During a normal menstrual cycle, an egg matures in the ovary in response to Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) which are secreted by the pituitary gland. Day 1 of the menstrual cycle is the first day of full flow bleeding. During the follicular phase of the menstrual cycle, the time from menses to ovulation, FSH and LH stimulate the ovary and result in growth of a follicle containing an egg.
In regularly cycling women, ovulation occurs when the the LH level spikes, the developed follicle ruptures and the egg is released. This usually occurs around day 14 in women with a 28 day cycle and day 16 in women with a 30 day cycle. The ovulated egg is then captured by the fimbria and enters the fallopian tube where fertilization would take place.
In most normal cycles, only one egg is released from the ovary. During the luteal phase of the cycle, from ovulation to menses, the corpus luteal cyst of ovulation produces estrogen and progesterone. Adequate levels of these hormones are essential to maintain the uterine lining so a fertilized egg may implant, resulting in pregnancy. If a fertilized egg does not implant, the corpus luteum stops making estrogen and progesterone and the levels drop, signaling menstruation and the beginning of a new cycle.
Patients undergoing Ovulation Induction may be treated with either FSH or Clomid or Femara.
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