When you start your fertility journey, one of the first things your specialist will look at is whether you are ovulating monthly. Ovulation plays a huge role when it comes to fertility, and TRIO’s team of experts will test your hormone levels and monitor your cycle. In this article, we share information on why it’s important and how it works.
Ovulation’s Role in Pregnancy and Conception
Ovulation is a regular part of the monthly menstrual cycle, and essential to becoming pregnant. It occurs when a mature, ready-to-be-fertilized egg is released from the ovary and travels down one of the fallopian tubes, where it has 24 hours to be fertilized by sperm. Sperm can live in the fallopian tubes for up to five days — sperm needs to already be inside the fallopian tube when the released egg arrives.
If fertilized, the egg travels into the uterus, where it implants on the uterine wall lining. If the egg is not fertilized, it will break down within a day and trigger the second half of your menstrual cycle (the luteal phase), leading to your period.
‘Regular Periods’ are about every 28 days but It’s common for periods to fluctuate a month or two each year and still be considered regular. . However, If you have infrequent or irregular periods or don’t have periods at all, your physician will conduct a series of tests to see if you have an ovulatory disorder. Many ovulatory disorders have effective and readily available treatments.
Most ovulatory disorders come down to miscommunication between the hypothalamus (a region of the brain that produces hormones), the pituitary gland (a gland at the base of our brains) and the uterus and ovaries. For ovulation to occur, the hypothalamus first releases gonadotropin-releasing hormone (GnRH), which prompts the pituitary to release two hormones: Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH).
FSH helps the egg mature in the ovaries and creates estrogen, which prepares the uterus wall’s lining. LH then comes in a surge and prompts the release of the egg from the ovary into the fallopian tubes and uterus. If the egg is fertilized, progesterone levels stay high. If pregnancy does not occur, progesterone levels decrease and menstrual flow follows.
Oligo-ovulation is the name for the infrequent release of eggs from the ovary or very irregular periods.
Anovulation occurs when the egg doesn’t release from your ovary during your monthly cycle.
Common Reasons Ovulation Doesn’t Occur
There are several reasons someone may have irregular, infrequent, or absent periods. We have listed the most common ones below.
One of the most common causes of anovulation is polycystic ovary syndrome (PCOS). Studies show that roughly 8-13% of assigned females at birth of reproductive age in Canada have PCOS. PCOS is a multifactorial disorder that may involve an excess of male hormones (androgens), including testosterone. These high levels of androgens cause the follicles in the ovaries (where the eggs mature before ovulation) to remain small. Other signs of PCOS may include weight gain, excess facial hair, acne, and small painless cysts on the ovaries.
While many of us recognize the emotional and mental toll of chronic stress, we often forget that it impacts us physically, as well. When we experience stress, our body releases cortisol, also known as “the stress hormone. ” Cortisol stimulates the nervous system to send us into fight-or-flight mode, readying us to survive.
To give the excess energy and resources to our survival system, the body has to divert that energy from “non-essential systems” — including the reproductive system. With chronic stress and high levels of cortisol, progesterone levels (a critical reproductive hormone) often diminish, making conception difficult.
Sometimes, our bodies produce too much, or too little, of certain hormones. If our hormones are out of balance, they can impact the communication between the hypothalamus, the pituitary gland and the ovaries.
NSAIDs, better known as non-steroidal anti-inflammatory drugs, help prevent and reduce inflammation in the body. While it can help with pain relief or an injury, consistent use may inhibit ovulation by preventing the rupture of the mature ovarian follicle. Speak with your healthcare provider if you’re regularly taking NSAIDS and are trying to conceive.
Weight — either over, or under — can also interfere with regular ovulation. Being overweight can affect the natural balance of reproduction-stimulating hormones. While being underweight can negatively affect the pituitary gland and interfere with the regular release of essential hormones.
Excessive exercise can lead to low body weight and high stress hormones, which affect our pituitary gland and can impact the regular release of the hormones that stimulate ovulation.
How to Know When You’re Ovulating
There are several ways you can identify when you’re ovulating, we’ve listed the most common below.
Basal Body Temperature Tracking
Your basal body temperature (BBT) is the lowest temperature of your body at rest. For accuracy, it’s important to check BBT right after waking up, before getting out of bed. BBT will dip right before ovulation, then rise and remain heightened after ovulation. This technique only works if you are consistent in checking your basal body temperature. It may take a few cycles to see the pattern of your reproductive cycle. Note that BBT can be impacted by other factors (ie. stress, smoking, illness, etc.). Many people find this method both difficult and stressful. As mentioned previously, stress is not helpful when trying to conceive.
Serum Progesterone Blood Test and Ultrasound
Your practitioner may recommend a blood test for serum progesterone on days 19 – 22 of your cycle to check your levels, which typically remain elevated a week after ovulation occurs. Ultrasound technology can also help confirm ovulation by identifying the presence of corpus luteum in the follicle where the egg was released.
Physical Signs You’re Ovulating
There are other physical signs of ovulation to look out for:
- An increase in clear, sticky vaginal discharge (a few days before and during ovulation)
- Breast tenderness
- Mood change
Seeking Support for Ovulation Disorders
If you are trying to conceive and suspect that you’re not ovulating regularly, the fertility team at TRIO can help. Feel free to reach out to us with questions.