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Female Fertility And Fertilization


Female fertility is a woman’s ability to conceive a biological child after a well-timed, unprotected sexual intercourse. Female fertilization processes are influenced by various stage of human development.

In the female, reproduction begins with a woman’s menstrual cycle. About midway through the cycle, usually 14days form the next menstruation, the ovaries release the egg during the process of ovulation. This is the time the woman is most fertile and she may have an increased libido. Her body temperature may also increase slightly, and her vaginal discharge may be very thin and stretchy. During ovulation, the woman may also feel some slight one-sided lower abdominal pains. These are normal signs of ovulation.

During fertilization, the egg cell is released from the ovaries into the fallopian tube, where fertilization will take place. Fertilization only materializes when the sperm swims to meet the egg (ovum).

Through sexual intercourse a man ejaculate semen into a women’s vagina. Over 20 million sperm cells are produced per each ejaculation. The sperms travel through the cervical mucus, up the lining of the uterus into the fallopian tubes to meet the egg releases from the ovary. There are two fallopian tubes and only one may contain an egg at a time. The sperm that chooses the correct fallopian tube will finally reach the area around the egg. However, the sperm undergoes such a tough journey that few sperms survive to successfully fertilize the egg. It is believed that this process may be nature’s way of allowing the healthiest sperm to fertilize the egg, to provide the best chances of having a healthy baby.

Sperms surrounding an egg and competing to fertilize it



Infertility is defined as inability to get pregnant despite frequent intercourse for at least one year. Female infertility affects millions of couples in Ghana. There are many different causes of infertility in couples. Medically-related issues that influence infertility in women include the following:

  • Ovulation disorders: infrequent or absent ovulation makes fewer eggs available for fertilization. This affects the release of eggs from the ovaries. These are sometimes influenced by hormonal disorders such as polycystic ovary syndrome (PCOS), hyperprolactinemia and thyroid disorders.









  • Uterine Fibroids: These are abnormal non-cancerous growths in various parts of the uterus. The cause infertility by blocking the tubes, distorting the inner lining of the uterus, taking up the space for implantation, or making the woman miscarry her pregnancies repeatedly. They are most common in Black women and Asians.








  • Uterine agenesis: When the uterus fails to develop. Here, the affected women usually do not have menstrual periods due to the absent uterus, hence women with this condition are unable to carry a pregnancy. They can only bear children via Assisted Reproductive Technology.
  • Uterine or cervical abnormalities, such as polyps or submucous fibroids in the uterus.
  • Tubal blockage: blockage of fallopian tubes occurs as a result of previous pelvic infections the woman may have suffered. Such infections may not show any symptoms, or may show symptoms of abnormal vaginal discharge, lower abdominal pains, painful intercourse, feverishness, high temperature among others. If untreated well, these infections persist for years and cause permanent tubal damage that results in infertility.
  • Previous tubal ligation for sterilization treatment, removal of blocked tubes.
  • Endometriosis: A condition in which endometrial tissue implants and grows outside the uterine lining, often affecting the function of the uterus and the fallopian tubes. This causes lower abdominal pain, menstrual pains, scarring and changes in the ability of the eggs to fertilize and create a pregnancy.
  • Early menopause, which occurs when the ovaries stop working and menstruation ends before age 40.
  • Pelvic adhesions are bands of scar tissue that bind two part of your tissue that aren’t normally joined together. A pelvic adhesion involves organs within the pelvis such as uterus, ovaries and Fallopian tubes after pelvic infection, appendicitis, or abdominal or pelvic surgery.
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  • Medical conditions such as poorly controlled diabetes, and some autoimmune diseases such as lupus.
  • Aging; delaying pregnancy can reduced the likelihood of conceiving. Generally, a woman’s fertility declines with age. However, after age 35years, this decline is sharper. This affects both the quantity and quality of the woman’s eggs, making it harder to conceive. It also results in having babies with some birth defects.


Generally, healthy lifestyle changes will enhance female fertility. These include: 

  • Avoiding multiple sexual partners that can lead to contraction of sexually transmitted infection such as chlamydia and gonorrhea. These cause long-term tubal damage.
  • Avoiding stress and relaxing will enable a stable hormones production and help reduce the risk of infertility.
  • Maintaining a well-balanced diet will enable healthy weight gain. Under-weight individuals can have infrequent ovulation
  • Avoiding tobacco smoking due to its association with reduced fertility. In females, smoking causes aging of the ovaries and this gradually leads to premature menopause.
  • Heavy drinking turns to increase the risk of ovulation disorders and impair hormones production at the various stages of the female menstrual cycle.


  • Heffner, L J and Schust D J, The Reproductive System at a Glance (4th edn, Oxford: Wiley Blackwell, 2014) and J Knight, The Complete Guide to Fertility Awareness (Routledge, 2016).
  • Mayo Clinic. (2013, June 27). Invitro fertilization (IVF).
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