As promised, today’s column will continue my response to last week’s question: I’m a former student who is now the parent of a 12-year-old girl and a 10-year-old boy. I really wish you could teach them but we live out of state. I’m your FB friend and I learn a lot from your posts. You recently posted an article about reproductive misinformation. Can you address the article’s myths in your column? People who don’t use social media need this education. Thanks for all you do!
– Grateful former student
Mary Jo’s response: Let’s look at two more reproductive topics under pregnancy: conception and ectopic pregnancy.
Conception: Conception is when an egg is fertilized by sperm. How that happens is one of the biggest areas of confusion I see, even among adults.
Ovulation refers to the release of an ovum (egg) from the ovary. Ovulation happens 12 to 16 days before the next menstrual period. A period is a cycle typically occurring between 28 to 32 days. As discussed last week, some periods are regular, but many are not. Ovulation kits and fertility monitors can be purchased to check fertility; their expense makes it unlikely a typical person would use them every cycle.
Ovulation can also be tracked by using natural family planning. People with ovaries can check their daily basal body temperature, which rises during ovulation. Testing the cervical mucus for changes (the cervix is the opening to the uterus) can help determine when the egg is released as well. This method takes commitment – it’s a little like a science project. I taught it decades ago; people avoid penis-vagina sex during the times when it appears ovulation is likely.
Here are some myths about conception and ovulation:
- Conception can happen any day in the cycle. No. The egg only lives 12 to 24 hours after leaving the ovary. Sperm, however, can live inside the fallopian tube for three to five days, so pregnancy can occur if unprotected sex happens three to five days before ovulation as well.
- Sperm and eggs are produced at puberty. No. Sperm are produced at puberty, but millions of eggs arrive at birth. Eggs (ova) mature at puberty.
- Pregnancy can only happen right after sex. No. Conception can occur minutes after sex or as long as five days after. I tell young people sex can happen on a Friday but pregnancy may not happen until a Tuesday!
- Ovulation happens in the middle of the menstrual cycle. Not always and only if the cycle is regular in length. Counting from the first day of a period won’t tell a person when the egg is released. Once ovulation occurs, a period will happen 12 to 16 days later. The uterus is prepared for a pregnancy. The lining thickens. If the egg isn’t fertilized, the period happens when the lining sheds.
- Positive pregnancy tests can be taken any time and be accurate. No. Pregnancy tests measure the amount of a hormone in the body called human chorionic gonadotropin (HCG). HCG is a produced during pregnancy. It appears in blood and urine as early as 10 days after conception. Most tests recommend taking a home pregnancy test after the first day of a missed period; some tests will not be accurate until a week after a missed period. Read and follow test directions carefully.
Here are some little-known facts about ovulation.
- Ovulation can be delayed and periods can be missed under stress or changes in normal routines. Every fall I receive texts from new college freshmen who are concerned about irregular menstrual cycles that are not related to pregnancy.
- Normal pain during ovulation is possible but uncommon. Called mittelschmerz (German for middle pain), it occurs about 14 days before the next menstrual period, may last for a few hours or even one to two days, and is a one-sided abdominal pain. A doctor should be seen if the pain is severe.
Ectopic pregnancy: An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. Normally, the fertilized egg attaches to the lining of the uterus.
Fertilization happens in the fallopian tube. Implantation takes place six to 12 days after conception, when the fertilized egg travels from the tube to the uterus. A slight amount of bleeding may occur then. This is called implantation bleeding and may be confused for a light period. Implantation bleeding is normal and the pregnancy continues.
An ectopic pregnancy most often occurs in the fallopian tube and is called a tubal pregnancy.
Some myths about ectopic pregnancy:
- An ectopic pregnancy can only happen in the fallopian tube. No. Although a tubal pregnancy is the most common ectopic pregnancy, it can also occur in other areas of the body, like the ovary, the abdominal cavity, or the lower part of the uterus (the cervix), which connects to the vagina.
- Ectopic pregnancies can be successfully moved to the uterus and the pregnancy can continue. Not at all. This is not medically possible. An ectopic pregnancy cannot proceed normally. The fertilized egg cannot survive; the growing tissues can be life-threatening if untreated.
Next week I’ll look at the myths surrounding miscarriage (spontaneous abortion) and postpartum (the time after birth).
Have a question? Send it to Dr. Mary Jo Podgurski’s email at email@example.com.