Learn from an embryologist, then ask her your questions

When people hear the word fertility, they often think of a simple yes or no question.

Fertility is a series of biological steps that need to come together, often at just the right time.

Here are those steps, and why one test rarely tells the whole story.

Step 1 of 6: an egg is released. Once in each cycle, usually one mature egg leaves an ovary. This is ovulation.

Step 2 of 6: a tube collects the egg. The finger-like ends of the fallopian tube gently sweep the egg inside.

Step 3 of 6: sperm reach the egg. They travel through the cervix and uterus into the tubes. Only a small fraction get that far.

Step 4 of 6: fertilisation. One sperm enters the egg and their genetic material combines, usually in the fallopian tube.

Step 5 of 6: the embryo develops. Over the next few days it divides into more and more cells as it moves along the tube to the uterus.

Step 6 of 6: the embryo implants. It attaches to the lining of the uterus, usually starting about six to seven days after fertilisation.

Each step depends on a different part of the body working well. That is why fertility can’t usually be understood from a single test.

A blood test tells you about one step. A semen analysis tells you about another. No single test checks them all.

Fertility involves both partners. Sperm health is part of the picture from the very beginning.

Why it can take months. Even when everything is working well, pregnancy doesn’t happen every cycle. Each month brings a chance, and over several months those chances add up.

Taking a few months is common. More than 8 in 10 couples conceive within a year of regular unprotected sex, when the woman is under 40.

If you are older, or something in your history concerns you, speak to a healthcare professional sooner.

Kara’s key takeaway: fertility involves several biological steps. Both female and male factors may need to be considered. A single test rarely tells the whole story. Taking several months to conceive is common.

For general education only. This video doesn’t replace advice from your healthcare professional. Next episode: How the Menstrual Cycle Works.

A menstrual cycle is not simply the days when you have your period. Your period is only one part of an entire reproductive cycle.

Let’s follow the rest of the cycle, one phase at a time.

Day 1 is your period. Professionals count the cycle from the first day of full bleeding. Light spotting before your period usually doesn’t count.

Four phases. Clockwise from the top: your period, the follicular phase, ovulation, then the luteal phase. Most of the variation happens in the first half of the cycle.

Phase 1 of 4: the menstrual phase. If there was no pregnancy last cycle, progesterone falls and the uterine lining is shed. This is your period.

Phase 2 of 4: the follicular phase. FSH, a hormone from the pituitary gland, helps a group of follicles grow. They make oestrogen, which thickens the lining again. Usually one becomes dominant.

Phase 3 of 4: ovulation. Rising oestrogen triggers a surge of LH, another pituitary hormone. Within a day or two of the surge, the mature follicle usually releases its egg.

Phase 4 of 4: the luteal phase. The empty follicle becomes the corpus luteum. It makes progesterone, which prepares the uterine lining for an embryo.

If no embryo implants, the corpus luteum fades after roughly two weeks. Progesterone falls and a new period begins.

Not everyone has 28 days. Many people expect 28 days and ovulation on day 14. Guidance describes normal adult cycles as roughly 24 to 38 days.

When to ask. Cycles regularly shorter than about 24 days or longer than about 38 days are worth discussing with a healthcare professional.

Kara’s key takeaway: day 1 is the first day of full bleeding. Follicles grow, an egg is released, then progesterone prepares the lining. Normal cycles range from about 24 to 38 days. Not everyone has 28.

For general education only. This video doesn’t replace advice from your healthcare professional. Next episode: How Do You Know If You’re Ovulating?