Created by CK-12 Foundation/Adapted by Christine Miller
Case Study: Trying to Conceive
Alicia, 28, and Victor, 30, have been married for three years. A year ago, they decided they wanted to have a baby, and they stopped using birth control. At first, they did not pay attention to the timing of their sexual activity in relation to Alicia’s menstrual cycle, but after six months passed without Alicia becoming pregnant, they decided to try to maximize their efforts.
They knew that in order for a woman to become pregnant, the man’s sperm must encounter the woman’s egg, which is typically released once a month through a process called ovulation. They also had heard that for the average woman, ovulation occurs around day 14 of the menstrual cycle. To maximize their chances of conception, they tried to have sexual intercourse on day 14 of Alicia’s menstrual cycle each month.
After several months of trying this method, Alicia is still not pregnant. She is concerned that she may not be ovulating on a regular basis, because her menstrual cycles are irregular and often longer than the average 28 days. Victor is also concerned about his own fertility. He had some injuries to his testicles (testes) when he was younger, and wonders if that may have caused a problem with his sperm.
Alicia calls her doctor for advice. Dr. Bashir recommends that she try taking her temperature each morning before she gets out of bed. This temperature is called basal body temperature (BBT), and recording BBT throughout a woman’s menstrual cycle can sometimes help identify if and when she is ovulating. Additionally, Dr. Bashir recommends she try using a home ovulation predictor kit, which predicts ovulation by measuring the level of luteinizing hormone (LH) in urine. In the meantime, Dr. Bashir sets up an appointment for Victor to give a semen sample, so that his sperm may be examined with a microscope.
As you read this chapter, you will learn about the male and female reproductive systems, how sperm and eggs are produced, and how they meet each other to ultimately produce a baby. You will learn how these complex processes are regulated, and how they can be susceptible to problems along the way. Problems in either the male or female reproductive systems can result in infertility, or difficulty in achieving a successful pregnancy. As you read the chapter, you will understand exactly how BBT and LH relate to ovulation, why Dr. Bashir recommended that Alicia monitor these variables, and the types of problems she will look for in Victor’s semen. At the end of the chapter, you will find out the results of Alicia and Victor’s fertility assessments, steps they can take to increase their chances of conception, and whether they are ultimately able to get pregnant.
In this chapter you will learn about the male and female reproductive systems. Specifically, you will learn about:
- The functions of the reproductive system, which includes the production and fertilization of gametes (eggs and sperm), the production of sex hormones by the gonads (testes and ovaries), and, in females, the carrying of a fetus.
- How the male and female reproductive systems differentiate in the embryo and fetus, and how they mature during puberty.
- The structures of the male reproductive system, including the testes, epididymis, vas deferens, ejaculatory ducts, seminal vesicles, prostate gland, bulbourethral glands, and the penis.
- How sperm are produced, how they mature, how they are stored, and how they are deposited into the female.
- The fluids in semen that protect and nourish sperm, and where those fluids are produced.
- Disorders of the male reproductive system, including erectile dysfunction, epididymitis, prostate cancer, and testicular cancer — some of which predominantly affect younger men.
- The structures of the female reproductive system, including the ovaries, fallopian tubes, uterus, cervix, vagina, and external structures of the vulva.
- How eggs are produced in the female fetus, and how they then mature after puberty through the process of ovulation.
- The menstrual cycle, its purpose, and the hormones that control it.
- How fertilization and implantation occur, the stages of pregnancy and childbirth, and how the mother’s body produces milk to feed the baby.
- Disorders of the female reproductive system, including cervical cancer, endometriosis, and vaginitis (which includes yeast infections).
- Some causes and treatments of male and female infertility.
- Forms of contraception (birth control), including barrier methods (such as condoms), hormonal methods (such as the birth control pill), behavioural methods, intrauterine devices, and sterilization.
As you read the chapter, think about the following questions:
- Why might sexual intercourse on day 14 of Alicia’s menstrual cycle not necessarily be optimal timing to achieve a pregnancy?
- Why is Alicia concerned about her irregular and long menstrual cycles? How could tracking her BBT and LH level help identify if she is ovulating and when?
- Why do you think Victor is concerned about past injuries to his testes? How might analysis of his semen help assess whether he has a fertility issue and, if so, the type of issue?