Trying to Conceive: Fertility Charting 101

WebMD Live Events Transcript

Who can you turn to with questions about your fertility cycle? How about yourself? Charting your daily temperatures can help you determine if and when you ovulate, which is a big key to successful conception. Amos Grunebaum, MD, medical director of the WebMD Fertility Center, talked about charting a course to pregnancy on June 21, 2004.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MEMBER QUESTION:
I saw my period on the June 9. I think I should be ovulating and am not. When do you think I will ovulate? My cycle is 29 days.

DR. AMOS:
With a regular 29-day cycle you would expect ovulation to happen around CD 15-16. Ovulation usually happens about 14 days prior to cycle's end so the calculation would be 29-14=15. If your period started on June 9th then you would expect ovulation around June 24 (9+15).

One way to determine that you are about to ovulate is to do an OPK. An OPK is an Ovulation predictor kit, which tests the presence of the LH hormone in your urine. LH increases about one to two days prior to ovulation. So when you detect first LH in the urine (a negative test followed by a positive test) then you can expect to ovulate within the next 12-36 or so hours.

However, you are wrong if you schedule making love only after the OPK is positive. In order to get pregnant you must make love before ovulation, preferably 24-48 hours prior to ovulation. So making love only after the OPK is first positive may be too late for conception. The best way to ensure conception is to make love regularly two to three times each week.

In addition, if he has enough sperms it's suggested to make love every day during the five to six fertile days. Your fertile days are the five days prior to ovulation as well as the day of ovulation.

MEMBER QUESTION:
I am 42 years old trying to conceive for the past three years. My fertility doctor told me that my follicles are not growing. What does that mean?

DR. AMOS:
In order for you to get pregnant, you must ovulate. Ovulation is usually at the end of a follicle developing in the ovaries, and if a follicle does not develop then you can't ovulate, and without ovulation you can't get pregnant.

In addition, even if you ovulate (do you?) the egg must be of a good quality. "Bad-quality" eggs are unlikely to get fertilized and implant. One way to determine the quality of the eggs is to check the FSH value on CD 3. A high FSH value usually means "bad-quality" eggs and low chance of getting pregnant.

MEMBER
I have very high FSH.

DR. AMOS:
I thought so. That usually means that your eggs aren't "good" enough for fertilization. Unfortunately, that means it's difficult to get pregnant with your own eggs.

"If you count 16+ days after ovulation and AF hasn't come, you can pretty much assume that you are pregnant."


MODERATOR:
Both of these chatters questions raise the issue of whether they are ovulating, Dr. G. So it sounds like charting their fertility would help. Since our "main" topic today is charting, can you tell us about it and how it might help them?

DR. AMOS:
I agree. The most important question to answer is first: "Do I ovulate or not?" Keeping a temperature chart will not only tell you whether you ovulate or not, it also tells you exactly when in the cycle ovulation happens and then how long the corpus luteum phase lasts. The CL phase is the time between ovulation and the next period. If the CLP is less than 12 days then even if the egg is fertilized it doesn't find enough time and environment to implant.

Another test to determine ovulation is to do a progesterone blood test about a week after ovulation. An increased progesterone means that ovulation has taken place.

MEMBER QUESTION:
Is making love every day around ovulation time bad? My DH had a normal SA.

DR. AMOS:
I am unsure what you mean by "bad." Could you explain?

MEMBER QUESTION:
Is that enough time to rebuild a healthy specimen!

DR. AMOS:
If the sperm count is fine, then once a day is usually suggested when you TTC. Once every 36-48 hours also has a high likelihood of pregnancy, but once every 25 hours has the highest likelihood. That's during the five days prior to and the one day of ovulation. Making love after ovulation is unlikely to get you pregnant.

MEMBER
OK, thank you. I think we may have hit it right this month! Thanks.

DR. AMOS:
Good luck!




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