Problems with Ovulation & How to Tell if you are Ovulating

Getting pregnant all comes down to timing intercourse each month, that is if everything is working right. Since getting pregnant is not possible without ovulation, we will explain potential problems that can occur with ovulation as well as how to find out if you are ovulating or not. 


What is Ovulation: Biology 101

Ovulation is controlled by an intricate system that involves the hypothalamus, pituitary gland, ovaries, and other glands, such as the adrenal glands and thyroid gland. Ovulation typically occurs once a month when a mature egg is released from the ovary.

Every woman is born with millions of eggs, but only approximately 400 eggs actually go through ovulation (source). After each period you have, your body starts to grow and mature another egg, as well as produce other hormones to thicken the lining of your uterus and create a sperm friendly environment.

From the ovary, the egg moves down the fallopian tube. If there is sperm that has made its way up the fallopian tube, the egg will be fertilized and travel down to the uterus. Your egg only lives for about 24 hours, and so if there is no sperm around and it’s not fertilized, then the lining of your uterus is shed.  


Problems with Ovulation:

Ovulation problems occur when the system mentioned above involving the brain, hormones or ovaries, malfunction.  For example, the pituitary gland may not produce enough luteinizing hormone and the ovaries may produce too little estrogen.

Ovulation problems are seen in the following cases:

  • Irregular periods
  • Anovulation
  • Polycystic ovarian syndrome (PCOS)
  • Ovarian cancer
  • Hormonal Issues
  • Premature menopause
  • Chronic medical conditions (i.e. diabetes)
  • Being overweight or underweight
  • Excessive exercise


How to Determine if Ovulation is Occurring: 

With your Doctor: 

Your doctor can help you to determine if you are ovulating by using ultrasonography, measuring of the level of progesterone in the blood or saliva or the level of one of its by-products in the urine. A marked increase in these levels indicates that ovulation has occurred. Your doctor may also check for polycystic ovary syndrome (PCOS) by measuring your level of testosterone in your blood.

Your doctor will ask you to describe your menstrual periods including the length and symptoms. Your menstrual history can help to determine whether you are ovulating. Signs of ovulation include regular cycles, premenstrual symptoms, and cervical mucus changes. Read here to learn more about what having a ‘regular’ period means. 

On your Own: 

If you want to try to determine whether ovulation is occurring on your own first, you can do so by measuring basal body temperature (BBT), changes in cervical mucus and using home predictor kits. Please see below on how to find your fertile window for more details on these methods. You should measure the results for at least 3 cycles.

Regular cycles, premenstrual symptoms, and cervical mucus changes all signs that you are ovulating regularly.  Read here to learn more about what having a ‘regular’ period means. 


What if I’m not ovulating?

One of the most common causes of not ovulating in women of fertile age is PCOS (source), however, ovulation issues may be due to other factors such as a hormone disorder or lifestyle habits. If you find that you are not ovulating, see your doctor to confirm your results.

Your doctor will then help you to determine why you may not be ovulating. Depending on what the reason is behind missed ovulation, your doctor may give you drugs such as clomiphene or letrozole, which can often stimulate ovulation. If it is due to lifestyle factors on the other hand, such as smoking or weight reasons, then you can get on a plan to make healthy habit changes and start to ovulate regularly naturally. 



How to Track Ovulation and Find your Fertile Window:

Since sperm typically lives anywhere from 3-5 days and your egg lives for 24-hours, your fertile window is considered 6 days long (including the day of ovulation). That said, you are most fertile 2 days before ovulation and the day of ovulation.

Tracking ovulation has not historically been an easy task. While there are a variety of methods to try, such as LH Sticks, measuring BBT and saliva tests, they typically do not work for women with irregular periods or PCOS.

New technology to help women take the guesswork and effort out of determining ovulation is on the rise. We are working on the Priya Ring which is a vaginal insert that measures continuous core temperature and messages your phone when you are most fertile. Click here to learn more. 


6 Steps on How to Find your Ovulation Day & Fertile Window:

  1. Download a period tracker app (many are free) and start tracking your period. This way you will have data on how long your period is and your estimated fertile days. If you go to see your doctor, you will have the information he/she will need.  
  2. Purchase your choice of ovulation predictor product (LH Sticks or Saliva Test) or BBT thermometer. You can buy most ovulation predictor kits at grocery stores or online. Purchase this soon after your period ends - you will need to start this earlier than you may anticipate.
  3. Keep an eye on your cervical mucus to turn clear, slick and slippery. This indicates that you are fertile.
  4. Record your basal body temperature (BBT) every morning at the same time before getting out of bed. Your BBT will rise about half a degree Celsius after ovulation has occurred. While this will not help with your fertile window, it will help you to see if you are ovulating or not and can help guide you for the next month. You can also use it to compare your results with your ovulation predictor kit.
  5. Consider joining a chat forum to ask any questions you have and for support.
  6. Have intercourse every day or every other day during your fertile window.

If you have questions or concerns about your cycle or are unsure if you are ovulating, don’t be afraid to contact your healthcare provider.