Ovulation is defined as the release of an egg from the follicle in the ovary. Once the egg is released, it’s then able to enter the fallopian tube, which is where the egg meets the sperm. If you are not ovulating regularly, your chances of getting pregnant naturally are very low. In fact, ovulatory dysfunction can be found in about 15% of all infertile couples and accounts for up to 40% of infertility in women.
The most common causes of ovulatory problems include polycystic ovary syndrome (PCOS), obesity, weight gain or loss, strenuous exercise, thyroid dysfunction, and hyperprolactinemia. Ovulatory dysfunction is something that I see commonly in my practice and the good news is that most cases are very treatable. Ovulatory problems are relatively easy to treat, it’s usually associated with a good prognosis, and in many cases, minimal intervention is needed to help a patient successfully conceive. So the question you may be asking yourself now is, “How do I know if I am ovulating?”
Here are 6 ways to tell if you are ovulating.
1. Track Your Menstrual Cycle
One very simple way to figure out if you are ovulating is to track your menstrual cycle. Most women who are ovulatory have regular, predicable menstrual cycles every month. Their cycles generally occur every 21-35 days and their flow characteristics are consistent. If your menstrual cycles are longer than 40 days or if there are months when you don’t have a bleed, there is a good chance you are not ovulating regularly.
You can track your menstrual cycle in several different ways. You can simply use a calendar or notebook, or you can download a period-tracking app on your phone. There are so many good ones available these days and some will even let you know about your ovulatory window. Try to track your menses for 2-3 months and look for a pattern. If you notice irregular cycles and you are trying to conceive, talk to a fertility specialist about your cycles.
2. Look For Ovulation Symptoms
Some women will experience specific signs of ovulation during their ovulatory window. Ovulatory symptoms might include cramping or bloating, one-sided abdominal pain, spotting or light bleeding, breast tenderness, increased libido, fatigue, mood changes, and headache. You may also notice a change in your cervical mucus from thick and sticky to a slippery, watery consistency. If you experience one or some of these symptoms regularly around the same time in your cycle each month, it’s usually a good sign that you are ovulating.
3. Measure Your Basal Body Temperature
Believe it or not, your body temperature actually increases with ovulation. Measuring your basal body temperature (BBT) daily throughout your menstrual cycle is another way to figure out if and when you may be ovulating. Measure your temperature using a digital thermometer first thing every morning before you even get out of bed for an entire cycle. Women who are ovulating will notice a 0.5-1.0 degree rise in basal body temperature around the time of ovulation. Also, look for at least 10 days of temperature elevation after ovulation and before you get your period. This is known as the luteal phase and a short luteal phase may also be a sign of more subtle ovulatory dysfunction.
There are a number of problems with using BBT measurements to figure out if and when you are ovulating.
- It can be tedious to take your temperature and document it every day and it can be a stressful way to start your day.
- The BBT test can’t reliably identify the time of ovulation and there is a lot of room for error.
- The test is retrospective, meaning that it is difficult to use this test in real time to identify when you are ovulating. Therefore, you can’t use the information to time intercourse in the same cycle you are testing.
But for those of you who are curious and motivated, there’s no harm in tracking your BBT for a month or two and seeing if you get that rise in body temperature.
4. Check Your Progesterone Level
Once a follicle ovulates and releases an egg, the follicle then transforms into a structure called the corpus luteum. The corpus luteum makes a hormone called progesterone which helps prepare the uterine lining for pregnancy. Testing a serum progesterone level at the appropriate time in the menstrual cycle is another way of determining whether or not ovulation has occurred. Instead of checking progesterone on a specific day (e.g., cycle day 21), the test should be obtained about 1 week before the expected start of the next menses. A progesterone level greater than 3 ng/mL is a good indicator of recent ovulation. Using progesterone levels, however, can be tricky because progesterone secretion is pulsatile, which means the levels can fluctuate pretty widely. Another limitation of measuring progesterone levels to look for ovulation is that the measurement is retrospective, meaning it tells you that you already ovulated and can’t use this information to help you get pregnant in that cycle.
5. Perform Serial Ultrasounds
Transvaginal ultrasound can be used to identify a dominant follicle in the ovary. By performing ultrasounds regularly throughout the cycle, you can look for evidence of ovulation like follicular growth, sudden collapse of a dominant follicle, a corpus luteum, and free fluid in the pelvis. Because this method is costly and logistically challenging, we generally reserve this type of monitoring for women who are in treatment cycles.
6. Try Ovulation Predictor Kits
In women who are ovulating, luteinizing hormone (LH) surges mid-cycle and precedes ovulation by 1-2 days. There are commercially available at-home ovulation predictor kits (OPKs) that can detect levels of LH in the urine and can help you predict when your LH level is surging and therefore when you might be ovulating. One of the main advantages of OPKs over other tests is that they can help define the interval of greatest fertility for patients who are trying to conceive, which is the day of the LH surge and the following day. By testing once or twice a day during the days leading up to predicted ovulation, you can try to time intercourse more accurately and improve your chances of conceiving naturally. These tests are generally accurate and correlate well with the peak in blood levels of LH, however, the test can have false-positive and false-negative results.
Ovulation is a critical step in successfully conceiving a pregnancy so it’s important for you to know whether or not you are ovulating. There are several ways to figure this out and most of them are easy, cheap strategies you can try at home without having to visit the doctor’s office. If you suspect that you are not ovulating or if you are struggling to use some of these strategies at home, consider taking to a fertility specialist. We can do a more advanced evaluation to determine whether you are ovulating as well as identify possible reasons why. Then we can work on fixing the problem or figuring out how to work around it to help you conceive successfully.
Dr. Ghazal is a double board certified Fertility Specialist, a Southern California native, and an award-winning Top Doctor and Rising Star in the field. She specializes in all aspects of female and male infertility, IVF, egg freezing, LGBTQ+ family building, miscarriage & pregnancy loss, PCOS, ovulatory disorders, intrauterine insemination, fertility preservation for cancer patients, endometriosis, and preimplantation genetic testing. Her research has covered a wide variety of topics in the field of reproductive medicine including assisted reproductive techniques, embryo culture, fertility preservation, endometriosis, implantation, and IVF outcomes. She has authored numerous book chapters and articles that have been published in top journals and she has been invited to present her research at national meetings.