Fertility and Temperature Charting -- Amos Grunebaum, MD -- 09/25/02

WebMD Live Events Transcript

The opinions expressed in this transcript are those of the health professional 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.

Trying to figure out when you ovulate? Do you know how to chart your basal body temperature (BBT)? What other methods tell you the best time to conceive? As part of National Infertility Awareness Week, WebMD joined with RESOLVE: The National Infertility Association to bring you the Trying to Conceive Cyber Conference. Amos Grunebaum, MD, joined us to answer questions about fertility and temperature charting.

Moderator: Joining us now is WebMD's own in-house pregnancy expert, Amos Grunebaum, MD. Welcome back, Dr. Amos.

Dr Amos: Hello, everybody.

Member: At what point do you recommend charting, seeing your doctor, and trying different methods if TTC is not successful?

Dr Amos: I usually recommend seeing your doctor when you are thinking of starting TTC. At that time, you can discuss all your concerns and get some prenatal vitamins with folic acid. Charting is a good idea to identify your fertility, when and if you ovulate, and how long the luteal phase (LP) is. Even women with regular cycles can benefit from charting to learn more about their bodies. But women with irregular cycles benefit the most from charting as it tells them a lot about their ovulation and fertility.

Member: Where can I get a chart?

Dr Amos: In the past, charting was sort of difficult. You had to get a piece of paper with grids and enter crosses and circles by hand. But with the Internet it's much easier. You now can go to a web site that offers you charting and store your curve online. The chart can be evaluated automatically or, even better, by an expert. You can also send the URL of your curve to a doctor and have your own doctor check it.

Member: I tried the BBT but my temperature was always high.

Dr Amos: High really doesn't tell me anything. With a typical ovulatory chart you expect to see a biphasic curve. Biphasic means the temperatures after ovulation stay a little elevated when compared to before ovulation. They can be high or low, that's different from woman to woman. What is important is to check for the ovulatory pattern.

Member: I am 37 and have been told I am in menopause. Will I still be able to conceive and how can I start charting for my ovulation?

Dr Amos: Menopause means your ovaries are not able to release an egg. You not ovulating at all and certain tests being abnormal make the diagnosis. Women in menopause don't ovulate, so there is no real need to chart for ovulation. Whether you can ovulate or not depends on how severe your condition is. Women with early menopause often don't ovulate on their own, and some can ovulate if they get certain medications.

Member: I always forget to take my temperature in the morning, is there a way to make me remember?

Dr Amos: I really don't know what to tell you. If your dh [dear husband] is with you, why not make him responsible for it? Or have a sign next to your bed with big letters: TEMP NOW. I have a small alarm clock that allows you to record a short message. That message is the first thing you hear when the alarm goes off, instead of a sound. On my alarm I have the Beatles singing Here Comes the Sun. So that's what I wake up to. You could record "Get up and temp now" for example. I bet that would work.

Moderator: You could sing, "Get up and Temp" to the tune of Here Comes the Sun.

Dr Amos: Even better.

Moderator: Or, Dr. Amos could sing it for you over the phone into you clock. That would wake you up.

Dr Amos: Absolutely not! Well, maybe.

Member: When doing the BBT, would it be better if your spouse/partner placed the thermometer in the mouth instead of us moving around to get the thermometer?

Dr Amos: That sounds like a really good idea. Many partners feel abandoned when it comes to getting involved in TTC. They often feel the only thing they can participate in are the 30 seconds, when, well, you do you know you what. So they just feel they're being used. Getting them involved, explaining to your partner what it is about, maybe making it into something sexy -- "You know, after you put the thermometer into my mouth maybe later you can place something else you know where!" I bet that would make your spouse more interested.

Member: I've been charting for the first time and my temp fluctuates between 97.6 and 97.9 degrees Fahrenheit, never getting above 97.9. Is this normal -- to have a low temp that fluctuates? I am on CD 16 and nothing above 97.9 so far. Any advice?

Dr Amos: You may not have ovulated yet. It's normal for the temperatures to be around those levels before you ovulate. Once you ovulate the temperatures go up by at least 0.2 degrees. And then they stay up until your next menstrual period comes. If you are pregnant, then the temperatures stay up for 15+ days after ovulation. That's one of the earliest signs that you are pregnant.

Member: So her 97.9 should stay that way until she ovulates, then she will hit 98.1?

Dr Amos: At least 98.1, or more. Often, the temperatures after ovulation go higher than 0.2 degrees. Many times it's at least 0.5 degrees higher.

Member: What is the best time of day to take BBT reading?

Dr Amos: The best and only way to do the BBT is when you get up in the morning before getting out of bed. You should have slept for at least three to four hours. And preferably take your temp around the same hour each day.

Member: Where can I buy this type of thermometer? Are electronic ear thermometers OK to use?

Dr Amos: You often don't need a special thermometer. But some companies make a special BBT digital thermometer. I believe it's less than $15. And you can usually get it in a pharmacy or large store. There are also many web sites that sell it and send it to you.

Member: How can you tell if you're ovulating if you do not have a period, not including BBT charting? My temps are never accurate.

Dr Amos: If you do not have a period then you likely don't ovulate. And if you don't ovulate then your BBT chart is all over the place. There is no clear biphasic pattern when you don't ovulate. Also women who don't ovulate have low progesterone levels.

Member: How do you calculate coverline?

Dr Amos: Good question. The coverline is a horizontal line in the curve that you create yourself. You can only create it after you have definitely ovulated. You create a line between the average temperature before, and those after, ovulation. But even better, you should use an online BBT chart. This chart will usually create the coverline for you automatically. And on one site there are specialists that will do it for you if the chart isn't that clear.

Moderator: To learn more about online resources, post on our pregnancy and conception message boards, where folks can direct you to the sites they've used and like. We, of course, have an ovulation calendar here at WebMD.

Member: I charted at one point. My temperature according to my thermometer was constantly around 89 degrees, then it shot up to 97 degrees one day. My normal everyday temperature is 97 degrees. Was I ovulating then?

Dr Amos: Not necessarily. You would have to have an expert look at the chart to evaluate what's going on. Many women get confused about single day temperature changes. The chart is just a general picture of a curve. A single day change isn't at all important. What counts is the general pattern of the curve, where it's heading.

Member: How many months of using the chart do we need before establishing a pattern of ovulation?

Dr Amos: You can usually know within a month what's going on in general. If you know the length of your cycles and do a chart, you find out shortly what's going on. That will help you identify problems. Many women chart for many months as they TTC. The chart will tell them, and more important their doctor, what's been going on. Learning about your fertility through a BBT chart is a very exciting way to get pregnant. It makes you understand your body and often gives TTC more of a purpose.

Member: My wife's temperatures are very erratic. The chart looks like the edge of a saw. Up down, up down throughout her cycle. Is this indicative of something? The doctor says not to worry, but we've gone through three IUI's and they have failed.

Dr Amos: Well if you got IUI then you must know when ovulation happened. Even with a "seesaw" pattern, many doctors can identify ovulation fairly easily. And charting it online and having it checked by an experienced person can help you tremendously.

Member: I understand that temperature should be measured the first thing in the morning before getting up from bed. Is that true? What if my lifestyle and work is very irregular and sometimes I get up in the afternoon?

Dr Amos: Yes, you must temp before you move and get up. If you don't sleep at night and you don't sleep for at least three to four hours, then taking your temperature may not be for you.

Member: Does climate affect BBT? It seems that when it was hot during this last summer, my BBT was higher than it is now.

Dr Amos: Yes, climate can affect the baseline. But it doesn't matter in general because the pattern counts most. So even when the baseline changes the temperature still goes up when you ovulate. And you can still recognize a pattern.

Member: I've been told that days 10,12, and 14 after the first day of your last period are your most fertile times. We've tried this for four months now. Are we on the right track? Should we keep this up?

Dr Amos: Your fertile days depend exactly on when you ovulate. So when you ovulate on CD 14, then your fertile days to make love are from CD 10-15. If you know exactly when you ovulate you may then see retrospectively if you made love the right days.

Moderator: Thanks to Amos Grunebaum, MD, for joining us this hour. For more information on fertility issues, be sure to explore all the TTC info here at WebMD, including our message boards and regular live chats with Dr. Amos.

Dr. Amos: Thank you for visiting today.

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