1. Why might sexual intercourse on day 14 of Isabella's menstrual cycle not necessarily be optimal timing to achieve a pregnancy? 2. Why is Isabella concerned about her irregular and long menstrual cycles? How could tracking her BBT and LH level help identify if she is ovulating and when? 3. Why do you think Omar is concerned about past injuries to his testes? How might an analysis of his semen help assess whether he has a fertility issue—and, if so, the type of issue?
Isabella, 28, and Omar, 30, have been together for three years. A year ago, they decided they wanted to have a baby, and they stopped using birth control. At first, they did not pay attention to the timing of their sexual activity in relation to Isabella’s menstrual cycle, but after six months passed without Isabella becoming pregnant, they decided to try to maximize their efforts.
They knew that in order for a woman to become pregnant, the man’s sperm must encounter the woman’s egg, which is typically released once a month through a process called ovulation. They had also heard that for the average woman, ovulation occurs around day 14 of the menstrual cycle. To maximize their chances of conception, they tried to have sexual intercourse on day 14 of Isabella’s menstrual cycle each month.
After several months of trying this method, Isabella is still not pregnant. She is concerned that she may not be ovulating on a regular basis because her menstrual cycles are irregular and often longer than the average 28 days. Omar is also concerned about his own fertility. He had some injuries to his testicles (testes) when he was younger, and wonders if that may have caused a problem with his sperm.
Isabella calls her doctor for advice. Dr. Bashir recommends that she try taking her temperature each morning before she gets out of bed. This temperature is called basal body temperature (BBT), and recording BBT throughout a woman’s menstrual cycle can sometimes help identify if and when they ovulate. Additionally, Dr. Bashir recommends she try using a home ovulation predictor kit, which predicts ovulation by measuring the level of luteinizing hormone (LH) in the urine. In the meantime, Dr. Bashir sets up an appointment for Omar to give a semen sample, so that his sperm may be examined with a microscope.
Discussion Questions:
1. Why might sexual intercourse on day 14 of Isabella's menstrual cycle not necessarily be optimal timing to achieve a pregnancy?
2. Why is Isabella concerned about her irregular and long menstrual cycles? How could tracking her BBT and LH level help identify if she is ovulating and when?
3. Why do you think Omar is concerned about past injuries to his testes? How might an analysis of his semen help assess whether he has a fertility issue—and, if so, the type of issue?
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