1. Misconceptions about Conception Menstrual cycle is not always 28 days. Ovulation does not always occur on day 14. It is true that there is a fixed amount of time between ovulation and menstruation, usually 12-16 days. Conception can only occur in the 2-3 days prior to ovulation and 24 hours afterward. Maximum fertile day is day of ovulation.

2. Necessary ingredients to conception An ovum, or egg that has been released Sperm (average ejaculate contains 300- 350 million sperm) Fertile-quality, “eggwhite” cervical fluid for the sperm to swim in

3. Fertile quality cervical fluid

4. Where conception occurs Once the egg has been released, it is pulled from the ovary into the fallopian tube. Most conceptions occur in the outer third of the fallopian tube. The fertilized egg is called a zygote.

5. Corpus luteum When the egg is released, a yellow spot is left behind on the ovary where the egg was. This is the corpus luteum. Function of the corpus luteum: to secrete hormones to prepare the uterine lining to receive a fertilized egg.

6. If fertilization does not occur The corpus luteum shrinks Progesterone levels fall dramatically Uterine lining is discarded through the menstrual cycle approximately 14 days past ovulation.

7. Zygote’s journey to the uterus It takes 7-9 days for zygote to go from the fallopian tube to the uterus Pulled along by the cilia of the fallopian tube Then it implants in the uterine wall. If you experience spotting (light bleeding) about 7-9 days after you ovulate, then there’s a good chance you’re pregnant. Called implantation bleeding.

8. hCG After the zygote has burrowed into the uterus, it starts releasing human chorionic gonadotropin hormone (hCG)…the pregnancy hormone. It is the presence of this hormone that pregnancy tests detect. Function of hCG is to send a message back to the corpus luteum to stay alive and start producing progesterone.

9. Role of Progesterone Progesterone keeps the uterine lining from shedding. Many very early miscarriages result from lack of progesterone. Taking progesterone supplements in early pregnancy can prevent a miscarriage. Placenta eventually takes over progesterone production from the corpus luteum.

10. Fertility rates by age AgeRate per cycle 15 40-50% 25 30-35% 35 15-20% 45 3-5%

11. Why do fertility rates decline? Women are born with all the eggs they’ll ever have. These eggs are exposed to every environmental toxin and illness the woman has. This exposure affects the genetic material of the eggs. As you age, your eggs become less efficient at producing a healthy fertilized embryo. Aging eggs are the biggest fertility problem facing women today. No solution to it.

12. Statistics of Infertility 1 in 5 (some sources say 1 in 6) couples will experience infertility. Putting off childbearing until late 30s results in 33% infertility rate. 30% of the time  woman’s problem 30% of the time  man’s problem 30% of the time, both the male and female have problems. 10% of the time, the cause is unknown.

13. Ethical Issues in Infertility Some people take issue with the idea of interfering with God’s domain of creating life. What should be done with the extra eggs, sperm, and zygotes? Does a surrogate mother have any right to the child she carries, even if it’s not genetically her own? Should embryos be tested for genetic abnormalities and destroyed before implantation?

14. Ethical problems continued Selective reduction of fetuses in “multiple” pregnancies Should medical insurance cover infertility treatments, or should only affluent couples be allowed to go through infertility treatment? Should only the “best” egg/sperm be selected in order to prevent birth defects?