ovulation guide
Fertility

Ovulation guide

If you’re trying to get pregnant, understanding the timing of your ovulation cycle can be critical. Find out how to pinpoint when you are most fertile. Here’s our guide to ovulation.

The first step to increasing your chances of conceiving is getting to know your ovulation cycle. As most readers are probably aware, in order for conception to take place, at least one healthy sperm must be waiting in the fallopian tube at the moment that ovulation occurs, and must be able to fertilise the egg within 12-24 hours of the egg being released from the ovary. Sperm survives for a maximum of seven days in the female reproductive tract and only a small number of sperm will even survive the long journey through the female reproductive tract.

For this reason, couples who are trying to conceive should plan to have intercourse a number of times in the days just prior to ovulation. In order to do this, you have to be able to predict when you ovulate. This task is easy for those who have a regular 28 day cycle, but it’s a challenge for those whose cycles vary from month to month. Thankfully, there are ways to predict when your most fertile days will occur during each cycle. It’s useful to understand each stage of your menstrual cycle before you go any further.

The menstrual cycle includes:

Menstruation: the shedding of the uterine lining.

Follicular phase: the hypothalamus triggers the pituitary gland to release follicle stimulating hormone (FSH), which prompts the ovaries to produce up to 20 follicles. Each follicle contains an immature ovum. Usually, only one follicle survives to maturity. Assuming the menstrual cycle is around 28 days long, a single ovum matures at about day 10. This event also prompts the thickening of the uterine lining (endometrium) in preparation for a fertilised ovum.

Ovulation – the maturing follicle prompts the release of higher amounts of oestrogen. The hypothalamus responds by secreting a chemical known as gonadotrophin-releasing hormone (GnRH), which makes the pituitary produce luteinising hormone (LH) and FSH. High levels of LH trigger ovulation within about two days. The mature follicle releases the ovum into the peritoneal cavity; it is then drawn into the open end of the fallopian tube. Small hair-like structures within the fallopian tube wave or ‘massage’ the ovum towards the uterus. Unless the ovum encounters a sperm within 24 hours, it will die.

Luteal phase – the follicle becomes the corpus luteum, a structure that makes the hormone progesterone. Unless a fertilised ovum implants into the uterine lining, the corpus luteum dies. Without its contribution of progesterone, the uterus can’t maintain the thickened uterine lining, and menstruation occurs.

Figuring out your fertile window:

1. Watch out for the signs of ovulation.

A physical sign is an increase in vaginal discharge, which changes from white, creamy or non-existent to clear, stretchy and slippery when you ovulate. You may also notice other signs, such as:

  • breast tenderness
  • bloating
  • mild abdominal pain
  • slightly increased body temperature
  • increased sex drive

2. Ovulation predictor kits.

There are many different kinds of ovulation predictor kits on the market. Most work by measuring the level of luteinising hormone (LH) in the woman’s urine.

LH levels rise about 24 to 36 hours before ovulation takes place. You need to estimate your approximate time of ovulation in order to use these kits effectively.

All kits come with detailed instructions and a number of testers.

Work out the length of your average menstrual cycle:

Day one is the first day of the menstrual period and the last day is the day before the next period begins. Let’s say the menstrual cycle is 28 days long.

  • Subtract 17 days. In this example, 28 days minus 17 days equals day 11.
  • Use the ovulation predictor kit on day 11. Continue testing daily until the test comes back positive. A positive result means you are going to ovulate within the next 24 to 36 hours.
  • Having sex around the time of ovulation means that the sperm and ovum have a good chance of meeting in the fallopian tube.
  • If you don’t notice any signs of ovulation or your periods are irregular, you should contact your doctor.

Ovulation problems can occur as a result of many conditions, such as:

  • polycystic ovarian syndrome (PCOS) – a condition that makes it more difficult for your ovaries to produce an egg.
  • thyroid problems – both an overactive thyroid gland (hyperthyroidism) and an underactive thyroid gland (hypothyroidism) can prevent ovulation.
  • premature ovarian failure – where a woman’s ovaries stop working before she is 40

expert advice

Acupuncture and ovulation

Acupuncture and natural medicine can be very helpful for ovulation problems. Traditional Chinese Medicine recognises and respects the delicate balance between hormones, blood supply and overall wellness required to enable successful ovulation every month.

If our hormones are out of balance for long enough, eventually it will signal to the body that regular ovulation is not supported. Poor circulation to the ovaries, be it from elevated stress levels, insulin imbalances (such as in PCOS), oestrogen dominance (endometriosis and fibroids) or lack of sufficient ‘qi’ (our ‘vital energy’) can all impede ovulation. Nutrition deficiencies, be they from poor diet, malabsorption or toxicity, will mean the ovaries are not getting the fuel they need to support egg growth.

The body may also be communicating with us through other symptoms such as skin problems, headaches, insomnia, digestive upsets or fatigue. By looking at the body as a whole, we can deduce which energies are affected and address them through acupuncture, herbal support, diet and nutritional supplementation, thus allowing the body to work optimally and support fertility.

Recent studies support the beneficial effects of acupuncture on ovulation. In March 2013, research published in the American Journal of Physiology, Endocrinology and Metabolism demonstrated that acupuncture increased ovulation and down-regulated testosterone in women with PCOS. In November 2013, and study carried out by Guangxi University of Chinese Medicine demonstrated dramatic effects on a research group of forty anovulatory women, improving hormone levels, womb lining and follicle diameter and ultimately resulting in an 85% successful pregnancy rate.

Acupuncture is an excellent support for all women facing fertility issues and hormonal imbalances, offering a gentle, relaxing and non-invasive approach.

Fiona O’Farrell is a naturopath and acupuncturist specialising in fertility, pregnancy and women’s health. For more information see www.thegateclinic.ie or call 01 201 7210. 

More like this:

All you need to know about fertility
Can hormones cause infertility?
Secondary infertility: what can you do?

Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.

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