Infertility Frequently Asked Questions

What is the normal process of conception?

For a couple to conceive, several biological processes need to take place successfully and at the right time. The following steps are necessary for conception to take place.

1. During her menstrual cycle, a woman's hormones stimulate the growth, maturation, and release of an egg from her ovary. This process begins when the hypothalamus signals the pituitary gland to send a hormone known as follicle-stimulating hormone (FSH) to the ovaries, prompting them to prepare an egg for ovulation. The FSH stimulates a group of follicles to grow on the surface of the ovary.
2. Over the next two weeks (the follicular phase of the cycle), the eggs mature and levels of estrogen, which is produced by the ovaries, increase.
3. As the estrogen levels increase, the pituitary gland decreases its production of FSH, and LH (luteinizing hormone) production is then triggered. The cervix begins to produce fertile alkaline mucus to help keep potential sperm alive and to speed their transport.
4. The LH production peaks, signaling the ovary to release a mature egg (usually only one) from its follicle in a process known as ovulation. The egg enters and begins to travel through the fallopian tube. The egg remains viable for about 24 hours.
5. For fertilization to occur, a sperm must locate and penetrate the awaiting egg while it is in the fallopian tube. If fertilization occurs, the fertilized egg, or embryo, continues to travel down the fallopian tube into the uterus.
6. On approximately the seventh day following fertilization, the embryo develops chorionic villi, which are special protrusions on its surface that enable it to attach, or implant, in the lining of the uterus.
7. The chorionic villi produce a hormone called human chorionic gonadotropin (hCG) that signals the corpus luteum to continue to increase in size and produce more progesterone to maintain the pregnancy; hCG is the hormone that is picked up by a pregnancy testing kit.

Thus in order for a couple to conceive, both the male and female reproductive systems must be functioning properly.

For a woman this means:

• Ovulation occurs and leads to the production of a viable egg.
• The fallopian tubes are open and functioning properly to allow the egg and sperm to meet.
• The woman's vagina, cervix, uterus, and fallopian tubes allow for the sperm to travel to the fallopian tube and attempt to locate the egg.
• The fertilized egg is able to move into the uterus and is not blocked from implanting in the wall of the uterus.

For a man this means:

• The testes produce viable, or normal sperm, as well as testosterone, the male hormone.
• Sexual intercourse involving an erection and ejaculation must occur during the woman's fertile period.
• Ejaculation is normal, with semen going through the man's urethra into the vagina.
• The sperm that are produced are properly shaped, able to move rapidly, and able to find the fallopian tubes to locate and fertilize the egg.

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