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In the previous article, Dr. Mushin Nsubuga, an obstetrician and gynaecologist from C-Care IHK, explained the importance of preconception care.
In this one, the actress Eleanor Nabwiso asks Dr. Nsubuga why couples must understand menstrual cycles and ovulation.
Nabwiso, who is a mother of four -- also talked to Sheila Aboth, a mother of two; and Gordon Mungurick, a father of four -- to share their experiences.
Nabwiso: Could you enlighten us on why understanding menstrual cycles and ovulation is crucial for couples planning to conceive?
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Dr. Nsubuga: When a girl is conceived, they are created with all their eggs that are undergoing continuous development. At a given stage that development is incomplete but "arrested" at the point when the baby girl is born. At around 12 years of age, because of the different changes in her body, she will resume the development of eggs and menstruation will start. This is common at 12 years of age.
Understanding menstruation is important if someone decides to deliberately conceive.
A menstrual cycle is between 21 to 35 days. If it's outside that range, someone needs to talk to their doctor. Day One is the first day the female sees the blood. The day before another menstrual period starts is the last day of the cycle.
On average, most people will have a cycle of around 28 days.
For such people, the ovulation point is usually at 14 days. The period seen on Day One indicates that the egg that had been "arrested" has been selected and is now growing again so that it can be ovulated and fertilised by sperm.
Around Day 14, the egg reaches full maturity and if intercourse happens, the egg will be fertilised to form a baby.
If fertilisation doesn't happen, the egg will last for 24 hours before it "dies". During the cycle, as the egg develops, it produces hormones that prepare the womb for the baby, i.e., thickening it and increasing blood supply.
When the egg dies, the hormone levels drop down leading to the breakdown of the walls of the womb thus the bleeding.
Nabwiso: Why should a couple monitor their menstrual cycle?
Dr. Nsubuga: As already noted, the egg only lasts 24 hours. However, the sperm's lifespan is three to five days. So, monitoring the cycle helps the couple to know the right time for conception.
For a woman to know that she's ovulated, there are some indicators to look out for, for instance, her basal body temperature rising by about O.5 degrees centigrade.
[He advised women to buy thermometers (which cost about Shs5k) and measure their temperatures for about six months every morning they wake up so that they can track these changes.)
During ovulation, the vaginal fluids will be more sticky and stretchy compared to other days.
Commercial kits can also be used to monitor hormones.
Naturally, the body will also start demanding sex.
Aboth: I am told there are sperm types that are not strong enough?
Dr. Nsubuga: When men hit puberty, their testicles start producing sperms every second. It takes 90 days for a sperm to mature and become ready for fertilisation.
One millilitre of a fluid a man ejaculates contains 15 to 39 million sperms. A low sperm count means a person has below 15 million.
A man's ability to impregnant a woman depends on the number of sperms, and structure & movement of the sperms. Some men produce dead sperm and others are just fluids with no sperm.
Hospitals can check a man and find out where the problem is.
Nabwiso: Do you have any special tactics or apps you used to monitor your menstrual cycle?
Aboth: No. I didn't have any. [She said she wasn't even prepared for the second baby.]
Nabwiso: What are some of the myths you've heard?
Aboth: That when you've sex in the morning, between 5 A.M. to 6 A.M., you'll have a baby boy.
Nabwiso: What's the role of men in conception?
Dr. Nsubuga: A quality sperm is a result of a long process that starts right from the way the boy was born. For instance, a boy must have a testicle for them to produce sperm. Some boys are born without testicles and in others, the testicles don't descend into the scrotum. So, when a baby boy is born, doctors need to check the health of the testicles. Activities a boy participates in can also hurt the testicles. Some diseases like mumps, and high blood pressure can also affect the health of the testicles
[He called for ensuring a balanced diet and exercising to avoid disorders like obesity which hinders the production of sperm, keeping away from drugs, and avoiding saunas which expose testicles to high temperatures.]
[The doctor advised men to support women in monitoring their menstrual cycles and also told them to protect themselves from STIs and UTIs because they also affect the fertilisation process.]
Nabwiso: What's your experience with conception?
Mungurick: C-Care has acted as my parent. [He said he and his wife took too long to have kids because he wasn't informed about preconception care and he also used to have issues with his wife when she would complain about things she would go through during the menstrual cycle.]
[He also said he heard of myths like a woman failing to produce because she had sex with different men before deciding to conceive. He called on people to always consult with doctors about reproduction.]
Nabwiso: How does it feel to know that a man cares about your menstrual?
Aboth: It's good for men to be available and provide the necessary support both physically and emotionally. It helps us to be prepared for the man by the time of ovulation.
Nabwiso: Do you have any final words?
Mungurick: We should value conception because, at the end of the day, it will be a determinant of the kind of life you are going to live as a couple and raising the babies that you are blessed with.
Neglecting medical advice may lead to problems in the future.
Aboth: Many mothers are struggling to get pregnant. Don't struggle in silence yet you can consult with doctors.
Dr. Nsubuga: The business of conception is between a man and a woman. Both understanding the menstrual cycle is very important because the window of conception is time-bound.
Nabwiso: It's very beautiful to have your husband on the journey to conception.
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