text: By Uche N. Azubuine
  So many people feel that ovulation is a process. Some even believe that the increase in temperature, slimy mucus secretion means they are ovulating.
  Ovulation is an event. It is that time in a woman’s cycle when a matured follicle has ruptured.
  There are times when a woman can have all the symptoms of ovulation but may in reality not ovulate.
  Let me start from the known to the unknown for this explanation.
  A normal female is born with two ovaries. Each month it is expected that the ovary will release one or more eggs(follicle) from one or both ovaries. It is worthy to note than the side that releases an egg each month is not controlled by the woman.
  Ovulation has been taught before now using the regular 28 day(lunar) cycle. Women are expected to ovulate around the mid point of their cycle. For those with 28 days cycle are taught to expect high fertile period between day 12 to day 16 of their cycle.
  For those with 30 days cycle they are taught to also use the mid point of their cycle which is on the 15th day and expect high fertility between 13th to 17th day of their cycle.
  This knowledge is not wrong but we are reviewing our knowledge to suit the times due to the effect of the recent life style changes in humans, numerous infertility cases that we have encountered and our evidence based findings through ultrasound imaging.
  So many women are involved in a lot of stress nowadays in a bid to make ends meet. These in addition to diet changes may have contributed in distortion of ovulation times away from the usual lunar calculation among women of child bearing age.
  In our practice to assess follicular(Female egg) growth, maturity and rupture we have been able to see that away from the conventional knowledge that so much happens inside which may not be a reflection of the signs and symptoms that manifest in women at the time they are expecting to ovulate.
  There are women who experience infertility just because their eggs do not grow to maturity, a condition known as polycystic ovaries. On ultrasound investigation the ovaries usually bear multiple follicles that fail to grow to maturity.
  Another group are females who their eggs grow to size but do not rupture at maturity. The eggs turn to cysts (sac containing fluids)known as annovulatory cysts. Some women have not been able to conceive for years just for this singular reason. Note that it could be normal for a female to have a single annovulatory cycle. This diagnosis however can be made in a single cycle but a cycle is not enough to conclude that successive annovulatory cycle is going on.
  Another very important group are those who their ovulation do not coincide with the sign of ovulation that they experience externally.
  On ultrasound monitoring, while some women experience signs that coincide with their real ovulation, others either ovulate earlier or later than they expect away from the natural promptings that they get.
  I have followed up a woman who have tried for a few years and failed with natural ovulation calculation. I monitored her and we both saw from the evidence in her results that her calculations do not in any way coincide with her real ovulation. The implication is that she may have been mating at the wrong times every month and getting the same wrong results.
  The message is simple, after successive trials to conceive it is necessary to have the ovaries investigated for follicular growth, maturity and rupture amidst other fertility investigations.
  There are other diagnosis involving the uterus (womb) that could be made in the process of follicular monitoring.
  This is not an exhaustive piece for fertility management.