By Amy Beckley PHD
Chief Executive Officer
MFB Fertility Inc.
A good way to increase your chances of conceiving a child is by monitoring ovulation. Ovulation is the process of a mature egg being released from your ovary. The lifetime of an egg after ovulation is only 12-24 hours, possibly less. Therefore, pinpointing ovulation is essential to increasing your chances of achieving pregnancy. The process of ovulation involves a delicate balance between 3 main hormones. First, an increase in estrogen allows for the egg to mature within the follicle. Second, a surge in luteinizing hormone (or LH) ripens the eggs and allows for its release from follicle (Ovulation). Finally there is progesterone, a hormone released from the ovary after ovulation has occurred. This hormone prepares your uterus to receive and nurture the fertilized egg.
Several companies offer “Ovulation Predictor Kits.” These are tests that allow women to monitor the surge of LH. Observing a positive LH test means the body is gearing up to ovulate and it “predicts” ovulation will occur in the next 24-48 hours. Since the 2-3 days leading up to ovulation are the most fertile, these tests are a great tool couples can use to determine their most fertile days of the cycle. However, these tests have one major limitation, they cannot confirm whether or not ovulation has actually occurred. In fact, there are several common conditions that cause LH to surge, but ovulation doesn’t occur.
- Polycystic Ovarian Syndrome (PCOS) – This is a condition that occurs in 1 out of 10 women. Hormonal imbalances lead to problems in ovulation. Women with PCOS often see several surges of LH and no resulting ovulation.
- Stress – Women under a lot of stress have an increased production of the stress hormone cortisol. A woman can get an LH surge, but cortisol can prevent the release of the egg from the ovary.
- Advanced Maternal Age – Women over the age of 40 can have chronically high levels of LH in their system, resulting in positive LH tests without ovulation following.
- Premature Ovarian Failure (POF) – Women with POF can have higher than normal levels of LH in their bodies. Therefore, they will get positive LH tests, but not actually ovulate.
- Clomid – Ovulation-inducing drugs such as Clomid can cause an increase in LH shortly after taking it. Therefore, this can cause women to have a positive LH test result without ovulation occurring.
- False peak – Occasionally LH will surge too early in the menstrual cycle and the egg is not mature enough to be released from the ovaries. This results in an LH surge with no ovulation after it.
- Luteinized Unruptured Follicle (LUF) – This condition occurs when all hormones are normal within a cycle, but the surge in LH fails to induce the rupture of the follicle and the release of the egg. It is estimated that 5-25% of women with infertility suffer from LUF.
Therefore, in order to make sure ovulation has actually occurred, it is good practice to monitor progesterone as well. Progesterone rapidly increases after ovulation has occurred. Therefore, combining a method of “predicting” ovulation with a method that “confirms” ovulation is important when trying to conceive a child.
After ovulation, the follicle that released the egg turns into the corpus luteum and starts producing the hormone progesterone. Progesterone is low in the first part of the menstrual cycle and increases significantly after ovulation. Therefore, monitoring the levels of progesterone in your cycle is an excellent way of confirming ovulation has taken place. Progesterone levels can be checked at a doctor’s office with a simple blood draw. Results are often provided to the patient in 1-3 days. However, if a trip to the doctor’s office doesn’t sound appealing to you, there are two methods to track progesterone at home.
- Basal Body Temperature – Basal body temperature is your body temperature when fully at rest. The increase of progesterone after ovulation is known to increase a women’s basal body temperature 0.2 to 0.5C (0.4 to 1.0F). In order to get an accurate basal body temperature reading, you need to take your temperature at the same time each morning and before getting out of bed or eating anything. Any movements can affect the temperature reading, therefore, you’ll want to make sure you’ve had at least 4 hours of restful sleep before taking your temperature.
- At Home Progesterone tests – There is a new test on the market that measures progesterone metabolites in the urine. The test works very similar to a pregnancy or ovulation predictor test. When the amount of progesterone metabolites in urine reach a level that confirms ovulation, the test will turn positive.
If you’re trying to conceive and want to hurry up and be pregnant already, I strongly suggest monitoring ovulation. If you’re not ovulating, you have a 0% chance of conceiving a child. Monitoring ovulation can help you self-diagnose possible causes of infertility. If you monitor ovulation at home and find you are not ovulating or ovulation is not consistent, then you have very valuable information to pass along to your doctor. Therefore, tracking ovulation will help you achieve pregnancy faster.