When the body’s levels of luteinizing hormone (LH) rise, it triggers the process of ovulation, and the most fertile period of the menstrual cycle occurs. Ovulation is the release of the mature egg from the ovarian follicle; the egg can then be captured by the fallopian tube, and following well-timed intercourse, sperm are able to meet the egg at the ampullary site of the tube. Therefore, tracking the LH surge can help couples plan the timing of intercourse and increase the chances of becoming pregnant.
A gland in the brain, called the anterior pituitary gland, produces LH. Levels of LH are low for most of the monthly menstrual cycle. However, around the middle of the cycle, when the developing ovarian follicle containing a maturing egg reaches a certain size, LH levels surge to become very high. The LH surge begins around 36 hours before ovulation. Once the egg is released, it survives for about 24 hours, after which time the fertile window is over. Because the period of fertility is so short, it may be important to keep track of it when trying to conceive and noting the timing of the LH surge can help. There are several ways to track monthly LH surges.
- Ovulation predictor kits (OPKs) are over-the-counter at-home tests that measure LH levels in the urine. Many brands are available, in pharmacies or on line. It is best to start testing levels when the fertile window is drawing near, or a handful of days before ovulation. Many women ovulate on day 14 (consider day 1 as the first day of menstruation with true blood flow), but this can vary, depending on the length of a woman’s cycle. With shorter cycles you should test a few days earlier.
There are a few disadvantages, and OPKs may not be the right choice for everyone. For example: (a) if a person has irregular cycles, testing can be difficult, expensive, frustrating, and unreliable; (b) women with polycystic ovary syndrome (PCOS) may experience persistently high LH levels, and tests may show (false) positive results throughout their cycles; or (c) women approaching menopause may also have elevated LH levels, which makes test results unreliable. If OPKs are ineffective, ask your reproductive doctor for a blood test to measure serum LH levels, and a vaginal ultrasound to ascertain that a dominant ovarian follicle is developing.
Trying to get pregnant can be one of the most stressful milestones in life. Every 2-week wait after potentially conceiving can seem like a lifetime and can feel unbearable when the test comes up negative once again. However, in addition to simple OPKs there are other options to assist with the process.
- Smartphone apps have become useful tools to help identify your most fertile time of the month. Some apps record your periods, a variety of health signs, mood, sexual activity, and medications, and display the data in eye-catching charts. They can also assist couples undergoing IUI.
At the time of the LH surge, the ovarian follicle that releases the egg converts into the corpus luteum, a functional structure that secretes lots of progesterone. Progesterone is the main driver of the endometrial lining making it receptive to embryo implantation.
- Measuring your basal body temperature (BBT) may also help you conceive faster by determining your most fertile days; charting is relatively easy and inexpensive. Your basal body temperature changes based on several factors, including and more importantly, progesterone levels. When you ovulate, the hormone progesterone causes your temp to rise. It remains higher throughout the two-week wait. Then, just before your period starts, if not pregnant, the hormone progesterone drops. This means your basal body temperature will drop too—unless you’re pregnant, in which case your temperatures will remain higher because progesterone will stay high.
Any regular thermometer can work, and it is best to take your temperature in the morning before you get out of bed or move around. You can find sample charts in some fertility books. Another option for charting is fertility awareness software, also known as fertility calendars, some of them online and free.
- Finally, vaginal discharge is a normal part of the menstrual cycle and color and consistency change throughout the month. However, keep in mind that some types of discharge may indicate an underlying condition, to be tested by your physician. At ovulation discharge is typically more abundant, clear, stretchy, and watery. A thin consistency helps sperm travel to the egg. After ovulation, higher levels of progesterone cause discharge to appear white. This type of discharge may last for up to 14 days. It may be thick and sticky, but there will be less than there was during ovulation.
In summary, urinary LH testing, with a OPK or using an app, checking your basal body temperature chart, monitoring your mucus discharge, all help you pinpoint the ovulation window. If after three months you cannot ascertain ovulation, or if pregnancy fails to ensue, come visit us at Sher Fertility Institute New York, where we will guide you to additional and more effective options to fulfill your pregnancy dreams.
Contact Sher Fertility Institute New York at 646-792-7476 or click here to schedule an appointment with one of our fertility doctors. Our Patient Care Specialists will contact you within the next 24 hours.