How irregular periods affect infertility

By professor Oladapo Ashiru
The regular menstrual cycle is supposed to be 28 to 30 days. That is, the woman is supposed to have her period every 28 to 30 days. When the period comes more frequently than this, it is referred to as dysfunctional uterine bleeding and it can be a major cause of infertility.
If the woman is bleeding constantly, it can cause infertility simply because the couple will not be able to have sex because of the bleeding.
For example, I had a patient whose period lasted full 17 days. Even though the period was not heavy, it created a problem because it made it impossible for her and her husband to have intercourse.
The period would go on for days, clear up for a few days only for the spotting to start again. They were married for six years without getting pregnant. About 70 per cent of women who have this condition do not release any egg during the menstrual cycle.
Their irregular periods are due to a hormonal imbalance between oestrogen and progesterone. This is a very significant cause of infertility making up to 10 per cent of the causes of infertility.
A woman’s menstrual cycle is controlled by two hormones, oestrogen and progesterone. The levels of these two hormones vary during the month. During the first half of the month oestrogen is high to stimulate the growth of the uterine lining which is called the endometrium, to produce egg.
When the egg is ready for fertilisation around the 14th day, progesterone rises and causes changes in the endometrial lining to prepare it for pregnancy.
If the egg is however not fertilised, the progesterone levels fall and the unfertilised egg is shed in the monthly period. If oestrogen levels are abnormal, there will be no production of eggs. This will also disturb the production of progesterone and therefore the periods will be irregular.
In cases of irregular periods, even when the couple have intercourse during the times that the woman should normally be fertile, there may be no eggs to be fertilised as she is not producing any eggs. Irregular periods are therefore the first sign that there are may be problems with a woman’s reproductive system.
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