Ovulation
What is "ovulation"?
Ovulation is the release of an egg from the ovary. Ovulation occurs typically once a month. In a woman who has regular, twenty-eight day cycles, ovulation occurs on day fourteen. Day zero is the first day of your period, day fourteen you'd ovulate. Now women don't always have regular cycles, but ovulation always will occur fourteen days before your period starts. But nobody can predict the future. So, you don't know when your next period is going to be if your cycles are every 47, 32, 19 days. You don't have any regularity, you can't predict when ovulation will occur. So there's other ways that you're going to have to devise methods to determine if you're ovulating, but ovulation is the release of the egg from the ovary.
When do I ovulate?
It is difficult to predict when you're ovulating, but many women actually are in tune with their bodies, such that they know changes that occur. Women can go as far as to actually feel when they ovulate. I've had many patients that can describe kind of a pinging, cramping sensation that they feel in their ovary, and they can tell which side they ovulate from - the left or the right. Other women can tell by the cervical mucus; it becomes more stringy, clear and stringy. It's called spinnbarkeit. Women can sometimes predict ovulation based on that. Also, there's sometimes mood changes that people experience, and they can kind of get a sense, based on some of the other symptoms - the mucus changing and a little twinge of pain and a mood change - that they can predict when they're ovulating. But often times you can't do that, and there's some other methods that we utilize. Basal body temperature, where you can actually check your body temperature in the morning - first thing in the morning before you do anything - you wake up, you lift your head off the pillow, you grab for the thermometer and check you temperature. There are certain surges during the month that suggest ovulation; they don't promise ovulation. There are actually kits you can buy nowadays from local drugstores where you actually pee on a stick, or you can order them online as well, and you pee on a stick and it suggests when you may ovulate within a twenty-four to thirty-six hour window.
What is an "ovulation predictor kit"?
An ovulation predictor kit is a device that detects a surge of the luteinizing hormone in the urine. That hormone surges when you're about to ovulate, so you can detect that initial surge on the urine stick, and you're able to predict, with some certainly, ovulation within about 24 to 48 hours.
What is "basal body temperature"?
Basal body temperature is different for everybody. Most women hover in the 98 to 99 degree temperature but if you were to check it every morning, the LH surge is associated with a slight rise in body temperature. By slight, I mean a half a degree. So if you are running 98.4, 98.3, 98.4 in basal body temperature consistently every morning and then you wake up and your temperature is 99, that does suggest ovulation.
How do I use my basal body temperature to know when I'm ovulating?
I would not use your basal body temperature to detect ovulation. It seems to cause unnecessary stress. People find themselves obsessed with temperature taking. They don't do anything. The phone rings, they don't answer it. Their other child calls for them, they won't get out of bed because they know they have to check their temperature first. Using your basal body temperature to detect ovulation tends to be something that becomes overwhelming and sometimes distracting to a couple that's trying to conceive. So, the recommendation from myself and from several reproductive endocrinologists I've spoken with is not an encouragement to use the basal body temperature as a means to detect ovulation as much anymore.
What is "cervical mucus"?
Cervical mucus is the gelatinous material that is excreted by the body and hovers around the cervix. It actually can do two things. It can actually both increase the ability for sperm to penetrate and, in certain consistencies, as spinnbarkeit, it actually makes it easier for sperm to travel through the cervix and up to the uterus to find the egg. At other times of the month, it may actually make it slightly more difficult, because the cervical mucus is a different consistency; one that's a little bit more difficult for the sperm to penetrate. The “spinnbarkeit” is the term that's used for the ripened cervical mucus around ovulation.
How can I check my cervical mucus to know when I'm ovulating?
To detect whether or not you have spinbarkite or ripened cervical mucus. You would insert a finger into the vagina and then remove it. Then usually simply by taking your index finger and your thumb and separating them, the ripened cervical mucus tends to typically not snap. If you separate and it snaps, it's not as healthy. If you separate it and you can stretch your fingers as far apart and there's still a string that remains there, that's usually a healthier cervical mucus or cervical ripening. Typically you'd do it around when you anticipate ovulation so maybe ten to twelve days after your period starts you could start doing it. Typically in a woman who has cycles that range from twenty-six to thirty-eight days, it would appear within a couple days of you initially starting to check.
