Five Facts You Didn't Learn in Sex Ed

When was the last time you dove into reproductive physiology? Was it in middle school in sex ed? I see a lot of women in my practice who are trying to get pregnant or having period problems who want answers to their hormone-related health concerns. I find that there is a huge gap between what we learned in middle school and the information that helps us move forward now in our 20’s, 30’s, 40’s and beyond. Here are the top five facts that I personally find fascinating and shed a lot of light on how we understand our bodies.

Fact #1: Women are born with all the eggs we will ever have.

Women are born with all the eggs we will ever have and if that doesn’t seem that surprising, consider that we are born with 1-3 MILLION eggs!  At puberty that number drops to about 300,000 eggs, and they all fit inside our ovaries which are the size of almonds. The average woman ovulates about 400 eggs in her lifespan, so what happens to the other 299,600 eggs?? Stay tuned for Facts #2 and #3!

Fact #2: Menopause does not happen because we run out of eggs.

In fact, we have about anywhere from 100 - 10,000 eggs hanging out in our ovaries when we go into menopause. As we enter our 40’s, our eggs begin to lose their fertile qualities. As egg quality declines, the ovaries become less responsive to the brain signals that are trying to tell the ovaries to ovulate. This is why our cycle begins to change in our 40’s - some women notice longer cycles, others shorter cycles or just irregular patterns. 

Fact #3: Ovulation requires 1,000 eggs each month.

Each month or each menstrual cycle we ovulate just one egg (rarely two but it happens…twins!). This egg is chosen among about 1,000 eggs that are growing each month. Most of these eggs die in a process called atresia. If you’ve been to an IVF clinic or seen a reproductive endocrinologist, you may have had a special type of ultrasound that counts the “antral follicles” for a given month. This count looks at how many eggs (one egg is inside of one follicle) are ready to respond to hormones in order to ovulate. So out of 1,000 eggs that are in different stages of growth, typically about 2-10 eggs are growing inside of each ovary and typically only one egg will be ovulated.

Fact #4: Birth control does not delay menopause.

Women continue to lose about 1,000 eggs each month to the process of atresia (see Fact #3) regardless if they are on birth control, and regardless if there are irregular cycles. Some conditions like polycystic ovary syndrome will impact how many cycles someone has in a year, but the process of egg development and atresia continues, even if ovulation doesn’t occur.

Fact #5: The most fertile time is before ovulation.

Conception happens when a sperm meets an egg in one of the fallopian tubes after an egg has been ovulated. The highest chances of getting pregnant happen a day or two before ovulation, not the day of ovulation or after. This is because the human egg only lives for 4-24 hours after ovulation so in order for conception to occur, sperm must be already in the woman’s reproductive tract waiting for the egg to be released by the ovary. Sperm can live up to 5 days in a woman’s body with the help of cervical mucus which nourishes and transports sperm to the fallopian tubes. This is why we talk about a “fertile window” of  5-6 days leading up to and including ovulation when it’s optimal to have sex if trying to get pregnant or to use birth control if getting pregnant is not your goal.

Anne Chiaramonte, M.S., L,Ac., FABORM is a board-certified reproductive acupuncturist in Santa Cruz, California. She specializes in treating infertility, period problems and mom burnout. With over twenty years experience integrating treatment plans with IVF protocols, Anne is well-versed in how acupuncture and functional medicine (lab testing and targeted supplements) dovetail with modern fertility and hormone treatments for the best outcome. She is passionate about giving her patients information to understand their health challenges and expanding the often limited set of tools doctors have for addressing the roots of those challenges.