thickness.
Anyone can struggle with fertility issues, but it doesn’t have to mean that you won’t be able to fulfil your dreams of creating a family. Our fertility team works to understand the underlying cause of your fertility challenges and discusses this with you in a way you’ll understand. We then work together to develop a personalised treatment plan that works for you.
For more information on female fertility or to book an appointment with one of our fertility specialists in Melbourne, please contact our friendly team.
We look forward to being part of your journey.
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