The Importance of Proper Timing

Tracking Ovulation 📈

Identifying your fertile window by tracking signs of ovulation and hormone levels is essential for timing intercourse and increasing your chances of conception - especially when there are factors at play that may be chipping away at optimal fertile window length.

Methods of Tracking Ovulation

(In order of my most to least favorite)

BBT (Basal Body Temperature) Monitoring:

Tracking your base metabolic activity by taking your temperature first thing in the morning every day with a specialized thermometer (calibrated to normal body temperature, measures to the hundredth of degrees, typically has a memory function) is a time-tested and informative way to gather information, not just about when you’ve ovulated, but your hormonal and metabolic health in general.

Pros of BBT Tracking:

⇒ Low financial investment. Thermometers range from $10 (basic) to $40 (app compatible)

⇒ Confirms ovulation

⇒ Can be used diagnostically by assessing temperature ranges and shifts throughout the cycle allowing for customized protocols

⇒ Usefully in visualizing changes as treatment progresses

Cons of BBT:

⇒ Does not predict when ovulation will occur but can confirm that it took place

⇒ Can lead to over-analysis paralysis. It’s important not to fixate on individual temperatures or focus too hard on trying to shift the temperatures with hacks

⇒ Can be influenced by poor sleep, illness, alcohol consumption

Hormone Monitoring Devices:

The inito hormone monitoring device is a small reader that connects to your phone (make sure yours is compatible) that measures the hormone levels via urine strips. The app will alert you to which days you should test (~15 days per cycle) and then creates a graphic representation of FSH, LH, Estrogen, and Progesterone levels.

Pros of using the inito device:

⇒ Gives real time data on hormone levels and relationships show rising estrogen levels and the LH surge as ovulation approaches to ensure proper timing of trying and confirms ovulation via progesterone levels in the luteal phase

⇒ Can easily be sent to me for review

⇒ HSA/FSA Eligible

⇒ Tracks multiple hormones, not just LH

Cons of using the inito device:

⇒ Initial investment of device $89-149 (use discount code LAURA89)

⇒ Ongoing cost of test strips ($50/cycle)

⇒ Biometric data released into the cloud 🤷‍♀️

⇒ Can lead to over-analysis paralysis. As with other forms of cycle tracking, it’s important not to get hung up on single data points, but observe patterns over time and use the information to fine tune treatment strategies going forward. There are no magical quick fixes when it comes to fertility. Your body is cyclical, your eggs are recruited in waves that started 3 to 4 months prior to your current cycle and there is no beneficial way to rush the process.

Cervical Fluid Monitoring:

The fluid/mucus that your cervix produces throughout your cycle has many roles depending on where you are in your cycle. After your period and before ovulation, your cervical fluid is thick and sticky, effectively closing your cervix against entry of foreign material into your uterus.

As ovulation approaches, in response to rising estrogen levels produced by your growing ovarian follicles, your cervical fluid begins to thin, becoming clear, slippery, and stretchy.

This type of cervical fluid is vital for assisting and protecting sperm as it travels through your reproductive tract into your fallopian tubes to hopefully await an egg at ovulation.

Pros of Cervical Fluid Monitoring

⇒ Free, no special equipment or devices needed

⇒ Obvious when optimized

⇒ If absent, indicates specific imbalances to address

Cons of Cervical Fluid Monitoring

• Slight ick factor if you’re squeamish about body fluids

• Does not confirm ovulation only rising levels of estrogen

• If your estrogen levels are low or other imbalances are at play, your cervical fluid changes may not be obvious

OPK strips:

Ovulation Predictor Kit strips are commonly used in the days leading up to predicted ovulation to identify your LH surge. Tests are interpreted by comparing the darkness of the ‘test’ line (the line that appears when there is significant LH present in the urine sample) to that of the ‘control’ line (which always appears to indicate the test is working). A light line indicates that LH levels are rising, while a line that is the same color or darker than the control line indicates peak LH levels and that ovulation is likely to occur in the next 24-36 hours.

Some newer and more advanced tests may give results with words or symbols, rather than the control and test lines.

Pros of Using OPK Test Strips:

⇒ Easy to use

Cons of Using OPK Test Strips:

⇒ Ongoing cost

⇒ Cannot confirm ovulation, only that there has been a surge of LH released

⇒ Timing is imprecise. It can be challenging to interpret the LH surge, which typically happens 24-36 hours before ovulation.

⇒ Does not assess any other fertility markers

⇒ Can give false positives. Sometimes there is more than one LH surge, especially in an under optimized cycles where the hormonal signaling between the brain and the ovaries is impaired. In conditions such as PCOS, the baseline levels of LH may be higher throughout the month and give false positives even when ovulation doesn’t occur.

Cervical Position and Openness:

Prior to the advent of newer technologies and monitoring devices, assessing ovulation was done primarily with a more hands on in approach.

Throughout your cycle, your cervix changes position and openness. During your period, your cervix is open to allow the discharge of your uterine lining. Following your period, it closes up and becomes sealed with thick, sticky cervical fluid. As ovulation approaches, the cervical reopens and your cervical fluid thins to facilitate the entry of semen into your uterus. Following ovulation, your cervix closes again to protect a potential pregnancy from bacteria or foreign material that may enter the uterus.

These changes can be felt with practice be inserting your finger or fingers into your vagina and feeling the relative position and openness of your cervix.

At ovulation cervix has a softer feel, is higher up within your vaginal canal, is open, and feels wet due to the presence of fertile cervical fluid. The acronym SHOW is used to help remember these qualities ties:

⇒ Soft

⇒ High

⇒ Open

⇒ Wet

Pros of Observing Cervical Position and Openness

⇒ Free and informative

⇒ Fosters autonomy and greater understanding of your body

⇒ Cons of Observing Cervical Position and Openness

⇒ Takes practice to build confidence in your observations

⇒ A little awkward to manage at first