When you think about fertility, everything comes down to the BIG "O": OVULATION.                  

When you are born, each of your ovaries has hundreds of thousands of eggs, but they remain dormant until your first menstrual cycle, when you start to ovulate, which occurs during puberty. During adolescence, the pituitary gland secretes hormones that stimulate the ovaries to produce female sex hormones, including estrogen, which help you develop into a fertile woman. At this time, you begin releasing eggs as part of a monthly period. Once a month, during ovulation, an ovary discharges a tiny egg that reaches the uterus through one of the fallopian tubes. Unless fertilized by a sperm while in the fallopian tube, the egg dries up and is expelled from the uterus.

There is no doubt: You need to ovulate before you can get pregnant. And your chances of conception depend on the egg and sperm meeting at the right time. But ovulation often doesn't happen, and you won't know, or it can happen irregularly or at an inopportune time. So it makes sense to understand just what's going on with those precious eggs of yours, especially if you want to improve your chances of getting pregnant faster.

It wasn't that long ago that people (even doctors) seriously believed you had three to four days before and three to four days after ovulation to get pregnant, and there are still many people today who believe this. Yet nothing is further from the truth.  

Newest studies have shown that you only have the four to five days BEFORE ovulation and the day of ovulation to get pregnant.

Sex and Getting Pregnant

Your chances of getting pregnant increase if you have sex regularly, more often, and as you get closer to the day of ovulation. Your fertility also increases the more often (but no more than once a day) you have sex throughout the cycle, not just during the fertile days. Your chance of getting pregnant is nearly zero if you have sex after ovulation. Why? Sperm need about 12 hours of "prep time" in your uterus before they can fertilize the egg. And the egg usually doesn't survive long, maybe only 12-24 hours, for that to happen. So to get pregnant it's best to have sperms already close to the egg when ovulation happens. That's why when you want to get pregnant the best time to have sex are the 1-2 days before and the day of ovulation. Not the day after.

If I bleed, does it mean I ovulate?

Bleeding in and by itself is not always a good enough confirmation of ovulation. It's possible to have vaginal bleeding without ovulation. Your regular menstrual periods come every 21-35 days and last on average three to six days, but you can have vaginal bleeding even if you don't ovulate; without regular ovulation, your menstrual periods are usually not as regular as those periods that follow ovulation. For irregular cycles, supplements such as FertilAid for Women can help promote hormonal balance and cycle regularity.

"How do I know whether I am ovulating?" is one of the most important and frequent questions Dr. Amos hears. There are several ways to find out.

Checking Yourself for Ovulation:

  • Regular menstrual cycles: If you have a very regular menstrual cycle lasting between 21 and 35 days, then you can usually assume you ovulate regularly.
  • Fertility charting: Fertility charting includes taking your basal body temperature and looking for other fertility signs such as changes in the cervical mucus. A biphasic basal body temperature chart, a curve that increases and stays up, shows reliably that you ovulated. We'll get into detail about charting in the next section since charting and charting tools are such a big part of BabyMed 
  • Cervical mucus: Typical changes in cervical mucus will also help you figure out when and if you ovulate and when your fertile days are. We'll discuss more about cervical mucus in just a bit. 
  • Ovulation predictor kits (OPK): OPKs are pretty reliable methods of detecting ovulation. A positive OPK can predict ovulation most of the time. 

How your doctor checks:

  • Blood progesterone levels: An elevated progesterone level about a week after presumed ovulation confirms ovulation. 
  • Pelvic ultrasound examinations: If they are done before and after ovulation, they can show the development of the follicle, and if it disappears, ovulation can be assumed. 
  • Endometrial biopsy: An endometrial biopsy about 10 days after ovulation can confirm that ovulation happened.