Few women know that the quality of ovulation, not just the presence of ovulation, is key to successfully getting and staying pregnant. It is therefore not surprising that many women feel frustrated on their fertility journey. They question why they're experiencing difficulties even though they’re getting positive results on home ovulation test strips and have timely intercourse during their fertile window. Today, we’ll break down the four ways you can assess the quality of ovulation and how charting your menstrual cycle and tracking biomarkers can provide valuable insights into your reproductive health.
Ovulation and the menstrual cycle
Ovulation is a critical part of the menstrual cycle. It is the process by which an egg is released from an ovary. And when this egg is fertilized by the sperm in the fallopian tube, an embryo is formed, resulting in pregnancy.
A woman’s cycle typically lasts 28-32 days, but it can vary from person to person. The first day of your period is generally considered the day one of your cycle. While women are told ovulation occurs around cycle day 14, this can vary from cycle to cycle and woman to woman.
The follicular phase spans from the beginning of your period to ovulation. On the other hand, the luteal phase is the time between ovulation and the start of your next period.
How to tell if you're ovulating?
Unlike the menstruation phase of the menstrual cycle, ovulation doesn’t have clear outward signs. As a result, it is estimated that only about 3% women in the world know when they ovulate. But there are a few ways to detect ovulation.
Home Ovulation Test
One way is by taking a home ovulation test. These tests measure the levels of luteinizing hormone (LH) in your urine. LH levels surge usually occurs about a day before ovulation. These tests only tell you if you have ovulated, but do not tell you about the quality of ovulation.
Modern Fertility Awareness Based Methods (FABMs)
Another way to assess for ovulation is by using one of the modern fertility awareness based methods (FABMs), also known as cycle charting. Modern FABMs include Creighton Model, FEMM, ChartNeo, Symptothermal. These cycle charting methods use different biomarkers such as cervical mucus observation and basal body temperature, to assess the timing of your ovulation.
I strongly encourage women to learn accurate cycle charting techniques from trained instructors. As part of my fertility program, I provide cycle charting instructions if necessary.
Assessing the Quality of Ovulation
As mentioned earlier, if you are trying to get pregnant, it is important to have high quality ovulation. This will ensure your egg is properly matured and is better able to successfully sustain pregnancy after fusion with the sperm. In other words, higher quality ovulation would result in less pregnancy loss.
So, let’s discuss the 4 ways to tell if you have high quality ovulation:
1. Mid-Luteal Estradiol and Progesterone Levels
Estradiol and progesterone are hormones that are produced by your ovaries. Estradiol has 2 peaks during the cycle, one large one before ovulation, and a second peak in the mid luteal phase. On the other hand, progesterone level peaks only after ovulation.
Optimal mid-luteal estradiol level is around 120pg/ml. And optimal mid-luteal progesterone level is at least 15ng/ml. Levels lower than these can be a sign of lower quality of ovulation. In order to accurately determine the midpoint of your luteal phase, it is best to do cycle charting.
2. How Quickly Your BBT Rises After Ovulation
Basal body temperature (BBT) is the temperature of your body at rest. It typically increases by about 1 degree Fahrenheit (or by about 0.5 degree Celsius) after ovulation. A quick rise in BBT after ovulation is a sign of high quality ovulation, as that shows the ovary (specifically the corpus luteum) was able to quickly generate progesterone.
Keep in mind that progesterone is the hormone that helps prepare the women’s uterus for potential pregnancy. Besides inhibiting uterine contractions, progesterone acts on the brain to set higher basal body temperatures.
3. How Sustained BBT Are Throughout the Luteal Phase
Higher quality ovulation would result in better sustained BBT throughout the luteal phase. If your BBT have dips in the luteal phase, it may be a sign of low quality ovulation.
4. Duration of Your Luteal Phase
A healthy luteal phase is about 13-14 days. A luteal phase of less than that is considered suboptimal, and it may be a sign of low quality ovulation.
So here you have it: the four ways of assessing the quality of ovulation. These four ways are based on my clinical experience as a wholistic fertility specialist, having helped many women improve the quality of ovulation. The bottom line is charting your menstrual cycle is very important for helping you assess if you have high quality ovulation.
Besides knowing if you have high quality of ovulation, cycle charting has many other benefits. Women can better understand their own bodies, and see if there are abnormal bleeding patterns, or if there is too little or too much cervical mucus. These observations can also have an impact on fertility.
A word of advice is to only learn about cycle charting from a qualified instructor (FEMM educator, Fertilitycare Practitioner for Creighton Model, ChartNeo Advisor… etc). And if you want further insights into your fertility, and you live in California, I invite you to schedule a 30-minute Fertility Insight Session with me. During this session, I will do my best to answer your number one question about fertility.