The possibilities of women seem limitless: they can stop a galloping horse, enter a burning hut, and even give birth at over 50 years of age! And, in fact, why not, if there is an opportunity? However, is it worth agreeing to such an event at such a mature age? What are the chances of conceiving, carrying and giving birth to a child at 50? What do doctors say about this?

How a woman's body changes during menopause

The news of pregnancy after 50 years has always caused a feeling of unprecedented surprise not only among the woman herself, but also among society. Women giving birth after 40 already evoke strange feelings in those around them, but what can we say about more mature ladies.

From a medical point of view, the greatest peak of fertility in women occurs between the ages of 20 and 25 years. This period is considered the most favorable for conceiving and bearing a child without further complications for both the baby and the mother. Is there a chance for older women to get pregnant?

From the first days of a newborn girl’s life, 400,000 eggs are present in her body. This number gradually decreases as you grow older, and by the age of 50 their number varies within 1000. With this number, the risk of pregnancy is significantly reduced, but it is there.

The eggs present in the female body are ready for the process of fertilization and the development of a new life. With normal production of eggs in a woman’s body, a menstrual cycle begins every month. By the age of 45 (±5 years), the amount of estrogen in a woman’s body gradually decreases, which leads to the onset of menopause.

Stages of menopause

During the onset of menopause, you can give birth to a child at 50 years old, if you know the stages of this condition, which contain the “moment” of possible conception.

Premenopause is the initial stage of the menopause. It begins 4-7 years before menopause and lasts the same amount. A woman can determine its onset by several symptoms: scanty and short periods that become irregular, hot flashes and heavy sweating, changes in mood, aversion to certain aromas and tastes, a feeling of morning sickness. The listed symptoms are very similar to signs of pregnancy, so many women confuse premenopause with toxicosis during pregnancy. However, what these two completely different conditions have in common is that they arise due to hormonal changes.
Menopause or menopause. It can be recognized by the long absence of menstruation. Most often, menopause occurs in women after 50 years of age, so the risk of becoming pregnant is almost zero.
Postmenopause is the final stage, which occurs approximately a year after the onset of menopause. It is also characterized by a complete absence of menstrual flow. However, the ovaries still retain the ability (albeit not fully) to perform their functions.

Possibility of late conception

Practice shows that you can give birth to a child at 50 years old. Some ladies take this step quite consciously. This situation is possible for a number of reasons:

For women, this is the first and desired pregnancy. Therefore, women do not dare to give up their long-awaited happiness even at 50.
A woman has started a serious relationship with a new man and wants to have a child with him.
During intimacy, the couple did not use contraception, being sure that pregnancy was impossible during menopause. However, at this stage of a woman's life, childbearing function remains, although with a lower probability.

The use of contraceptives remains relevant even during menopause. If a woman is 50 years old or later and has regular sex life, she should consult a doctor about the use of contraceptives. A good examination will help determine how fertile a woman is at this age.

As soon as the first stage of menopause sets in, many women relax, realizing that their reproductive function is no longer so active. But at this time the eggs are still quite active. Therefore, after 45 years, women should be especially attentive to their health.

We can summarize: a woman retains the ability to bear children for another 3-5 years after the onset of menopause.

What is the danger?

Despite the fact that it is possible to give birth at the age of 50, there is considerable danger for both the woman and the fetus. Firstly, the body of a fifty-year-old woman cannot “boast” of the excellent health it had 20-30 years ago. Organs begin to malfunction, the function of the musculoskeletal system is disrupted, the amount of vitamins and hormones decreases, and metabolism slows down. All this does not contribute to the proper bearing of the child. The body will need strength, which at 50 years old is not so much.

As soon as pregnancy is confirmed in a mature woman, she is immediately placed under the strict supervision of a gynecologist, since the risk of miscarriage is extremely high. Also, in most cases, there is a significant deterioration in the condition of the pregnant woman herself.

The most dangerous thing is that in the early stages of pregnancy it can be easily confused with the onset of menopause, because the symptoms are the same. Therefore, not all women are able to recognize their “interesting position” right away. A visit to a gynecologist during early and late menopause is simply necessary.

Are there any benefits to late birth?

Some women have a desire to have a second child at age 50. In this case, they already know what awaits them and are psychologically more stable than first-time mothers. At this age, the risk of postpartum depression, which young girls are often exposed to, is virtually eliminated.

The advantages of such a late birth include the fact that by the age of 50, a woman in labor is already a fully formed personality. She has financial wealth and life experience. Therefore, maintaining and caring for a newborn will not cause problems for the “young” mother.

Another reason to leave pregnancy in adulthood is well-developed medicine, which allows you to closely monitor the entire period of bearing a child.

Another reason to leave the baby is that at this age a pregnant woman “rejuvenates.” The point is that at this time a restructuring is taking place in the woman’s body, the hormones necessary for normal gestation are actively being produced. The woman in labor feels several years younger, and the risk of heart attacks, stroke and osteoporosis decreases.

How to recognize pregnancy at 50 years old

As mentioned earlier, the signs of such a late pregnancy are similar to the symptoms of menopause. You should be especially careful if you experience the following sensations:

Morning dizziness and nausea.
Delayed menstruation or complete absence.
Insomnia.
The appearance of aversion to familiar smells and tastes.
Swelling of the mammary glands.
Fast fatiguability.
Frequent mood swings.
Irritability.

If these sensations appear, you should immediately consult a doctor.

First pregnancy after 50: truth or myth

A woman’s desire to give birth to a second or third child at 50 does not evoke as many emotions among others as to give birth to a first. However, this is a completely natural process, if the use of the IVF method was not necessary.

Before giving birth to a second or even first child at 50, a woman must weigh all the risks.

For natural conception and bearing a child, the following factors are necessary:

Preservation of ovulation.
Producing sufficient amounts of estrogen.
Maturation and release of a mature egg.
The process of fertilization of a mature egg.

Danger for the unborn baby

It is possible for a woman to give birth to a child at the age of 50, but before that she needs to understand all the risks not only for herself, but also for her baby. This is not just about premature birth or miscarriage. Most often, it is children born from a mature woman who suffer from congenital pathologies and serious diseases.

If the child is born completely healthy, the presence of elderly parents may affect his psychological state. Some children feel uncomfortable around such fathers and mothers in society and are embarrassed by them. As practice shows, the relationship between children and elderly parents is not very trusting.

Every age has its own preferences and desires. A dad who is over 60 is not as active as one who is only 30-35. It is unlikely that he will be happy to play football with his son or engage in other outdoor games. A mother who is too old, who just wants to relax, but who must spend the whole day on her feet caring for her little child, is unlikely to find the strength to go with him to the park or get ready for a matinee.

In addition, growing children are often accompanied by the fear of losing their elderly parents in the very near future. Therefore, such a decisive turn in life as late pregnancy must be made after weighing all the pros and cons.

Difficulties during childbirth

Both pregnancy and childbirth in a mature woman are accompanied by difficulties. It is worth considering several complications that may occur during childbirth:

Weak labor due to low concentration of female hormones.
Heavy bleeding that appears during pregnancy and delivery.
Numerous ruptures of the birth canal due to the fact that tissue elasticity is lost with age.

Due to the high risk of an upcoming natural birth, many women after 50 years of age undergo a cesarean section. However, the possibility of natural delivery is not excluded if the only limiting factor is age.

Doctors' opinion about late pregnancy

Is it possible to give birth at 50? What do doctors say about this? Feedback from experts is ambiguous, since how smoothly this important period in the life of a mature woman will go depends only on the individual characteristics of the body.

Some doctors see nothing wrong with women becoming mothers at 50, especially for the first time. Others believe that the risks of complications are too high for both the mother and the unborn child.

Most doctors are convinced that it is worth refusing to plan a pregnancy at such a late age. The body is no longer adapted to pregnancy and childbirth. A woman will need to provide it with the necessary vitamins and microelements throughout the entire period of pregnancy.

The most significant criterion against late pregnancy is the high chance of giving birth to a child with genetic disorders. According to statistics, mothers over the age of 40 are much more likely to give birth to children with Down syndrome. Other chromosomal abnormalities are also not uncommon. Therefore, many doctors recommend that their patients think carefully before planning the birth of a child. If a woman is determined, she is strongly recommended to undergo all the necessary examinations every month to eliminate the risk of developing fetal abnormalities.

Ways to conceive a child after 50

1. Natural process. Can a woman give birth at 50? Yes, but first you need to choose a method of conceiving a child. Violation of natural conception is a modern problem even for young couples, not only for older ones. But such a possibility is not excluded.

2. In vitro fertilization. Giving birth at 50 without IVF, as many people want, is unlikely, but possible. However, IVF is the most effective process suitable for mature women. The procedure is expensive, but safe for both the woman and the unborn fetus.

3. Surrogate insemination. This is an option that is only approached when a woman is unable to become pregnant and bear a child on her own. But a child developing in the womb of a surrogate mother has the genetic information of a woman who is not capable of bearing a child. Therefore, this method is the easiest and most painless for an elderly woman.

How to protect yourself from late pregnancy

Women who have regular sex life during menopause and do not want to have children should take care of contraception.

Intrauterine contraceptives (IUD) are highly not recommended for use by women over 50 years of age.
Several oral medications are recommended to balance hormone levels during menopause. But it is better not to use emergency contraception medications (Postinor).
Surgical sterilization.
Barrier contraceptives.

Conclusion

You can give birth at 50 years old. A woman who decides to take such a step must undergo all examinations and listen to the opinion of the gynecologist.

Women who give birth at 50 are undoubtedly admired. What will be the future fate of their baby? It depends on dozens of factors. Women who decide in favor of childbirth must weigh everything in advance.

There are two opinions that at first glance are completely contradictory to each other. The first says that giving birth is good for health, the second says that childbirth weakens the body. So should a woman give birth at all and how many times can she do it?

Give birth, but how many?

Experts are unanimous: it is necessary to give birth. “Pregnancy and childbirth are the strongest activators of women’s immunity and tone. They mobilize all the hidden reserves of a woman’s body, thereby strengthening her health and increasing life expectancy, says Mikhail Berkengeym, head of the Moscow medical center “Marriage and Family”. - A woman’s body is “designed” to give birth to three or four children. If this does not happen, then various imbalances begin. Hence the diseases."

But it is not so easy to unequivocally answer the question of how many times a woman should give birth. This may depend on many factors. “There is such a concept - population reproduction,” says obstetrician-gynecologist, candidate of medical sciences Sholpan Sarmuldaeva. - To do this you need to give birth to three. Otherwise, different women experience pregnancy and childbirth differently. Some give birth for the fifth or eighth time, and this does not affect them in any way. And someone gives birth to one and cannot recover for a long time. Everything is very individual."

How often can you give birth?

Theoretically, a woman can be ready for a new pregnancy within a month or two after giving birth. Some people believe that pregnancy is impossible during breastfeeding, but the frequently occurring “phenomenon” of similar children refutes this myth.

The situation may become more complicated if the woman had a previous caesarean section. If pregnancy occurs in the first six months after birth, then everything depends on the condition of the suture. It is possible that a woman will have to spend most of her pregnancy in a hospital so that the stitches do not come apart. Ideally, it is better to plan the next pregnancy 1.5-2 years after cesarean.

According to Professor, Doctor of Medical Sciences, President of the Russian Association of Human Reproduction Vladislav Korsak, normally the female body fully recovers after natural childbirth in 2-3 years. Each subsequent birth lengthens the recovery period. If a woman plans to have more children, she should lead a healthy lifestyle: avoid unnecessary work and household stress, exercise, eat more healthy foods and take vitamins.

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What are the dangers of frequent childbirth?

Frequent childbirth is still stressful for the body, since during pregnancy we undergo intense hormonal changes. If pregnancies are too frequent, this is fraught with endocrine disorders and problems with internal organs. They can be dangerous for both the mother and the unborn child. There are a number of pathologies in which childbirth is generally contraindicated or indicated with a number of reservations. These include, for example, diabetes mellitus of the second degree. With this disease, it is not recommended to give birth to more than one child, and during pregnancy, the expectant mother must strictly follow medical recommendations. Both too early and late births increase the risk of an unfavorable outcome. The optimal age for pregnancy, even if it is not the first, is from about 20 to 30 years old, doctors say.

You can, of course, remember our great-grandmothers who gave birth “as many as God wills,” sometimes every year, from their marriage at 17-18 years old until menopause. But in those days it was, firstly, a forced necessity, since infant mortality was high. Secondly, our ancestors ate organic foods, not chemicals, and died more often from infections than from cancer or atherosclerosis. Thirdly, frequent childbirth does not always have a beneficial effect on a woman’s body and appearance. By the age of forty, she could look almost an old woman, since she had a house, a household, children, and field work. Now look at today's 40-year-olds!

At-risk groups

Not long ago, professors Uri Elhalal and Menachem Friedlander from the Department of Clinical Pathology of Pregnancy at the Adasa Ein Kerem Hospital in Jerusalem (Israel) came to the conclusion that the optimal number of children for one woman is from two to four. After observing 45,000 women giving birth for 37 years, scientists calculated that mothers who gave birth to only one child had a 3.7% risk of premature death, and those who gave birth to 5 to 9 children had a 13.5% risk of premature death. Those who gave birth 2 to 4 times had a minimal risk of premature death. In addition, mothers with many children more often developed diseases such as cancer, diabetes, and diseases of the cardiovascular system. True, the relationship between the development of these diseases and the number of births has not yet been identified.

Tells Vladislav Korsak, professor, doctor of medical sciences, president of the Russian Association of Human Reproduction.

“AiF”: - Officials believe that a family with 3 children should become the norm in Russia. What number of births do doctors consider optimal for the female body?

VC.:- The concept of norm in reproduction does not exist. It’s not for nothing that pregnancy is called the body’s touchstone. One woman can endure both, while another, at best, can “bear” one. This can only be determined experimentally. Doctors have determined only the optimal frequency of childbirth - in order for the body to recover, the interval between them must be at least 2 years.

Early is not great

“AiF”: - Are there diseases of girls that put an end to the possibility of giving birth in the future?

VC.: - Only boys have such diseases (mumps, or mumps). The female reproductive sphere is quite reliably protected, and the consequences of diseases are usually surmountable. A negative prognosis is given only in adolescence and early onset of sexual activity. The optimal age for the first birth is from 18 to 26 years, when the body is already fully formed and hormonal levels have been established.

“AiF”: - Today, girls mature early - some begin menstruation at the age of 10...

VC.: - Normally, girls should reach puberty at 12-13 years of age. But the onset of menstruation at both 10 and 15-16 years of age is also considered normal. This is a clock wound by nature; it is impossible to influence its progress.

“AiF”: - There is such a problem as early menopause (at 35-40 years old). Stress, diet and early puberty are blamed for its onset...

VC.:- A woman who is “burnt out at work” and exhausts herself with diets may actually stop having periods. But this has nothing to do with early menopause - menstruation usually returns when a woman begins to eat normally. Early menopause (premature ovarian failure syndrome) is inherent in nature. Whom he threatens can be found out by a blood test. Women with ovarian depletion syndrome have high levels of gonadotropic hormones (FSH, LH).

“AiF”: - In Russia, 15% of families are infertile. After how many years of family life should you sound the alarm?

VC.:- A woman has only three fertile months a year. The probability of pregnancy within a year is about 25%. We recommend that young couples consult a doctor if pregnancy has not occurred within a year of regular sexual activity. But, if a woman’s age is approaching 35 years (and her ovulatory reserve is depleted), the search for the cause should begin after 6 months of marriage. Most causes (hormonal, adhesive) are removable. Doctors usually give a woman 2 years to treat illnesses. If pregnancy does not occur, you need to think about IVF. And we must hurry! IVF after 43 years of age in the vast majority of cases is carried out with donor eggs; by this time the potential mothers themselves no longer have them.

Old-timers

“AiF”: - In 2012, former Minister of Agriculture Elena Skrynnik (51 years old) and Ilze Liepa (46 years old) gave birth; Irina Bezrukova (47 years old) is expecting a child. Such examples inspire women who put off children “for later.” Until what age is pregnancy possible?

VC.: - The Old Testament describes the story of 100-year-old Abraham and Sarah, who gave birth at 90 years old - “when her womb was already dead.” Similar cases still occur today. In my practice, there was a patient who independently, without medical help, became pregnant and gave birth at the age of 54 (after five years of menopause). But these are the rarest exceptions. Therefore, every woman must decide for herself whether to wait for a biblical miracle to happen to her, or to give birth when nature should - until she is 40 years old.

“AiF”: - After the statement of the chief pediatrician that 75% of children born as a result of IVF are disabled, many are in no hurry to resort to this procedure...

VC.: - Serious research has been carried out around the world, which convincingly shows that IVF technology does not have a pathological effect on the offspring. But the health of the child is determined primarily by the age of the parents, and couples of older reproductive age usually resort to the IVF procedure. After 40 years, the risk of having a child with genomic disorders increases catastrophically - regardless of how he was conceived. In addition, it is often multiple births. It is fraught with premature birth, cesarean section (also negatively affects the child), the birth of children with low body weight, with eye pathology. Therefore, now in many countries the state pays women for several IVF attempts, provided that they agree to transfer only one embryo. They decided that it was cheaper to pay for the procedures than to have children born after complications from a multiple pregnancy.

Infertility: numbers and facts

Women

Fertility is highest at 20-30 years old.
At 35 years old, the chances of getting pregnant are 2 times lower than at 20 years old. At 40 years of age, the chance of spontaneous pregnancy is 10% compared to 20 years of age.
40% of women who consulted a doctor are overweight.
According to WHO, in recent years, a psychogenic form of infertility has become increasingly common, affecting women of “fine mental organization” and business women working under constant stress.

Men

Around age 40, fertility begins to decline.
One of the newest methods of treating male
infertility - ICSI, intracellular sperm injection, in which one sperm is injected with a needle directly into the egg.
If there is obstruction of the vas deferens, the sperm needed for the procedure are removed directly from the testicle.

married couple is associated with:

30% - women's problems,
30% - male problems,
30% - violations in both partners,
10% - due to unexplained reasons.

“Such experiments have two sides,” said Deputy Director of the Institute of Genetics. N.I. Vavilova, Doctor of Biological Sciences, Evgeny Platonov, - firstly, a person needs to reproduce sexually, this is the natural adaptability of the human body to the environment, which otherwise may sharply decrease or disappear completely. Secondly, an embryo created only by the mother’s genomes is more likely to have deviations. On the other hand, with sufficient study of this issue, women all over the world will be able to get rid of infertility. In our country we are also conducting experiments with stem cells; scientists have been working on this problem for about twenty years. But we don’t have such powerful funding as in the West.”

Russian biologists note that such developments will not be put into practice any time soon, and the possibility of switching to a same-sex reproductive system is still unlikely.

English biologists plan to obtain the first results in the next ten years, but within five years it will be possible to talk about the success of the experiment.

Discussion of the article “A woman does not need a man to give birth to a child”

Alyona

It will be simply wonderful when Women can give birth themselves) This will be an opportunity for Same-sex couples. It would be desirable for Men to have this and for children to be born healthy). And then everything will be fine in the world.

23.02.2020 (23:05)

Anna

I believe that children should be born only out of great mutual love!
In a heterosexual society, children are most often born by chance, they are given birth because it is necessary. Maybe that’s why there are so many evil people on the planet..?!
Dear member-worshippers, please give birth to your men.
I’m really looking forward to the time when it will be possible to continue together with the woman I love. And if such a scientific experience is possible, then the Universe will sooner or later give us a chance to become parents of a beautiful child! I want my child to have my blood and a loved one flowing through me, and not some stranger who I don’t fucking need.

30.10.2018 (14:21)

Unknown

So ten years have passed. How is it going? 😊😅

22.08.2018 (09:12)

Aspid

I don't think this should be a big problem. First of all, there really are same-sex couples who love each other. And if for two men there is no such question as such, then two women may well want to have a common child. Secondly, often in single-parent families, and these are much more common than same-sex families, children are raised by two women - mother and grandmother. Not eating is good, but not fatal. And finally, thirdly, couples of two women are a statistically rare phenomenon even in a tolerant society. So they will not have any significant impact on the development of society. Well, unless we get a chance to move even further away from cave thinking and prejudices.

27.05.2018 (03:09)

Sofia

It would be great to give birth to a common child from the woman you love. With her eyes. and not from a stranger

02.11.2017 (18:41)

marina

What the hell are you? Lesbians, run to the gayropa, they will understand you. I would never trade motherhood from a man (2 children) for some dubious experiment.

09.08.2017 (17:09)

Elena Korotkova

Brad, you shouldn't believe it.

16.12.2016 (08:40)

Irina

Well, I can say the following from this article.
I once knew a doctor who proved to me that a woman can give birth to a woman. And I took up this issue closely, only seven years later did something become clear.
I am not against same-sex love, I had such experience. I dated girls, looked for the one, and lived with one for two years. But I think that it was just adolescence and problems with female sexual dysfunction, as well as passive men. However, a girl should have her first kiss from a man, lose her virginity from a man, and have a child from a man, even if she is in a relationship with a woman... Let's think sensibly! How to take this fluid from the brain without harming yourself and, God forbid, the child. Women can find a suitable man, one gives birth, the other becomes a godmother and love each other, but the child must be given birth by a man.

25.06.2016 (16:12)

Elina

I want to give birth to a child from the woman I love!! I love her very much. We have known each other for a year and 3 months and I want her or I to give birth to a baby GIRL similar to my beloved. I will love her even more for her the happiness given to me in fulfillment and the birth of a child. I wish everyone the same love!! Loving is great, but loving your BELOVED WOMAN is unparalleled happiness, spiritual wealth.

29.03.2016 (21:07)

Tatiana

Good day to all. Please tell me where to go (which is the nearest reproductive center) to give birth to the woman I love. And how much does it cost. Thanks to everyone who cares. Be happy with your loved ones!

17.12.2014 (16:33)

Lena

Good article

16.01.2012 (02:08)

Yaroslav

Elena, respect to you! Thank you! Some people just don’t really understand how desperately they want a child from their LOVED person. So that the child would be common. It is important! The degeneration and decline in the birth rate occurs precisely because some people who love each other, if it is impossible for each other to become pregnant, refuse to have children at all. And in our country it is even impossible to adopt a child of a loved one if he is of the same gender as you, and to raise adopted children together. Here you have, dear girls, a decline in the birth rate, here you have degeneration. Degeneration of a lagging nation.

07.02.2011 (02:29)

Elena

And this is very necessary for those who do not want to give birth to men!!

23.10.2009 (18:50)

Albie

Men cannot be discounted; this will lead humanity to degeneration. No robots can replace a living person. Unfortunately, many people can hardly be called alive at all. All their life aspirations concern only their body. Such men can be replaced with a vibrator without any damage. A living person is the most valuable thing. He carries in his heart such wealth that no amount of money can buy. And he will then pass this wealth on to his children.

01.06.2008 (22:10)

Olga

And why is this necessary? Poor men, soon they will have such a hard time, because a woman has already taught almost everything, and we have some elements of the male body on sale, soon there will be a robot to replace men, if we can conceive children ourselves, then it’s understandable why they began to look at their own kind and change floor. I wouldn’t want the weaker sex to be around, but science wants to do this, or replace men.

05.04.2008 (11:48)

Bagheera

Everything should be natural!! as God created, as nature created!

08.03.2008 (21:13)

mom pvlch Olya 8

Doesn't Need a Man (Research)

Men all over the world were shocked by the news that a woman would soon be able to conceive a child without male participation. This is precisely the bold statement made by British biologists from the University of Newcastle. The British have already submitted an application to begin research that will allow them to obtain full-fledged sperm from female bone marrow in a few years. The main material in such an experiment will be brain stem cells, which can be transformed into cells of any type.

The term "fertility" comes from the Latin word fertilis, which means "fertile, prolific." In the understanding of doctors, fertility is the ability of a sexually mature organism to produce viable offspring. A woman's fertility depends on three factors: her ability to conceive a child, her ability to carry a child to term, and her ability to give birth. If any of the mentioned factors is absent, then fertility is considered to be reduced. The presence of all three factors indicates normal fertility.

It must be said that in most cases, fertility is more associated with the possibility of conception, but the possibility of childbirth fades into the background. And indeed, with the modern development of obstetric science, the issue of delivery in the overwhelming majority of cases is resolved successfully: at the stage of preparation for childbirth or during the process of childbirth itself, the question is promptly raised about whether a woman can give birth herself; if this is impossible, a caesarean section is performed. The ability to carry a pregnancy to term is a separate topic of discussion, which usually arises with previous failures to carry a pregnancy to term. Therefore, at the first stage, it is important to assess the ability to conceive and bear a child.

To understand what factors are important for conception, let’s remember how this process occurs. In the middle of the menstrual cycle, an egg matures in the ovaries, ready for fertilization. It leaves the ovary - occurs, after which the egg enters the fallopian tube, where it remains viable for about 24 hours. If fertilization does not occur, the egg dies.

During a male orgasm, between 200 and 400 million sperm enter a woman's vagina. Part of the sperm flows out of the woman’s genital tract, the rest through the cervix enters the uterine cavity and then into the fallopian tubes. The speed of sperm movement is different. It is believed that sperm containing the Y chromosome move faster (if fertilized they will be a boy) than sperm containing the X chromosome (if fertilized they will be a girl). In general, sperm remain in a woman’s body for 48–72 hours. The egg and sperm meet in the fallopian tube. Sperm surround the egg and secrete a substance that dissolves its shell, and one of the sperm penetrates it, determining the beginning of conception. After this, another male cell can no longer penetrate inside. The sperm fuses with the egg, creating a single-celled embryo - a zygote. As the fertilized egg moves down the fallopian tube, it divides into more and more cells. Around the 4th day it reaches the uterine cavity. By this time it already contains about 100 cells. In the following days, the egg moves inside the uterus. At the beginning of the 2nd week after fertilization, the egg begins to penetrate the mucous membrane of the uterine wall. This process is called implantation. As soon as the egg is securely attached to the wall, the conception process is considered complete. The villi of the embryo's outer cells penetrate the epithelial layer lining the uterus and connect with the mother's blood vessels to subsequently form the placenta. Other cells will develop into the umbilical cord and membranes that protect the fetus. The internal cells will divide into three layers and give rise to various organs and tissues.

So, for pregnancy to occur, a normal menstrual cycle is important, which is a kind of guarantor, a sufficient supply of eggs in the ovaries, passable fallopian tubes and an endometrium capable of receiving a fertilized egg.

A normal menstrual cycle is one of the main indicators of the condition of the organs of a woman’s reproductive system. There are several characteristics by which one can judge the “normality” of menstruation.

The duration of one menstrual cycle is on average 28 days, but a cycle length of 21 to 35 is considered normal, and the duration of the menstrual cycle can vary not only throughout life, but also from cycle to cycle. Normal menstruation usually lasts 3–7 days. During this time, the woman loses about 250 ml of blood. This value is quite difficult to measure, so it is customary to focus on the number of hygiene products (pads) that have to be spent during menstruation. Normally, one pad should last for 2–4 hours. In the first days, menstruation is usually somewhat heavier than in the end. Menstrual blood may contain small clots.

In order to easily navigate your menstrual cycle, you need to keep a calendar. Modern electronic gadgets allow you to do this without any problems, you just need to download any program with a menstrual calendar into your phone or tablet. Any changes in the cycle outside the specified limits: lengthening, shortening of the cycle, menstruation itself, both an increase and decrease in the amount of menstrual blood, the appearance of intermenstrual bleeding - may be a sign of decreased fertility.

Follicular reserve, or ovarian reserve, is a reserve of follicles in the ovaries that are capable of developing normally and ovulating with a mature egg.

Every female body, even before birth, receives a huge reserve of follicles (about 5-7 million), capable of giving life to an egg. However, by the time a girl is born, there are only 1–2 million of them left, of which 90% remain in their infancy, and only 10% are capable of becoming full-fledged eggs. By the beginning of puberty, only 200–400 thousand remain. This is a kind of reserve.

So, in one menstrual cycle, together with the dominant follicle (from which the egg will be released), about 1000 follicles simultaneously become activated, grow and atresia (reverse development of immature follicles). Thus, the available reserve is consumed in just 3–4 decades. On average, a woman has only about 400 follicles reaching full development throughout her life.

It has now been established that after 37–38 years the rate of follicular atresia increases, and this significantly reduces ovarian reserve and the likelihood of becoming pregnant. And by the time of menopause, the follicular reserve of the ovaries is completely depleted.

In order to evaluate this parameter, on the 5th–7th day of the cycle, an ultrasound examination is performed and the level of a number of blood hormones is determined.

It is good if at the beginning of the menstrual cycle there are at least 5 follicles in each ovary. To assess the presence of your own ovulation, several ultrasound examinations can be performed during one menstrual cycle in order to determine whether the dominant follicle (which contains the egg) is growing and whether the egg is being released from the ovary. In this case, in the ovary, at the site of the dominant follicle, in the second phase of the menstrual cycle, an ultrasound examination reveals the corpus luteum.

Female fertility: determination of blood hormones

Hormones are biologically active substances that are produced by the endocrine glands, that is, they come from these glands directly into the blood. From there, hormones are sent to target organs - places that need hormonal influence and are able to perceive this influence.

You and I are interested in the hormones that control the organs of the woman’s reproductive system, which are responsible for childbearing in women. Let's try to figure out how this happens and what tests a gynecologist usually recommends to take to find out if there is a problem with hormones.

So, the central control station for hormonal flights is located in the very center of the brain - the hypothalamus and pituitary gland. The hypothalamus produces biologically active substances statins and liberins, which control the functioning of the pituitary gland (these substances are not tested in the laboratory in normal medical practice). The pituitary gland produces follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones act on the ovaries: under the influence of FSH, the follicle grows, which is both a “house” for the egg and an endocrine gland that produces estrogens (estradiol, estriol). Estrogens, in turn, act on the uterus, mammary glands, skin, hair, nails, etc.

Under the influence of LH, the ovaries secrete the hormone progesterone. It is produced by the corpus luteum, a gland that forms in the ovary when an egg leaves it (after ovulation). Progesterone also acts on target organs - the uterus, mammary glands, etc. In addition, if pregnancy occurs, progesterone ensures its normal course in the initial stages of gestation. In this case, pituitary hormones and ovarian hormones interact according to the principle of negative feedback: when little estrogen enters the blood from the ovaries, the amount of FSH begins to increase, and when the amount of progesterone decreases, the production of LH increases. Such waves of hormone production replace each other during the menstrual cycle: in the first phase of the menstrual cycle, FSH prevails, followed by estrogens, and in the second phase, LH, followed by progesterone. With the onset of menopause, when the ovaries almost stop producing female sex hormones, the production of FSH increases significantly.

In order to determine how large the supply of eggs is in the ovaries, the doctor may need to test for anti-Mullerian hormone (AMH) and inhibin - the higher these values, the greater the follicular supply.

The pituitary gland produces another hormone that affects the female body - prolactin (PRL). Its importance is undeniable during breastfeeding, but prolactin production occurs throughout life. If the amount of prolactin increases outside of pregnancy, this negatively affects the functioning of the ovaries, up to blocking the maturation of the egg and the cessation of menstruation.

Oddly enough, the female body cannot do without male sex hormones, and they are produced mainly in the ovaries and adrenal glands. Women, as a rule, are bothered by an excess of male sex hormones. It is extremely rare that an increased amount of male sex hormones occurs suddenly and is caused, for example, by the appearance of an ovarian tumor that produces male hormones. Much more often, an increased level of male hormones is a feature that is given to a woman from birth - it cannot be eliminated completely, but the undesirable effect of male sex hormones can be neutralized. In order to understand whether there is an excess of them, the blood levels of testosterone (or a more accurate analysis of the free testosterone index), 17-hydroxyprogesterone (17-OPA) and dehydroepiandrosterone sulfate (DHA-S) are determined.

In addition to the listed hormones, a woman’s well-being, menstrual cycle, and reproductive function are influenced by the work of the thyroid gland, so it may be necessary to determine the amount of pituitary thyroid-stimulating hormone (TSH) and free thyroxine (free T4).

Fertility: determining the condition of the endometrium

As already mentioned, in order for a fertilized egg to grow in the uterine cavity, the endometrium (the lining of the uterus) must be ready to receive it. There are several ways to evaluate the endometrium more or less accurately. During ultrasound examination, the endometrium before ovulation appears to be a relatively thin layer. Gradually, as the menstrual cycle progresses, its thickness increases. With full ovulation, it continues to grow and reaches 10–12 mm before the onset of menstruation.

If there is a suspicion of a particular problem with the endometrium, then hysteroscopy is prescribed - a study in which a small video camera is inserted into the uterine cavity, and after that a piece of the mucous membrane is taken for analysis (biopsy).

Fertility determination: are the fallopian tubes patent?

This issue is usually not a priority when assessing the fertility of a woman planning a pregnancy in the future; it is resolved if there is a suspicion of infertility or there have already been unsuccessful pregnancies, especially if it was an ectopic pregnancy. Anatomically, the fallopian tubes are tubes 10–12 cm long and only about 5 mm in diameter. These formations are normally not visible during ultrasound examination (by the way, if the ultrasound description states that the tubes are not visualized, this is normal). To see the fallopian tube, it is filled with one or another liquid, and the moment of filling is recorded using an X-ray machine, ultrasound, or laparoscopy.

Thus, fertility is a complex concept, to determine which in different cases more or less examinations are used, and determination of fertility should in any case be the first stage of pregnancy planning.

The causes of premature depletion of the follicular reserve are:

genetic predisposition on the female side: mother, grandmother or sisters experience various menstrual irregularities, problems with conception, pregnancy, early menopause;
a decrease in the initial intrauterine follicular reserve is likely if the mother of the woman being examined had a difficult pregnancy with complications, for example, severe infectious diseases, various conditions leading to oxygen starvation of the fetus;
operations on the ovaries with excision of their tissue or operations during which the blood supply to the ovaries is disrupted;
various diseases of the pelvic organs, for example, adnexitis, salpingoophoritis, which contribute to the development of adhesions in the pelvis, the development of connective tissue in the ovaries, decreased blood supply and death of follicles.