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Do you know when you ovulate? If you’re part of the majority, chances are you don’t. The problem with this is if you don’t know when you’re ovulating and you’re trying to plan for pregnancy, you’re just playing a guessing game. Fortunately, the body gives us plenty of signals as to when we’re ovulating and fertile - we just have to know what to look for.
There are only 12 - 24 hours per month when we are actually able to conceive because that is the lifespan of an egg. However, sperm can survive for up to 5 days, meaning that a woman can have sex five days prior to ovulation and still conceive. The fluids and secretions women produce leading up to ovulation nourish the sperm that hide out in the crevices of the Fallopian tubes - how amazing is that!? Then when the egg is released, the sperm are there ready to fertilize. That sounds pretty simple, right? Well there are actually a lot of factors that come into play leading up to ovulation, or the release of the egg, and many of those factors give us clues as to what is happening in the body if we know how to read them.
There are four phases of the menstrual cycle - the follicular phase, ovulation, luteal phase, and then menstruation. During the follicular phase, FSH (follicle stimulating hormone) rises stimulating the egg follicles to grow. The dominant follicle then begins to secrete the hormone estrogen. Estrogen steadily rises after menstruation, but peaks 3 - 4 days before ovulation. Once a follicle is matured, it causes estrogen levels to drop, which allows for an LH (luteinizing hormone) surge. This surge happens 24 - 36 hours before ovulation occurs and causes an egg to be released from the ovary, leaving behind a corpus luteum. The corpus luteum secretes progesterone, which helps prepare the uterine lining for implantation. Detection of a rise in progesterone confirms ovulation occurred. So how do we track this information and what do we do with it once we have it?
Three things we will want to track are basal body temperature, discharge, and hormones. We can use the clues we gather to cross-check and predict what is happening within the body. Basal body temperature is a person’s lowest body temperature at rest. It must be checked first thing in the morning while still in bed before you start moving around. Generally you can expect to see your BBT (basal body temperature) around 98 degrees Fahrenheit throughout the majority of your cycle, which signals healthy progesterone levels. Higher estrogen levels may result in a lower body temperature, while higher progesterone levels may result in a higher body temperature. Then, a couple days before ovulation, you may experience a slight dip in BBT as estrogen levels peak. Ovulation, and a rise in progesterone, causes your BBT to rise around .5 degrees Fahrenheit 1-2 days post ovulation. This elevated temperature should stay steady for at least three days. If pregnancy occurs, we will expect the BBT to stay elevated.
There are a couple ways to track basal body temperature - either with a hand held BBT thermometer, checked each morning around the same time and then tracked on paper or on an app like “Read Your Body”, or by using a device like Tempdrop. Tempdrop is amazing for anyone who wakes up at different times in the morning, works nights, is up throughout the night with a nursing baby, or is frequently traveling/experiencing different time zones. You wear this device throughout the night on your arm and then it syncs to an app on your phone, creating an easy to read graph (contact me for a 10% off code!). This is the first piece of the puzzle.
It’s important to then take into account vaginal discharge. As a result of the rise in estrogen a couple days before ovulation, the vaginal discharge takes on an egg white consistency. This discharge signals that the cervix is open and helps to improve sperm mobility, as well as to nourish sperm while they await the release of the egg. This is your most fertile period and the time in which you should plan to have sex if trying to conceive. If your body's estrogen levels are low, you may not have as much fertile quality cervical mucus, which can impact the sperm's ability to survive the otherwise hostile environment of the vagina and to make it to the egg for conception. In women with healthy estrogen levels, estrogen levels will decline post ovulation and progesterone levels will rise, causing the discharge to dry up and signaling that the fertile window is closed.
When trying to determine if your vaginal discharge is "egg white" like, you can try to stretch it between your fingers. It should be able to stretch a couple inches between your fingers and be clear and mucus like.
The third piece is tracking hormones. The LH (luteinizing hormone) surge, which occurs right before ovulation, can be detected using cheap over the counter LH test strips. The tricky part is catching it, as it only lasts 12 - 24 hours and returns right to baseline. Unlike hCG (pregnancy) test strips, which should be used first thing in the morning, it’s best to test for LH in the afternoon, when levels are usually highest. If an LH surge is detected, ovulation should occur within the next 24 - 36 hours and it would be a great time to try to conceive, if that is the goal.
For a much better understanding of exactly what all of your hormones are doing in real time, I recommend using the Inito Fertility Monitor, which tracks FSH, estrogen, LH, and progesterone in a super user-friendly way - it even tells you when your “peak fertility” window is! To use this device you pee in a little cup and use a test strip, similar to a pregnancy (hCG) or LH test strip. This test strip is then inserted into a monitor connected to your phone where it reads all four hormone levels and graphs them on the Inito app. Each hormone level is labeled with exact values and the graphs allow you to see if the hormones are following optimal patterns. Expected hormone levels are below:
Estrogen during the follicular phase has a baseline level of 20-60ng/ml rising to 100-600ng/ml before ovulation
Estrogen during the luteal phase drops to 80-200ng/ml, then declines to baseline levels
LH during the follicular phase is 3-5mIU/ml, peaks at 25-100mIU/ml right before ovulation for 12-24 hours, then returns to baseline in the luteal phase
Progesterone during the follicular phase is 0-3ug/ml and during the luteal phase (after ovulation) is 6-30ug/ml
FSH has a baseline of 4-12mIU/ml, peaking around 25mIU/ml before ovulation
* If progesterone remains at baseline throughout your cycle and estrogen is the only fluctuating hormone, you may be experiencing an anovulatory cycle, meaning ovulation is not taking place and no egg is being released, therefore conception is not possible.
If using the Inito Fertility Monitor, you don’t necessarily need to know these values, as the monitor will interpret the data for you and let you know when it is “peak fertility” time. (You can use code PRIMAL15 for 15% off your Inito monitor).
Now that you know the various ways to read your body’s signals, this is how I recommend integrating these data collection methods:
Collect your basal body temperature daily using a BBT thermometer and tracking on an app like “Read Your Body” or use a device like Tempdrop. Look for a spike of .5 degrees Fahrenheit to confirm ovulation has occurred. For best results, you will have already had sex BEFORE ovulation occurred, as the egg only survives 12-24 hours.
Monitor your discharge daily and look for an egg white consistency, signaling that ovulation is just around the corner.
If using the Inito Fertility Monitor, begin testing five days before your expected ovulation date (as estimated by previous BBT charting or 10-14 days before the first day of menstruation). Continue to test daily until peak fertility has passed. If trying to conceive, have sex every other day beginning 5 days before your expected ovulation and on the day of “peak fertility”.
If using LH strips (instead of Inito), begin testing when the egg white consistency discharge appears or when you see a dip in BBT (before the ovulation spike). Test daily in the afternoon until LH is detected. If trying to conceive, have sex for the next 3 days, expecting to ovulate in the next 24 - 36 hours.
If using the Inito Fertility Monitor, you can continue to test daily to see if progesterone levels stay elevated. If so, that is a sign that conception may have occurred. A BBT that is still elevated (does not drop when menstruation normally begins, around 10-14 days post ovulation) is also a sign that you may be pregnant.
Ideally, you will cross check the above signals beginning with discharge (egg white consistency occurring a couple days before ovulation), hormones (an LH surge occurring 24-36 hours before ovulation, followed by an increase in progesterone), and basal body temperature (with a .5 degree Fahrenheit spike caused by the increase in progesterone following ovulation). Within ten days post ovulation, hCG levels should be high enough to show a positive pregnancy test if you have in fact conceived.
Wishing you happy baby making!
Resources:
@initofertility
Image 1: https://www.insider.com/guides/health/reproductive-health/menstrual-cycle
Image 2: Tempdrop: https://www.tempdrop.com/blogs/resources/detecting-pregnancy-or-ovulation-on-your-basal-body-temperature-chart
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