Case Study: Trying to Conceive
Isabella, 28, and Omar, 30, have been together 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 Isabella’s menstrual cycle, but after six months passed without Isabella 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 had also 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 Isabella’s menstrual cycle each month.
After several months of trying this method, Isabella 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. Omar 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.
Isabella 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 they ovulate. Additionally, Dr. Bashir recommends she try using a home ovulation predictor kit, which predicts ovulation by measuring the level of luteinizing hormone (LH) in the urine. In the meantime, Dr. Bashir sets up an appointment for Omar 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 Isabella monitor these variables, and the types of problems she will look for in Omar’s semen. At the end of the chapter, you will find out the results of Isabella and Omar’s fertility assessments, steps they can take to increase their chances of conception, and whether they are ultimately able to get pregnant.
Most of the information in this chapter is in terms of cis-gendered individuals because there is a lack of data on lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. About 3.5% of Americans identify themselves as lesbian, gay, or bisexual, and 0.3% identify themselves as transgender. The acronym LGBTQIA+ is an umbrella term that includes a number of groups: lesbian (homosexual woman), gay (homosexual man or woman), bisexual (person who is attracted to both genders), transgender (person who identifies their gender as different from their biological one), queer (a synonym for gay; some people prefer to identify themselves as queer to empower themselves and take their identity “back from the bullies”), questioning (people who are unsure about their gender identity/sexuality), intersex (people with two sets of genitalia), asexual (people who are not sexually attracted to anyone and who don’t identify with any orientation), allies (the loving supporters of the community, though not necessarily part of it), two spirits (a tradition in many First Nations that considers sexual minorities to have both male and female spirits), and pansexual (person sexually attracted to others of any sex or gender).
Chapter Overview: Reproductive System
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 include 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, matured, stored, and 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), behavioral methods, intrauterine devices, and sterilization
As you read the chapter, think about the following questions:
- Why might sexual intercourse on day 14 of Isabella's menstrual cycle not necessarily be optimal timing to achieve a pregnancy?
- Why is Isabella 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 Omar is concerned about past injuries to his testes? How might an analysis of his semen help assess whether he has a fertility issue—and, if so, the type of issue?
- Couple holding hands by aprilsylvester; Pixabay license
- Day 222 - temperature by Phil and Pam Gradwell licensed CC BY 2.0 via Flickr
- Some text is adapted from Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review; Hudaisa Hafeez, Muhammad Zeshan, Muhammad A Tahir, Nusrat Jahan, and Sadiq Naveed; Cureus. 2017 Apr; 9(4): e1184. Published online 2017 Apr 20. doi: 10.7759/cureus.1184; CC BY 4.0.
- Text adapted from Human Biology by CK-12 licensed CC BY-NC 3.0