Schedule* an Initial Fertility Consult (covered by your insurance) with our Gynecologist Dr. Faust-Rakos HERE!
*Dr. Faust-Rakos will further talk to you about this and order any necessary tests, and then you will be scheduled in our office with Dr. Wheeler.
Understanding Ovulation and Fertility
Welcome to “Ovulation and Fertility 101,” where we will review ovulation and fertility, from the different phases in your monthly cycle to your fertile window, to predicting ovulation, to your lifestyle’s impact on your chances of becoming pregnant and more.
First thing’s first: the math behind your cycle.
Your monthly cycle begins on the first day of your period and ends when the next period begins, generally lasting between 24 and 28 days, but shorter or longer than that can also be normal. For some women, the length from cycle to cycle varies and may change as they get older, which is usually nothing to worry about. Most girls start having their period when they’re between 12-13 (the onset of the period is called the menarche). Women typically stop having their periods at an average age of 51, which is menopause. The menopausal transition typically takes a few years and is different for everyone.
Understanding Your Monthly Cycle & Ovulation
As you already know, your monthly cycle is about more than just menstruation. It’s many different processes that work together, involving your brain, ovaries and uterus communicating through hormones to essentially prepare your body for pregnancy. Read on for a step-by-step breakdown of what happens during your cycle:
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- Menstruation (Uterine Cycle): Everything starts with your period, which is essentially your body shedding off blood and tissue from inside your uterus (‘the lining’) through your vagina. An average period lasts between 4-6 days. This shedding happens because pregnancy did not occur, and the blood and tissue are not necessary to support a growing embryo, fetus and baby – until the next cycle when this happens all over again.
- Follicular phase (First Half of the Cycle): While your uterus is busy getting rid of last month’s tissue, your ovaries are beginning to prepare for this month’s ovulation. The pituitary gland, a hormone-producing area inside your brain, kicks this process off by releasing follicle-stimulating hormone (FSH). This hormone tells your ovaries that it’s time to prepare an egg for ovulation (release one egg from either one of your two ovaries). Both ovaries are filled with sacs (‘follicles’) containing one egg each, which are now all beginning to mature in a race to see which one will become the dominant follicle. A few days after your period ends, the largest follicle (the “dominant” follicle) will prepare to rupture so it can release the egg at ovulation. This follicle is now producing an increasing amount of estrogen, with peak levels right before ovulation. On average, this phase lasts 10-22 days.
- Proliferative Phase (Uterine Cycle): Another name for the follicular phase, this time describing what is happening in the uterus. In the days between the end of your period until ovulation, your uterus is rebuilding the thick inner lining that it shed while you were menstruating. This process occurs because of the rising levels of estrogen produced by the dominant follicle, and is meant to prepare your uterus for “housing” an embryo.
- Ovulation: About midway through your cycle – again, variations are normal – an egg is released from one ovary into the fallopian tube. This happens thanks to high estrogen levels that instruct the brain to release luteinizing hormone (LH), which is what triggers ovulation and the hormone measured in Ovulation Predictor Kits (OPKs). This hormone spikes 12-48 hours before ovulation. At this point, you’re about 13-15 days away from your next period.
- Luteal Phase (Second Half of the Cycle):
- After the egg has burst through the follicle and been released to travel into the fallopian tube, the dominant follicle that previously contained the egg transforms into a cyst (corpus luteum), which produces progesterone and estrogen.
- If the egg is fertilized, the progesterone also supports your pregnancy. If not, the cyst will break down, causing progesterone and estrogen levels to drop, inducing menstruation.
- Most women have a 12-14 day luteal phase.
- Secretory Phase (Uterine Cycle): Another name for the luteal phase, this time describing what is happening in the uterus. The lining of your uterus produces certain chemicals that will either support a pregnancy or help break down the tissue in preparation for your period (the phase gets its name from secreting chemicals).
Why Do I Have A 21-Day Menstrual Cycle? What Impacts the Length of My Cycle?
The length of the menstrual varies from woman to woman, with the average woman getting her period every 28 days. However, 21-40 day cycles can still be considered normal and healthy and can lead to successful pregnancies.
Some factors that may impact the length of your cycle are your age, genes, overall health, body mass index (BMI), your lifestyle, the use of birth control methods and stress. Given that most of your cycle is determined by your hormones, anything that can throw them off balance has the potential to impact the length of your cycle. This includes your diet, exercise, stress, jet lag, excessive alcohol consumption, the morning-after pill and other factors. Health conditions, such as Polycystic Ovary Syndrome (PCOS), can also impact your cycle. Speak to your OB/GYN if you’re worried about your cycle or have noticed significant changes recently.
When Am I Most Fertile During My Cycle?
You’re most fertile in the three days leading up to and including ovulation. For many women, this ‘fertile window’ is typically 13-15 days away from the start of their next period. However, these numbers are unique to each woman, so it’s important to learn the length of your cycle and the time you normally ovulate before relying on averages that may not be helpful in your conception journey.
It’s unlikely to get pregnant right after your period, but sperm can sometimes survive in the body for up to seven days, so it is not impossible (sperm usually survive about five days)!
How Long After Ovulating Am I Fertile? What is the “Fertile Window”?
As mentioned earlier, a woman’s ovulation occurs about midway through her cycle, and an ovulated egg lives for 12-24 hours. Sperm have strong survival skills, allowing them to survive in the female body for about five days. This means you can get pregnant anywhere from five days before ovulation to a day after ovulation. This period is considered your fertile window. After this time, you can no longer get pregnant, as the egg is no longer alive and ready for fertilization.
How Do I Measure and Track My Ovulation?
There are a few ways you can track and predict ovulation – and increase your chances of becoming pregnant. If you came here to read about Ovulation Predictor Kits, skip to the next question!
One option is Ovulation Calculators/Calendars/Charts/Apps, which generally work best for women with very regular periods as they are based on the typical length of your menstrual cycle. You start by entering the date of the first day of your last period and the length of your regular cycle. It will then use an average number of days for the different phases of your monthly cycle that we outlined above (unless you provide more specific estimates). Based on this information, it will then predict ovulation and your fertile window.
Another way to track approaching ovulation is by monitoring the consistency of your cervical mucus. This requires you to look at and touch your vaginal discharge daily, just in case you don’t do this already. When your body is about to ovulate, and while it is ovulating, the mucus will transform into an egg-white-like consistency (called “Egg White Cervical Mucus” or EWCM) which is designed to help sperm travel from the vagina to the uterus.
Last but not least, you can monitor your Basal Body Temperature (BBT) to predict ovulation. Your BBT is your body’s temperature when you first wake up in the morning, or when you’re fully “at rest.” As you’re nearing ovulation, your BBT will increase, which you can track with special thermometers. You’re most fertile in the three days leading up to and including ovulation, so tracking your temperature will allow you to determine the best moment to have sex. Your body temperature varies throughout the day and is based on your activity level – if you want reliable measurements, you have to be consistent and take your temperature first thing every morning, which means this method isn’t for everyone. BBT can also vary based on your health level (if you’re sick, it will be off), the amount of sleep you get, the time you wake up and even the number of times in the night you get up to pee!
Other indicators for nearing ovulation are more difficult to track, including increased sexual desire, breast tenderness, and a change in the way your cervix is positioned (no, you don’t need an OB/GYN to monitor this). Still, women usually stick to OPKs, charting, EWCM and BBT.
Do Ovulation Predictor Kits Work? What Are Some Popular Ovulation Predictor Kits?
Yes, they work, and yes, you should get some! Ovulation Predictor Kits (OPKs) are a popular and easy way to monitor impending ovulation. They work by detecting luteinizing hormone (LH) in your urine, which is the hormone that tells your ovary to release an egg into the fallopian tube (i.e., to ovulate). OPKs detect the surge of LH in your body as you’re about to ovulate, which means you should be having sex for the next two-three days once you get a positive test result.
There are many kits on the market, and some also detect estrogen and progesterone in addition to LH, which may give you an earlier warning that ovulation is coming. The Clearblue Digital Ovulation Predict Kit is a popular option as it’s easy to read (a smiley face will tell you to have sex), and it is OB/GYN-recommended. Wondfo LH Ovulation Strips and Pre-mom Ovulation strips are also solid choices and very affordable compared to Clearblue. Ultimately, your choice comes down to convenience (easy-to-read), the hormones you want to track (LH, or LH + estrogen + progesterone) and cost.
*If you have Polycystic Ovary Syndrome (PCOS), you can have a high LH level throughout the cycle, which means these tests won’t work as well to predict when you’re about to ovulate, if it all, since PCOS can prevent ovulation entirely.
Does Weight Affect My Ovulation Cycle and Fertility? What About My Age?
Yes, research strongly suggests that excess weight, particularly abdominal fat, can cause hormonal imbalances, increasing the risk of irregular menstrual cycles and reducing fertility. A healthy diet and exercise that leads to weight loss and hormonal regulation can significantly improve the regularity of your menstrual cycle.
Age is one of the most significant factors affecting a woman’s chances of becoming pregnant. A woman is born with all the eggs she will ever have in her life and these eggs age with her, impacting quantity and quality as she gets older. A woman’s fertility will start a significant, yet slow, reduction in her early 30s, with a drop at 35 and an even bigger one at 37, decreasing annually. Once a woman is in her early 40s, her chances of conceiving either naturally or with In Vitro Fertilization (IVF) is low, although multiple family building options still exist for women in their 40s.
Is Ovulation the Only Predictor of Fertility?
You cannot get pregnant naturally unless you ovulate. Still, even if you do ovulate, you may not get pregnant – this is why ovulation is only one of several fertility indicators. Others include the thickness of your uterine lining, the openness of your fallopian tubes, the health of your partner’s sperm and the quality of your eggs, to name a few.
Can I Ovulate Twice a Month?
Some very limited research suggests that women can ovulate more than once a month. However, this still needs to be confirmed by additional independent studies. You can certainly ovulate more than one egg at the same time (hello, fraternal twins), but this is still counted as one episode of ovulation.
Now that you have a better understanding of ovulation and fertility, you can start tracking your cycle and trying to conceive.
Just remember that every woman is different, cycles vary based on what’s happening in your life at the moment, and that pregnancy can take several months even when everything is working perfectly – when sex happens during ovulation in a healthy young couple, the chance of pregnancy each month is just 25 percent. If you’re under 35, you can try to conceive for up to a year before seeking help, whereas you should see a fertility doctor after six months of trying if you’re 35 or older.
Happy baby-making!
Schedule* an Initial Fertility Consult (covered by your insurance) with our Gynecologist Dr. Faust-Rakos HERE!
*Dr. Faust-Rakos will further talk to you about this and order any necessary tests, and then you will be scheduled in our office with Dr. Wheeler.
