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A couple in their early 40's are wanting advice for contraception…

- - - - Days 1-13 of 28 day ovarian cycle
      - ~ 20 primordial follicles stimulated to mature by LH and FSH
        
        Few primary follicles maturing into secondary follicle
        
        Usually only one matures to vesicular follicle
        
        Volume of fluid increases within follicle antrum
        
        Oocyte forced to one side of follicle
      - Primary oocyte in follicle finishes meiosis I to form 2 cells
      - Other cell derived from primary oocyte receives bulk of cytoplasm
        
        Becomes secondary oocyte in vesicular follicle
        
        Reaches metaphase II before arrested again
        
        Completes meiosis if fertilized, if not it will break down in 24 hours
    - - Release of secondary oocyte from mature follicle
      - Occurs on day 14 of 28 day cycle
      - Usually only one ovary ovulates each month
      - Induced within the peak in LH secretion
      - Antrum increases in size and swelling
      - Expands until ovarian surface thins
        
        Eventually ruptures, expelling secondary oocyte
    - - Remaining follicle cells become corpus luteum
      - Occurs on days 15-28 of cycle
      - Corpus luteum
        
        Temporary endocrine gland
        
        Secretes progesterone and estrogen
        
        Builds up uterine lining, prepares for fertilized oocyte
        
        Life span of 10 to 13 days if oocyte is not fertilized
      - Corpus luteum regression
        
        Causes drop in secreted progesterone and estrogen
        
        Causes shedding of uterine lining, menstruation
        
        Marks end of luteal phase
  - - - Influenced by estrogen and pregesterone
      - TImeline based on 28-day uterine cycle, but varies (21-35)
    - - Days 1-5 of cycle
      - Sloughing off of the functional layer
      - Last through period of menstrual bleeding
    - - Days 6-14 of cycle
      - Development of new functional layer of endometrium
      - Overlaps time of follicle growth and ovary estrogen secretion
    - - Days 15-28 of cycle
      - Increased progesterone secretion and uterine gland development
      - Increases vascularization and uterine gland development
      - If fertilization does not occur:
        
        Degeneration of corpus luteum and dramatic drop pf progesterone
        
        Without progesterone, sloughs off functional layers
- - - - Where fertilization occurs
      - Moves the egg from the ovaries to the uterus
    - - Flow of menstrual blood from the uterus to vagina
      - Directs the sperm into the uterus during intercourse
- - - - Uterus is divided into 2 parts
        
        Cervix: lower part of uterus that opens to the vagina
        
        Corpus: main body of the uterus
    - - Also known as the birthing canal