The top reason for not getting pregnant

Anovulation (when you do not ovulate) is the top reason for women not getting pregnant. That is why each woman trying to get pregnant must find out if and when she ovulates.

What are the typical ovulation symptoms and signs?

Typical symptoms and signs of ovulation include mittelschmerz (pain in the middle), light pelvic pain on one or both sides of the pelvis, spotting, changes in cervical mucus, breast tenderness, moodiness. But they are not always reliable. The babyMed ovulation calculator can help you find out exactly when you ovulate and your most fertile days. 

Why should I know if I ovulate or not and when? 

Finding out exactly if and when you ovulate should be the very first step in assessing your fertility when trying to get pregnant. When you are trying to conceive your entire world can revolve around knowing when you are ovulating. There are several ways you can keep track of ovulation at home. While none of these methods guarantee you will conceive, it will greatly increase your ability to calculate the time you are ovulating and thus your chances for conception will increase as well.

When am I most fertile?

You are fertile only 5-6 days each month, those are the days you can potentially get pregnant from sex. These days are the day of ovulation and the 5 days before ovulation. You cannot get pregnant after ovulation, and the 3 most fertile days are the 2 days before and the day of ovulation. Because of this narrow window of fertility, it is extremely important to know when you are ovulating.

Does ovulation always happen on day 14?

Recent studies have shown that even in regular menstrual cycles ovulation can possibly happen over a range of days. So you cannot always assume that if your menstrual cycle lasts 28 days, ovulation always happens on day 14. Below is a table from a 2018 research study showing you the range of possible ovulation days based on the length of the menstrual cycle. Choose your menstrual cycle length, then move across to show how likely ovulation will be on different cycle days.

Adapted from: CURRENT MEDICAL RESEARCH AND OPINION  2018, VOL. 34, NO. 9, 1587–1594

Why should I keep track of my menstrual cycle?

Keeping track of your cycle is one of the easiest ways to tell when you are ovulating. If your cycle is predictable it is much easier to predict your ovulation. The first day of your menstrual cycle is the day you first begin bleeding. On an average twenty-eight-day cycle ovulation occurs on the fourteenth day. If your cycle is shorter or longer than average you may want to use another method of prediction in conjunction with tracking your cycle.

For the most accurate way to estimate the days of ovulation, try using a calendar to mark the 12^th day until the 16^th day out from your next menstrual cycle. This, of course, will only give you a base guideline for ovulation and will work most effectively in women who have regular menstrual cycles.

Methods of finding out when you ovulate:

1. Progesterone in the blood (Close to 100% but only retrospectively)
2. Ultrasound, finding a growing follicle with the right size (80+% reliable)
3. Basal body temperature charting (Over 90% reliable, but only retrospectively)
4. OPK Ovulation predictor kit (Less than 90+% predictable)
5. Ovulation calculator (Not 100%)
6. Cervical mucus changes (80+% reliable)
7. Ovulation pain: Mittelschmerz (Less than 50% reliable)
8. Saliva ferning ovulation test
9. Fertility Monitors (80+% reliable)

Combining two or more of these improves the reliability of ovulation detection.

Ovulation detection in doctor's office

1. Blood Progesterone Test (100% diagnostic if elevated)
2. Ultrasound Exams of Ovaries (100% diagnostic)

The only 100% correct diagnosis of ovulation can be made if you become pregnant, or if your ovulation shows on sonogram or you have an elevated progesterone level about a week after ovulation.

Basal body temperature (BBT) charting

This involves keeping a record of where you are in your menstrual cycle and then recording your daily basal temperature (temperature in the morning before you get up).

The basal body temperature chart is the best way to record and monitor body temperature that occurs after ovulation. A BBT chart provides a good visual basis for determining ovulation. It cannot predict when ovulation will occur in a given cycle, but by looking at records from a few cycles you can notice a pattern from which ovulation can be estimated.

Cervical mucus changes monitoring

The consistency of your cervical mucus undergoes a number of changes during your menstrual cycle. By observing changes in cervical fluid, you can predict ovulation which is your most fertile time for conceiving a baby.

One of the purposes of cervical mucus during ovulation is to sustain the sperm in a healthy medium and to allow it to move freely through the cervix. Logically there will be an increase in cervical mucus at ovulation, as well as a change in texture - the mucus becomes more clear, stretchable, and slippery.

Using clean fingers, or if you prefer toilet paper, you can examine your cervical fluid. Prior to ovulation, during non-fertile periods, you will experience a dryness (or lack of cervical mucus). Gradually, as you approach ovulation, the cervical mucus will increase, though the consistency will be "sticky" and the color will be white, yellow, or cloudy in nature.

Directly prior to ovulation cervical fluid will increase greatly and the mucus will be semi-transparent, slippery, with the consistency of "raw egg white." This is your most fertile period and ovulation will take place at about this time.

If you find that your cervical mucus is not reaching the "raw egg white" stage, you may want to try a lubricant like Pre-Seed. Pre-Seed is the only truly sperm-friendly lubricant currently on the market, and many people have found success in getting pregnant while using it. If you have concerns about the quantity of quality of your cervical mucus, there is a natural supplement called FertileCM that can help with this issue. FertileCM helps to improve mucus quantity and quality while also strengthening the uterine lining for implantation of the embryo.

However, finding fertile stretchy cervical mucus in and by itself does not necessarily mean that you ovulated. Mucus is made stretchy by the estrogen hormone which normally rises before ovulation. However, there are many circumstances where estrogen can be elevated without ovulation, the most important one being women who have PCOS, or polycystic ovary syndrome. These women often don't ovulate but they can observe stretchy egg-white cervical mucus.  

Mittelschmerz/lower abdominal discomfort

About one-fifth of women actually feel ovulatory activity, which can range from mild aching to twinges of sharp pain. This ovulation symptom, called Mittelschmerz, may last anywhere from a few minutes to a few hours and is usually noticed in the right side of the lower abdomen.

Ovulation predictor tests (OPK)

OPKs can also predict ovulation. An OPK test for a woman's level of luteinizing hormone (LH) which rises to a higher level just before ovulation. If you take an OPK every day starting 5-6 days before suspected ovulation than ovulation usually happens within 12-34 hours after the test first becomes positive.

Saliva ovulation tests

Saliva ovulation fertility tests work by detecting saliva ferning. An increase in estrogen leading up to ovulation increases the salt content of saliva. This can be detected under a microscope by the way saliva crystallizes when it dries. When the salt content is high, the saliva dries in a fern pattern. In the 3-4 days leading up to ovulation salivary ferning is visible and also for a couple of days after ovulation. When you are not in the fertile window the saliva dries in shapeless blobs.

This test involves an initial outlay to buy a mini-microscope to enable you to see these changes. Once you've got this vital bit of equipment, this method of ovulation testing is relatively inexpensive as the microscope can be used again and again. However, it isn't the best method of ovulation detection. A review of different home-use methods of predicting ovulation concluded that salivary ferning was not as accurate as LH ovulation predictor kits.

What is the basal body temperature (BBT)?

Tracking your basal body temperature (BBT)  is another easy and inexpensive way to know if and when you are ovulating. Your BBT is the temperature at the time when you wake up, before you even get up. During the first two weeks of your menstrual cycle, your BBT is lower, and it rises when you are ovulation and stays higher after you are ovulating until the next menstrual bleeding. If it stays up longer than 16-17 days after ovulation and you did not get your menstrual period then chances are you are pregnant. By taking your temperature every morning at the same time you will be able to chart your temperature and notice the increase that indicates ovulation. To effectively chart your temperature you must take it prior to any physical activity and begin charting it on the first day of your menstrual cycle.

Ovulation predictor kit

An ovulation predictor kit is a more advanced method of predicting ovulation. The kit is much like a pregnancy test in that you expose the test to a urine sample and it tests for specific hormones. This is a more expensive way of predicting ovulation but may be more accurate than other methods.

Predicting ovulation is all about knowing your body and understanding the changes in the body. When trying to predict ovulation for conception, make sure to keep track of your menstrual cycles for a few months in a row to create a baseline for your monthly cycle. After 3 or 4 months, add together all of the time between your cycles and divide by the number of months. That will give you the average time between cycles and thus a better beginning point for ovulation prediction.

Ovulation is the time when the egg is ready to be fertilized. With egg life span only at 12 to 24 hours, it is important to know exactly when your eggs are being released for fertilization.