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Tracking Ovulation: A Pathway to Pregnancy Success

Jessica Joseph, RN, BSN, MHA
Updated: May 12, 2024
Ovulated egg with sperm surrounding it
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Ovulation is a 24-hour time window that begins when the egg is released from a follicle in the ovary, and travels to the fallopian tube where it can be fertilized by sperm.  Having sex the day of ovulation can result in pregnancy. However, to further increase chances of pregnancy, you should also focus on your fertile window.  The fertile window is a broader time span, which includes the ovulation period and the days leading up to it. Sperm can survive in a warm moist environment, such as your reproductive tract (uterus, fallopian tubes, ovaries), for up to five days.  Therefore, having sex during the five days prior and up to your ovulation, which is considered your fertile window, can also result in pregnancy.

Key Ovulation Hormones

Four key hormones are involved in your cycle that influence ovulation.

Follicle-stimulating hormone (FSH): Responsible for egg growth and development, selects follicle(s) for ovulation, also linked to ovarian reserve (quantity of eggs).

Estrogen: Prepares your uterus for pregnancy, rising levels designates the start of the fertile window.

Luteinizing hormone (LH): Spikes right before ovulation, indicating egg release is about to occur.

Progesterone: Released after ovulation (confirms it took place) and supports embryo implantation.

Menses, Hormones, and Ovulation Chart

The graph above represents hormone levels during four specific phases of the cycle: menstrual, proliferative (combined representing the follicular phase), ovulatory, and secretory (luteal) phase.

Ovulation Prediction​

Ovulation tracking can be done using multiple methods that are subjective (what you feel) and objective (what can be measured independently).  It is recommended to use a combination of both since subjective methods alone does not confirm ovulation, but are more of a guidance. ​

Subjective signs of ovulation include:

  • Increase in cervical mucus (thin stretchy discharge, often compared to egg whites)

  • Ovulatory discomfort/pain (known as Mittelschmerz) that is in the lower pelvic area and is usually one-sided (left or right)

  • Mid-cycle spotting of blood (ovulation with bleeding)

 

You may have all, some, or none of these subjective symptoms

Objective signs of ovulation include:

  • A slight rise in basal body temperature (BBT) detected by a specialized thermometer

  • Luteinizing hormone (LH) surge, which rises right before ovulation and can be detected via urine or blood work

 

Alternative Options to Ovulation Tracking

You may prefer not to be so regimented with ovulation tracking when attempting to conceive.  If you and your partner have intercourse 2-3 times a week, ovulation tracking may not be necessary.  As long as there are no underlying reproductive health issues.  If you get periods consistently at the same time each month (for example, every 28 days, every 30 days, etc.) you are in the fortunate position to track your ovulation easily.  To calculate ovulation, you would subtract 14 from the number of days in between the first day of their period.  So, for instance, if you get your period every 29 days, you would subtract 14, which indicates you ovulate on cycle day 15.

Ovulation Tracking Tools

​Ovulation tracking tools can help you determine the ideal timing for intercourse.  There are many options available, including:

​1. Ovulation predictor kits (OPKs) can be purchased at local pharmacies or online.  These kits contain urine dip wands that detect your luteinizing hormone (LH).  OPKs can vary in capacity, clarity, and price.  In addition, some may be more obscure to interpret than others.  

2. Apps that can be downloaded on devices such as smartphones and tablets.  Some apps require inputting data such as the first day of the period. You roughly get your period 12-14 days after you ovulate.  These apps aggregate data from previous menstrual cycles to predict future ovulation.  Other apps request more detailed info, including the first day of the period, temperature, ovulation cramping (discomfort/pain), breast tenderness, and spotting.​

 

3. Blood work done with a fertility specialist can indicate LH surge and tend to be more accurate than OPKs and apps. This blood work is sometimes done with other hormones and a sonogram to visualize the follicle(s).

Hormone Analyzer Device

 Mira Monitor

Analyzes reproductive hormones at home

​Factors that Affect Ovulation​

While trying to conceive, you may be concerned if you are ovulating every month.  Certain factors can affect menstruation and ovulation, including diet, stress levels, medications, and medical conditions.  Below are some in-depth reasons for anovulation, or the lack of ovulation:

1. Hormonal Imbalances: Hormonal imbalances, such as polycystic ovary syndrome (PCOS), can disrupt the regularity of ovulation.

2. Age: As you age, the quantity and quality of your eggs decrease, which can affect ovulation.

3. Stress: High levels of stress will increase cortisol, which can disrupt the hormonal balance in your body, potentially affecting ovulation.

4. Weight: Both being underweight or overweight can interfere with ovulation. Maintaining a healthy weight is important for regular ovulation.

5. Exercise: Intense or excessive exercise can impact hormonal levels and disrupt ovulation.

6. Medications: Certain medications, such as those used for chemotherapy or certain antidepressants, can affect ovulation.

7. Medical Conditions: Certain medical conditions, such as thyroid disorders or diabetes, can interfere with ovulation.

8. Smoking and Alcohol: Smoking and excessive alcohol consumption can negatively impact fertility and ovulation.

9. Environmental Factors: Exposure to certain endocrine disrupting chemicals (EDCs) such as pesticides or chemicals, can affect ovulation.

10. Birth Control: The use of certain hormonal birth control methods, such as the pill or IUD, can temporarily suppress ovulation. It's important to note that these factors can vary from person to person, and consulting with a healthcare professional is always recommended for personalized advice.

Promote Ovulation: Balance Your Hormones​

If you do not ovulate every month, you should focus on strategic interventions on how to improve hormone levels to promote ovulation.  For ovulation promotion tips and key strategies to improve regulating your cycles and getting monthly periods, please refer to Fertility Unleashed: Balance Your Hormones to Achieve Pregnancy.

Cover of Guide for Balancing Hormones

​Further Fertility Evaluation​

You are encouraged to consult a fertility specialist if you meet one of the following criteria:

 

  • Under the age of 35 and have been trying to conceive for at least one year without success.

  • Thirty-five or older, and have been trying to conceive for at least six months.

  • Have irregular menstrual cycles since they may not be able to accurately pinpoint their ovulation using the techniques outlined in this article.

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