Am I ovulating?

Am I ovulating?

by Crystal Chan, author on The Conception Diaries Crystal Chan 12 February 2018

If you’ve been trying for a pregnancy and have not been successful, or your menstrual cycle is not typical or regular, then “Am I ovluating?” is a very good question. In fact, whether or not a woman is ovulating is one of the first things a fertility specialist will try to figure out. Absent or infrequent ovulation is a very common problem, and it contributes to infertility in approximately 30% of couples who see a fertility specialist.

Ovulation simply means the release of a mature egg from the ovary. Like all our bodies’ processes, egg development, maturation, and ovulation are controlled by hormonal signals. The specific signal that causes ovulation is a surge in levels of a hormone called a luteinizing hormone (LH), which is released from the pituitary gland in the brain. This surge begins 36 hours before the egg is released. Once the egg is released, it has a chance of getting fertilized and resulting in a pregnancy. But if pregnancy does not happen, your period will arrive approximately 14 days after ovulation.

Understanding this basic biology, even without doing any specific testing, you can find a few clues to help determine whether you are ovulating, by tracking your cycles.

The first clue is the regularity of your menstrual cycle. One myth to debunk is that a “normal” menstrual cycle is 28 days long. Very few women actually have the “textbook” 28-day cycle. A regular menstrual cycle lasts anywhere from 24 to 38 days, with cycle variation of up to 20 days! Even if your periods don’t arrive like clockwork, if you are getting a period once a month, you are probably ovulating monthly.

Nowadays, many apps are available to help you track your cycle. You can even do this from the comfort of your own phone! Check out a few of the apps — such as Flo, Period Tracker, and Clue, to name a few — and choose the one you like best! These apps can help track your cycle and ovulation and can predict your most fertile periods as an initial step in your attempt to conceive.

Other natural signs of ovulation are more subtle, yet many women have a good sense of whether these changes are happening. If a woman is ovulatory, her body’s levels of estrogen hormone are highest right before ovulation. This causes her cervical mucus to be thinner and stretchier, much like the texture of an egg white. After ovulation, levels of progesterone hormone rise, and the mucus then becomes thicker.

The hormonal changes before ovulation also affect libido, and women often find that their interest in sex is heightened around this time. If you observe these changes in cervical mucus and libido throughout your cycle, you are likely ovulatory. So, for those of you who think that you feel more aroused at certain times of the month, you are probably right, and this likely corresponds to your fertile period!

For those women who have the motivation, commercial devices are also available to confirm ovulation. The first is a basal body thermometer. This is a specialized, very sensitive digital thermometer that is able to pick up small changes in body temperature, to the decimal point! After ovulation, high progesterone levels in the body cause a slight increase in body temperature, by 0.3°C to 0.6°C. By measuring and charting your body temperature every morning right before getting out of bed, you can document this rise and confirm ovulation.

However, this technique has two big downsides. First, since most of us are rushing in the morning, it can be a real pain to reliably measure and track temperature at the same time every single day. Secondly, although this method enables you to figure out whether you’ve ovulated, it does not help you determine the best time to try to conceive because body temperature only rises after ovulation is over. At this point, it is probably too late to try to conceive because the best time to have sex is just before the egg is released. Some patients will not see a rise in basal body temperature but are still ovulating.

The second tool, for the techies out there, is an ovulation predictor kit (OPK). An OPK is a great tool. Different brands, devices, and packages are out there, but they all work the same way. An OPK detects the LH surge by measuring urine levels of LH. If your cycle is pretty regular, start using an OPK around 17 days before your next anticipated period, or starting on day 10 of your cycle (with day 1 being the first day of full flow). A few days later, it should turn positive, indicating that an LH surge is happening and ovulation should occur in a day or so. If you are trying to conceive, this would be the best time to have sex.

As with any device, an OPK is not perfect and sometimes malfunctions. Some women can have false negatives: An LH surge happens but the OPK fails to detect it. False negatives are uncommon (less than 10%) but could happen to anyone. Some women can have false positives: The OPK detects an LH surge but it is not actually happening. Women with hormonal conditions such as polycystic ovary syndrome are particularly prone to false positives.

Any of these techniques could be a good starting point for couples trying to conceive or for women who are interested in learning about their menstrual cycle. We recommend that women start tracking their cycle a few months prior to when they are actively trying, to get a good idea of when they ovulate, so that when the time comes to really go for it, they have got the timing down!

If you are tracking your cycle and looking out for the signs mentioned above and are still unsure whether you are ovulating, don’t despair! A fertility doctor can order cycle monitoring to track your cycle with ultrasounds and blood tests to confirm whether ovulation is happening.

But even with cycle monitoring, we still encourage women to track their own cycle because understanding the ebb and flow of your own hormones can be empowering. Happy tracking and trying!

Crystal Chan, guest author on The Conception Diaries Guest author: Crystal Chan is a Fellow of the Royal College of Surgeons and Physicians of Canada, with dual specialization in obstetrics and gynecology and reproductive endocrinology.