If you’ve been at this Trying to Conceive game for a while – or even if you’re just starting out – you’ve probably figured out one very important truth.
Ovulation is really important.
It’s not just important; it’s the name of the game.
Ovulation is the one thing we need to get pregnant. Without ovulating, it’s not gonna happen, my friends.
Issues with ovulation are the number one cause of female infertility. So getting a handle on ovulation is most often the first line of attack in improving your chances of conceiving. It’s important whether you’re trying naturally or are in treatment.
What is Ovulation?
Ovulation is the process of releasing an egg from the ovary. During the first part of our monthly cycle, follicles grow in the ovaries. Follicles are tiny sacs that contain the eggs. The ovaries produce estrogen that helps the follicles to grow and for the eggs inside them to mature. When they’re mature, our brain sends signals to our pituitary gland to release hormones (primarily Luteinizing Hormone) that make ovulation happen.
That’s a very simplified look at ovulation but it gives you the gist of it.
Since ovulation is so important for conception, it’s important to make sure you’re ovulating regularly to maximize your chances of conceiving.
During IVF, doctors actually suppress your natural ovulation because the IVF process involves manipulation of your cycles through medication and stimulation. For this reason it’s not recommended to ovulate on your own during IVF. However, since ovulation is connected with hormone levels and balance, having a healthy ovulation is still a good sign for overall reproductive health.
Signs of Ovulation
Your monthly menstruation is the most obvious sign of ovulation. Your period is the byproduct of ovulation that did not result in a pregnancy.
Getting a period every 21-35 days means that things are going pretty well for you as far as ovulation goes. If your periods aren’t regular, your cycles are not regular, which means you are not ovulating regularly
If you don’t get your period and a pregnancy test keeps coming up negative, or if your period isn’t coming regularly, there’s likely something going on with your ovulation that you need to pay attention to.
In addition to our monthly menstruation, our bodies have amazing ways to let us know when we’re ovulating. The most obvious is cervical fluid. Cervical fluid is also affected by our hormone levels and because of this, its properties vary throughout the month. When you are the most fertile time in your cycle (i.e., gearing up for ovulation), your cervical fluid will be very wet, slippery or may have a consistency and quality similar to eggwhites. It may be like this for up to a week before ovulation. After ovulation, cervical fluid will no longer have these properties, and may even dry up.
Other physical signs that you may notice happen around the time of ovulation. You may experience tenderness or pain around your ovaries (this is called mittelschmerz, or “middle pain”), bloating (the rise in Luteinizing Hormone may cause your body to retain water), or breast tenderness (again, caused by hormonal shifts during your cycle).
These physical signs are different for everyone. You may experience one or more of these, or maybe none at all, and you may still be ovulating regularly. They may also vary from month to month. I almost never experience mittelschmerz but have a time or two. These signs are simply things that you may want to keep an eye on if you are interested in learning about your own unique ovulatory patterns.
Other indicators of ovulation come from the tools that we can use to track our cycles and vary in reliability, but they’re good to note. The first is Basal Body Temperature (BBT). If you are charting BBT then you know when you’re ovulating. Your BBT rises after ovulation due to your body’s rise in progesterone. If your BBT fails to rise, you have not ovulated during that cycle. BBT is incredibly reliable and always lets you know if you have ovulated and when, down to the day.
Ovulation Predictor Kits (OPKs) are also widely used to try to pinpoint ovulation. These home test kits detect the rise in Luteinizing Hormone from a urine sample. So they don’t actually detect ovulation, but they can let you know when it’s coming. There are some reliability issues with OPKs, so I don’t recommend putting much stock in them, but they can be helpful.
A foolproof way to know whether you are ovulating is via blood test. Since progesterone levels rise after ovulation, your progesterone level in the latter part of your cycle is higher than in the earlier phase. Your doctor can test your progesterone late in your cycle to see if it’s at a higher level to indicate ovulation.
This test is usually given 7 days after suspected ovulation. Since the common thinking is that women ovulate on Day 14, the test is commonly referred to as the “Day 21 Test.” However, as we know, ovulation day is different for everyone. It can even be different for the same woman from cycle to cycle. If you want to test your progesterone to confirm ovulation, you can discuss the right time to do this with your doctor.
What to do if you’re not ovulating regularly
If, after your inner detective work, you believe that there are issues with your ovulation, there are things you can do to hopefully get it back on track.
Look at Your Lifestyle
I’ve said it before and I’ll say it again – diet and exercise play a huge part in our overall health as well as hormone balance. The female menstrual cycle is a delicate balance of hormones and hormone balance is crucial for optimal reproductive health.
If you are overweight, this can also play a role. You don’t have to be obese for weight to affect your hormones. Studies suggest that losing just 5-10% of your body weight can go a long way toward restoring hormone balance and can drastically improve your chances of conceiving.
Eating a well-balanced diet of whole foods – whole fruits, vegetables and grains, lots of water and little to no sugar or processed foods — does wonders for hormones, health, mental clarity and overall feeling good.
Exercise is important as well. Experts recommend 30 minutes of moderate-intensity exercise 5 times a week. Aim for a mix of cardio, strength training and flexibility. Exercise combined with diet will keep you healthy, your hormones balanced, and your weight at a desirable level.
Keep Stress in Check
While we all hate hearing “just relax and it’ll happen,” there is something to be said for lowering stress levels while trying to conceive. Studies suggest that high levels of stress enzyme alpha-amylase negatively affects fertility. High stress also leads to high blood pressure, and decreased health overall.
See Your Doctor
In addition to taking the proactive steps of living an active life and managing your stress, your doctor may able to help you get your ovulation back on track.
[Originally appeared at B Fit, B Fertile, 7/16/19]