Turns Out, It’s Actually Pretty Difficult to Get Pregnant

03.31.2019 Home & Motherhood
Heather Sundell
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I don’t have a strong memory of my own sex education course in ninth grade. Though I’m confident that it definitely wasn’t as fun as the musical “Reproduction” from the critically unacclaimed film, Grease 2. I do, however, know I eww-ed my way through the required Miracle of Birth VHS and chit-chatted about my classmate’s new Guess jeans in the back of class. The teacher wasn’t taking it very seriously, and neither was I. Besides, I already knew the basic mechanics of how sex worked, and that I should try very hard not to get pregnant –– assuming, of course, that it was very easy.

Even when I was diagnosed with PCOS (Polycystic Ovarian Syndrome) at 16, and was quite literally told that it might be difficult for me to conceive, I was still encouraged to do whatever possible to prevent a pregnancy. The fear of God was put in all of us that even one penis-in-vagina encounter could lead to early parenthood.

And that’s not completely un-true. Many women really do get pregnant à la Knocked Up, but, (and it’s a pretty big but), it is unlikely. In fact, even when everything is working properly on both ends, there’s only a 20% chance a pregnancy will occur for healthy and normal reproductively functioning women in their 30’s.

I didn’t really understand this until I, at the age of 30, decided to go off birth control after being on it for half my life. However, my period didn’t return for nearly two whole years, which prompted me to proactively seek out the proper reproductive health education I never got as a teenager.

Through an acupuncturist, reproductive endocrinologist, and way too many articles and online forums for answers and support, I learned what my fallopian tubes actually do, how to differentiate the phases of a menstrual cycle, and perhaps, most importantly, how babies are made. Like, really made.

I thought I knew, but embarrassingly I didn’t (most likely because I spent half my life trying not to create one). Turns out, making a human is super complicated, and it’s honestly astounding that anyone is born safely at all!

If your high school also failed you in reproductive education, let me save you some midnight Googling and co-pays…

Your menstrual cycle:

Okay, let’s get some math out of the way. The average female is born with one to two million eggs at birth, and that’s all you’re gonna ever get. In fact, by the time you get your first period, this supply has already dwindled down to about 300,000. These little precious puppies are the reason you have a menstrual cycle in the first place.

Chances are, the only time you’re thinking about your cycle is once a month when you’re doubled over with cramps and trying not to bleed through your jeans. But, your cycle is actually happening all of the time.

The typical period length is 28 days, but it’s totally normal for it to be anywhere from 24-38. Even for women who have irregular periods (hi, hello, it me), there are still always four phases to your cycle: menstrual, follicular, ovulation, and luteal.

The menstrual phase is your period, where the uterus sheds its lining after an egg was released with no fertilization.

The follicular phase begins on the first day of menstruation and lasts until ovulation. The pituitary gland secretes the FSH (Follicle Stimulating Hormone) that stimulates egg cells in the ovaries to grow. One of these egg cells begins to mature in a sac-like-structure called the follicle. It takes anywhere from 7-19 days for the egg cell to reach maturity. While the egg cell matures, its follicle secretes a hormone that stimulates the uterus to develop a lining of blood vessels and soft tissue called endometrium.

The ovulation phase is short — it’s the one day where you drop a little eggo into your fallopian tube.

The luteal phase begins right after ovulation. If a sperm cell does not impregnate the egg cell within that time, the egg cell disintegrates. Progesterone, causing the uterus to retain its endometrium, gets used up by the end of the menstrual cycle, which signals the uterus to shed.

The fertility window:

It’s crazy that we were taught that you could get pregnant any ol’ time, when that is not factually possible at all. There is really only a window of about 24 hours where this can potentially happen.

“If a woman ovulates 500 times between the ages of 12 and 52, and if not all of those eggs are considered to be healthy, what you’re left with is a select few eggs that are truly viable for pregnancy,” says Alan Copperman, M.D., director of Reproductive Medicine Associates of New York and co-director of the Division of Reproductive Endocrinology and Infertility at The Mount Sinai Hospital in New York City.

Let’s also factor in that once you actually successfully ovulate, the egg is only viable for fertilization in a 12-24 hour window. But don’t worry if you can’t get freaky on the day of… sperm can live inside your body for five days. (Not creepy at all.)

Other obstacles:

It’s estimated that 1 in 10 women have PCOS, which, in my experience causes anovulatory disorder (AKA: I don’t ovulate with any regularity). Endometriosis is another all-too common reproductive disorder which affects about 200 million women worldwide and causes uterine lining tissue to travel out the end of the fallopian tube and into the abdomen. This can potentially attach to other organs, which causes inflammation and irritation of local tissue, which can cause extreme pain and fertility issues. Throw in uterine fibroids (tumors) and fallopian tube scarring which can impact fertilization and embryo implantation, and there are plenty of potential reproductive roadblocks.

And while it’s really rude of biology, egg quality is still the number one factor in fertility and quality is dependent on age. Even though women get better with age, their eggs do not. While there still may be enough eggs left, the risk of chromosomal abnormalities increase significantly after 35. Also, unexplained infertility is somehow an actual medical diagnosis.

This is all to say that plenty of women at any age have beautiful, healthy babies, with or without fertility assistance. It’s just a lot more complicated than we were ever taught in sex education class, and when you break it all down, it really is a miracle.

Heather Sundell is a Los Angeles-based writer, blogger, storyteller, and content and branding professional. Her writing has been featured in the Los Angeles Times, Refinery29, Forbes, XOJane, Los Angeles Magazine, and more. You can find her online as her digital alter ego @MissHezah, blogging at MissHezah.com, or, when in doubt, check the mall.

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