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What’s the fertile window for women and why does PCOS cause infertility?

During my clinical practice, I find a lots of couples didn’t have the right knowledge about the fertile window when they were trying to have baby.

Basically, the sperm needs to meet the egg to make fertility happen, but the lifespan of sperm usually last from 3-5 days while egg only survives for 6-24 hours, and it can take from 45minutes to 12 hour for the sperm swimming to fallopian tube to meet the egg after intercourse. So it does make sense if the sperm is already waiting inside woman’s body while the egg is released, they have better change to fertilise.

It’s a simple math to calculate the possible days to fall to pregnant after sexual intercourse. There are between 5 days before to 24 hours after ovulation which is called the fertile window. But the most fertile days will be only 2-3 days leading up to ovulation.

Then the question is how do we know when the ovulation happened or going to happen? If you have regular period, it will be as simple as a kindergarten math–just subtract 14 from the number of days in the cycle. For instance, a woman with 28 days cycle is most likely to ovulate at 28-14=14, so answer is day 14.

But if you’d like to have more accurate result or you have irregular period, you should step further. There are a few choices from Observe cervical mucus, Basal Body Temperature Charting to Ovulation Urine Test Strip and Saliva Ovulation Test. I personally recommend Saliva Ovulation Test, as it can predict as early as 5 days before ovulation and only cost about $40.

The final option will be have a blood tracking and ultrasound test by medial Dr. if you fail to find out the date of ovulation. But not every woman will ovulate in every cycle, especially if you are diagnosed with PCOS.

You may wondering what PCOS is meaning in terms of fertility. We all know the egg needs to meet sperm to let conceive happening, but if there is no egg present every month as it should be, the chance of pregnancy will be dropped dramatically.

I have explained the ovulation should happen around 14 days before next period, but if you have PCOS, your ovaries contain a lots of follicles while they hardly get mature, then the egg can’t grow mature and release from the follicle every month, or even do not ovulate at all.

Though there are a few options of medical treatment to treat PCOS, but the underlying hormonal disturbances cannot be reversed by medical therapy.

In Chinese Medicine, the PCOS is caused by imbalances of Yin Yang and accumulating of phlegm. For instance, you may have overactive of yang and excess of phlegm if you have excess facial and body hair growth, and you may have Yin deficiency if you are overweight. Recent scientific research found the Acupuncture helped 89.79% of participants had menstruation and hormonal balance return ( Lim, Danforn. Acupuncture for menstrual disorder in women with PCOS: UNSW Australian Medicine 2010), and Acupuncture resulted in significantly higher ovulation frequency in women with PCOS (Johansson, J., Acupuncture for Ovulation Induction in PCOS: A RCT. AM J Physiol Endocrinol Metab 2013.)

If you’d like more information about PCOS and fertility please call myself Joseph Zhang (Dr. of TCM) at Kingsford or your closest Health Space Clinic for a consultation to see how Acupuncture and Chinese Medicine can help with Ovulation and PCOS.

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