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MONITORING PHYSIOLOGICAL CHANGES
SCIENTIFIC BASIS OF FERTILITY AWARENESS / NFP
Male physiology
Fact file on sperm
Sperm are produced by the testes continuously.
At ejaculation, between two and five millilitres of seminal fluid is released, containingaround 100 million sperm per millilitre.
Sperm will survive for 3-5 days or longer in a woman‘s cervix in the presence of fertilemucus.
Sperm penetration is impeded by a thick sticky mucus plug blocking the cervix during theinfertile phase of woman‘s menstrual cycle.Sperm remaining in the vagina are destroyed within hours by the acidity of the vaginalsecretions.
Sperm may be contained in the small amount of lubricating fluid a man releases prior toejaculation.For this reason genital contact or withdrawal method (‘being careful‘) could causepregnancy if fertile mucus is present at the vaginal entrance.A man is always potentially fertile, whereas a woman‘s fertility recurs on a cyclical basis. Forthis reason we have to look in more detail at the woman‘s physiology to understand the phasesof fertility and infertility.
Physiology of the female fertility cycle
The female cycle is usually referred to as the menstrual cycle, menstruation being the mostprominent event, however for our purposes, we will use the term fertility cycle, placing theemphasis on the cyclic changes of fertility.Cycles vary in length from 23 days or less in a short cycle, to over 35 days in a long cycle. Fewwomen have an absolutely regular menstrual cycle, and a variation of up to 7 days is perfectly
Page 1 of 8NFPS-20 Physiology
normal. For convenience, we will use an average length cycle of 28 days.
Hormonal changes in the fertility cycle
The fertility cycle is under the control of sex hormones. It may be conveniently divided into twophases - the phase before ovulation (pre-ovulatory) and the phase after ovulation (post-ovulatory)
Pre-ovulatory phase - controlled by FSH and oestrogen
The pituitary gland at the base of the brain secretes FSH (follicle-stimulating hormone) which,stimulates the ripening of follicles in the ovary. The ripening follicles produce increasingamounts of oestrogen.As the
oestrogen
levels rise approaching ovulation, certain changes take place:-
The endometrium
(lining if the uterus) becomes thicker
The cervix
becomes higher and softer and open
Cervical mucus
produced by the glands or crypts in the cervix changes to a very‘sperm-friendly mucus‘:
Increased salts,sugar and amino-acids - to nourish sperm
Increased fluid (to keep cells isotonic). Up to 10x increase in mucus volume
Highly-fertile mucus is 98% water - Transparent, glistening, slippery, stretchy -spinnbarkeit effect.
The structure of fertile mucus using nuclear magnetic resonance shows a loose networkaiding sperm penetration.
The temperature
remains on the lower levelWhen the oestrogens reach a certain level in the blood, the pituitary gland is stimulated toproduce a sudden surge of LH (luteinising hormone) which precipitates ovulation within 36hours. The most mature follicle ruptures and releases the ovum. -
Ovulation
Changes During the Fertility Cycle
Page 2 of 8NFPS-20 Physiology
Post-ovulatory phase - controlled by progesterone
Following ovulation, luteinising hormone or LH causes the ruptured follicle to develop into thecorpus luteum, the flower-like structure in the ovary which produces the second ovarianhormone - progesterone.Under the influence of
progesterone
, the following changes occur :-
The endometrium
softens in preparation for the implantation of a fertilised ovum
The cervix
becomes lower, firmer and closed
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