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Calculating Ovulation 

If you are healthy, have no fertility problems, and want to conceive a baby, you can dramatically improve your chances of becoming pregnant by tracking when you ovulate and having sex near that time. There are several tools available to help you determine the appropriate time to have sex each month.

The first and easiest step to improving your chances of getting pregnant is to chart your menstrual cycle so that you can have sexual intercourse as close as possible to ovulation. Begin by keeping track of the intervals between day one of your period and day one of your next period. The number of days between the first days of your periods is known as your cycle interval.

Once you know your cycle interval, subtract 14 from that number to determine when in your cycle you will likely ovulate. For example, if you have a typical 28-day cycle, by subtracting 14 from 28 you can feel confident that you ovulate around the 14th day of each cycle.

To increase your chances of getting pregnant, have sex every other day around the day you ovulate. For example, if you are on a 28-day cycle, you should have sex on days 10, 12, 14, 16, and 18 of your cycle to maximize your chance of pregnancy. Because sperm can live two to three days, this every other day approach helps to ensure that sperm will be available when eggs are released at ovulation.

Basal Body Temperature

If you are not sure if you are ovulating, a natural birth control method is charting your basal body temperature. To use the basal body temperature method, you chart your morning temperature and monitor changes in your body’s temperature. Simply take your temperature before you get out of bed each morning and plot it on a chart. When you see a shift of at least 0.4 degrees Fahrenheit, you know that ovulation occurred. Most women have a lower body temperature right before ovulation and a higher body temperature right after ovulation. Because the basal body temperature method can only tell you after the fact that ovulation occurred, it is not an optimum way to maximize your chances of pregnancy. It is, however, useful over the long term for understanding when you ovulate so you can determine the optimum time for having intercourse.

Ovulation Predictor Kits

Ovulation predictor kits test your urine for signs of hormones that indicate that ovulation is about to occur. These kits usually detect levels of luteinizing hormone (LH), which triggers ovulation and generally rises 12 to 36 hours before you ovulate. To increase your chances of pregnancy, have sex every other day around the day you ovulate.

To properly use ovulation predictor kits, you should start testing your urine three days before you think you ovulate. For example, if you think you have a 28-day cycle, you ovulate on day 14 so you should begin testing your urine on day 11 of your cycle. This approach allows you to clearly see a negative result, indicating the lack of LH, and then clearly see a positive result, indicating the presence of LH. You should ovulate about 36 hours after a positive test result. To improve your chance of getting pregnant, you should have intercourse the day you see a positive result and the day after a positive result.

Infertility Testing 

Infertility occurs when a couple is unable to conceive after 12 months of having intercourse without the use of birth control. The male partner, the female partner, or both partners may have a problem with their fertility.

In men, the most common reasons for infertility are sperm disorders, such as low sperm count, low sperm motility, malformed sperm, and blocked sperm ducts. The main cause of infertility in women is anovulation or lack of ovulation, and the inability of the fallopian tubes to carry eggs from the ovary to the uterus. Men and women are equally likely to have fertility problems.

It is generally recommended that you have an infertility evaluation after you have tried unsuccessfully to become pregnant for 12 months or more. In cases, where the female partner is over 35, it is recommended that you have an infertility evaluation after six months of unprotected sex. The infertility evaluation will determine the reasons you have been unable to conceive so that a treatment plan can be developed.

If you have not been able to conceive after 12 months of having sex without the use of birth control, you may want to have an infertility evaluation. The basic infertility workup includes:

  • Physical exam for both partners
  • Medical history of both partners
  • Semen analysis
  • Check for ovulation
  • Tests to check for a normal uterus and open fallopian tubes
  • Discussion of how often and when you have sexual intercourse

Male Infertility Tests

Semen analysis is a key part of male infertility testing. This analysis may need to be conducted more than once. The semen sample is obtained by masturbation. Sometimes the semen sample can be obtained at home, other times it is obtained in a lab. Your doctor will give you instructions and make sure you feel as comfortable as possible about the semen analysis. The semen sample is then sent to a lab, where it is analyzed for:

  • The number of semen present
  • The shape of the semen
  • The movement of the semen
  • Any signs of infection

If any potential problems with the urinary tract are found, the male partner most likely will be referred to a urologist for further testing.

Female Infertility Testing

For women, infertility evaluation begins with a physical exam and a comprehensive health history. The health history will focus on four key points:

  • Menstrual function, such as irregular bleeding or pain
  • Pregnancy history
  • Sexually transmitted disease (STD) history
  • Birth control

Another important part of the evaluation is determining whether and when you are ovulating. Here are some of the tests that may be performed:

  • Urine test: This test is performed at home and indicates if ovulation is about to occur.
  • Basal body temperature: You take your temperature every morning before you get out of bed and record it on a chart. Keeping this body temperature chart for two to three menstrual cycles will show whether or not you are ovulating.
  • Blood test: The blood test measures progesterone, which can indicate whether or not you are ovulating.
  • Endometrial biopsy: Because the lining of the uterus changes during ovulation, analyzing sample tissue from the uterus can determine if ovulation occurs.

Other tests may be used to examine your reproductive organs. These tests check the appearance of your uterus and determine if your fallopian tubes are open. Your individual circumstances and symptoms determine which of these tests are performed:

  • Hysterosalpingography (HSG): This test is an x-ray that shows the inside of your uterus and fallopian tubes. A small amount if dye is placed in the uterus through a thin tube inserted through the cervix. An x-ray is then taken.
  • Transvaginal Ultrasound: A device is inserted in the vagina that uses ultrasound waves to produce images of your ovaries and uterus.
  • Hysteroscopy: A thin telescope-like device is placed through the cervix. The inside of your uterus may be filled with a harmless gas or liquid so that the doctor can correct any problems and obtain a tissue sample if needed.

Laparoscopy: A small telescope-like device is inserted through a small cut at the lower edge of the navel. The doctor looks for pelvic problems in the fallopian tubes, ovaries, and uterus.

Infertility Treatment Options

Infertility can be a result of something as simple as “timing” or complex.  Your provider at Capital Women’s care can help you determine where to start, and if additional referral to a fertility subspecialist is required.  We partner with many providers in the area such as CCRM to handle those more challenging cases. Contact your Capital Women’s Care provider if you have any questions about your fertility. We’re here for you throughout your pregnancy journey.