North American Registry of Midwives (NARM) Practice Exam

What signifies the end of a woman's menstrual cycle and the beginning of pregnancy?

1. Ovulation

2. Implantation of the blastocyst

3. Menstruation cessation

4. Fetal development

The correct answer is: Implantation of the blastocyst

The correct choice identifies implantation of the blastocyst as the significant event that marks the transition from the end of a woman's menstrual cycle to the beginning of pregnancy. After ovulation, if fertilization occurs, the zygote travels down the fallopian tube and develops into a blastocyst. Upon reaching the uterus, the blastocyst implants into the uterine lining, which signals the start of pregnancy. This implantation triggers hormonal changes that prevent menstruation and support the developing embryo, effectively ending the menstrual cycle. The cessation of menstruation occurs as a result of this hormonal shift, but it is the actual implantation event that signifies the definitive beginning of the pregnancy. Other options represent relevant phases or outcomes in the reproductive cycle but do not directly indicate the beginning of pregnancy. Ovulation refers to the release of an egg, while fetal development begins after implantation and the establishment of pregnancy, and menstruation cessation is a consequence of the entire process rather than a standalone event that signals the start of pregnancy.