Ovulation Timing

One of the major requirements for conception is ovulation. Strictly speaking, ovulation refers to the release of the ovum (egg) from the ovary. But ovulation is a complex series of events, which results in maturation of the ovum, release of the ovum, and alteration in the lining of the uterus. If there is an abnormality in any of these phases, then either conception will not occur or the pregnancy will not proceed to delivery. For these reasons, it is essential to thoroughly evaluate all of the phases of the menstrual cycle to determine if any ovulation abnormalities exist. In many instances, these abnormalities can be corrected and thus increase the chances of conceiving. An ovulation monitoring cycle is based upon tests done at specific times during the cycle. All cycles start with the first day of actual bleeding, the first day of full flow, designated as Day 1.

During the first part of the cycle, the ovary selects a single ovum for maturation. The ovum, as it matures, causes a fluid – filled sac to form around itself. The more mature the ovum, the larger the sac. This sac is referred to as a follicle and can easily be seen using ultrasound. Beginning after Day 10, two ultrasounds will be scheduled which will determine whether an ovum has been selected and then matured.

In order for the ovum to complete its maturation and be released, the body must release a large amount of the hormone LH. The body excretes this hormone in the urine, which can be measured in home testing kits. Therefore, at some point after Day 10 or 11, home urine testing for the LH surge can be started. The LH surge precedes the actual release of the ovum and a couple can use this to time intercourse just before ovulation occurs. This too allows for very accurate timing of a post coital test if this is necessary.

After the LH surge, the ovum will be released in 18 – 36 hours and a third ultrasound may be done 3 – 4 days after the surge. This is to make sure the follicle actually opened and released the ovum.

The second half of the cycle involves fertilization and growth of the pre – embryo. It is also during this time that the body prepares the lining of the uterus to receive the pre – embryo. The LH surge triggers the ovary to start making progesterone. The progesterone alters the lining of the uterus and also causes an elevation in the basal body temperature. Basal body temperature charts may be helpful in establishing progesterone production, but because of the alternative methods available to monitor ovulation, this test has become utilized less frequently. Progesterone can be measured directly in the blood and therefore a blood level done 6 – 7 days after the LH surge is a very good indicator of how well the ovary is doing in its progesterone production. It is also possible to determine the total effects of the progesterone by doing an endometrial biopsy 10 – 12 days after the LH surge.

The preceding information outlines how the physicians at the Hoxsey – Rinehart Center, for the most part, evaluate ovulation. It requires time and commitment from you and your partner. However, many problems with ovulation can be detected with this testing and, more importantly, the problems can usually be corrected to enhance your chances of having a child. Specifics related to your treatment plan and care will be discussed and explained by the staff of the Hoxsey – Rinehart Center.

To Summarize Ovulation Monitoring