Ovulation is a convoluted topic, often solely associated with pregnancy. However, ovulation can help you fully understand your monthly cycle ad health. Understanding how to track your ovulation is a bit confusing, but hopefully we can help! In this article, we will review 6 ways that you can monitor your ovulation, so you can decide what method is best for you.
Transvaginal ultrasound (aka “the Gold Standard”)
Transvaginal ultrasounds are the best, and yet most invasive methods for testing ovulation. Using a wand-like transducer, the technician will take images of the follicle in your ovaries. Ovulation is designated as the time the follicle is released from the ovary, and can be shown most clearly through these images (if you’re a professional!) (1). It can be very cool to be so up-close and personal with your reproductive system, and yet it can be quite time consuming and expensive.
Salivary Ferning
Salivary ferning is a very unique method of tracking ovulation that can be a bit harder to understand. If, after careful analysis of your saliva, you see a plant-like structure appear on the slide, you are likely to be ovulating! Although it may seem intriguing to use your saliva to track ovulation, keep in mind that this pattern in saliva is found in many other, non-menstruating populations (1). Additionally, many of the slides you analyzed may be inaccurate, or mis-predict ovulation (1,2).
Basal Body Temperature
Menstrual cycle tracking has long used the infamous “basal body temperature,” because of its ease of use. BBT is primarily used because of the temperature-changing effects of estrogen and progesterone. For the purposes of ovulation, BBT is known to dip slightly below 97-98°F just before the egg is released (1). Following ovulation, temperature raises slightly as compared to pre-ovulation levels.
As often as BBT is used, we should note that taken independently, BBT cannot be relied upon. Body temperature is impacted by a variety of things outside of hormonal fluctuations, including alcohol, illness, etc. (1)! Therefore, if used as a partner to other ovulatory symptoms (i.e., cervical mucus), BBT is a more reliable predictor of ovulation outside of BBT alone!
If you’re interested in using BBT as a way to track your ovulation, our partners at Oura use BBT in partnership with Natural Cycles to track the menstrual cycle! You can find your Oura in our Wild.AI shop!
Progesterone (and things like it)
Progesterone is the primary hormone released after ovulation, in the second half of the menstrual cycle (3). Therefore, ovulation can be confirmed using progesterone levels, though this hormone is often used to indicate the closure of the fertility window.
Progesterone and its Derivatives: When aiming to track menstrual cycle patterns for overall health, in place of fertility, progesterone is a promising hormone. After follicular release, the corpus luteum forms to prepare the uterus for implantation of a fertilized egg. This group of cells releases progesterone to continue the development of the uteral environment (3).
Progesterone measurements can be taken directly, i.e., through laboratory analysis of blood, or indirectly, i.e., measurements of basal body temperature or through the measurement of urinary pregnanediol 3-glucuronide (PDG). Though using PDG often requires the presence of an additional ovulatory symptom (i.e., cervical mucus) (4).
A more direct method of analyzing progesterone is to measure the hormone concentration in the blood. During the follicular phase, progesterone levels are relatively low; however, during the luteal phase, concentrations jump close to five times pre-ovulatory levels. Comparing levels of progesterone with those of estrogen levels, that peak just a day before the LH surge, clinicians can confidently assess the phase of menstruation an individual is in.
Cervical Mucus
Cervical mucus is the cheapest option for tracking ovulation because all it takes is yourself! During times of infertility (i.e., the follicular phase) your cervical mucus is sticky and thick (1). During more fertile periods (i.e., ovulation) your mucus becomes more liquid. This is due in a large part to a increase in extracellular water, and a decrease in sperm-deterring sugars (1). At this point, the mucus at your vulva is likely egg-white-resembling!
Urine LH
The least expensive option (second to the free-ness of cervical mucus) is luteinizing hormone test kits. Late in the follicular phase a drastic increase in LH concentration, encouraged by rising levels of estrogen, causes the release of the egg. This is commonly referred to as the LH surge, and is a relied upon signal of ovulation.
As effective as LH detection may seem, it is variable in when it can be accurately detected. Using blood monitoring, LH peaks 32-44 hours BEFORE ovulation, but when using urinary test kits (as many of us do), the LH surge may lag by close to a day (1,5,6).
Though the accuracy of urinary LH tests has reached upwards of 100% in several studies, peak urinary LH detection of ovulation has been noted to fall close to 12 hours behind that of ultrasonography-detected ovulation (7). This is likely due to the urinary clearance delay noted above, but is an important variable to keep in mind, nonetheless. Due to this lag, it has been suggested that the initial rise in LH is a better predictor of ovulation than the LH peak itself.
Detecting ovulation can be difficult, but using Wild.AI and Oura together can help you fully understand your cycle (including that short ovulatory period). Download Wild.AI here and find your Oura here!
!! The “typical” cycle is assigned an arbitrary length of 28-days. However, cycle lengths are largely variable. !!
Originally published: 21.07.2022
References
[1] Su, Hsiu-Wei, et al. “Detection of Ovulation, a Review of Currently Available Methods” Bioengineering & Translational Medicine, vol. 2, no. 3, 2017, pp. 238–46, https://doi.org/10.1002/btm2.10058.
[2] Berardono, B., et al. “Is the Salivary ‘Ferning’ a Reliable Index of the Fertile Period?” Acta Europaea Fertilitatis, vol. 24, no. 2, Apr. 1993, pp. 61–65.
[3] “Corpus Luteum: Development, Anatomy & Function.” Cleveland Clinic, https://my.clevelandclinic.org/health/body/21849-corpus-luteum. Accessed 8 June 2022.
[4] Ecochard, R., et al. “Use of Urinary Pregnanediol 3-Glucuronide to Confirm Ovulation.” Steroids, vol. 78, no. 10, Oct. 2013, pp. 1035–40, https://doi.org/10.1016/j.steroids.2013.06.006.
[5] Jacobs, Ellis, et al. Laboratory Medicine Practice Guidelines: Evidence-Based Practice for Point-of-Care Testing. American Association for Clinical Chemistry, 2006, https://www.aacc.org/-/media/Files/Science-and-Practice/Practice-Guidelines/Point-of-Care-Testing/POCT-Entire-LMPG.pdf?la=en&hash=FAB661858E6C81B5467B641C99E2EE6BA29D50F6.
[6] Krotz, Stephan, et al. “Prevalence of Premature Urinary Luteinizing Hormone Surges in Women with Regular Menstrual Cycles and Its Effect on Implantation of Frozen-Thawed Embryos.” Fertility and Sterility, vol. 83, no. 6, 2005, pp. 1742–44, https://doi.org/10.1016/j.fertnstert.2004.11.078.
[7] Owen, Martin. “Physiological Signs of Ovulation and Fertility Readily Observable by Women.” The Linacre Quarterly, vol. 80, no. 1, 2013, pp. 17–23, https://doi.org/10.1179/0024363912Z.0000000005.
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