FERTILITY BASICS
Understanding Your Cycle
YOUR MENSTRUAL CYCLE DECODED
Follicular Phase
Part 1 - Menstrual Flow: The lining from the previous cycle is shed. Ideally this lasts 4-5 days.
Part 2 - Ovulation: a rise in LH triggers a release of an egg around CD14. Ideally this occurs around CD12-16.
Luteal Phase
Part 3 - Fertilization to Implantation: If the egg is fertilized, it takes a journey around 7 days long to the uterus and implants in the uterine lining.
Part 4 - If implantation has occurred, HCG rises, doubling every 48-72 hours. Sensitive home pregnancy tests may show a very faint positive at just 9 days post-ovulation (dpo), and most pregnancies will be clearly detectable by 14 dpo. If fertilization/implantation has not occurred the lining will shed signaling the start of the next cycle. Ideally the luteal phase lasts about 14 days.
TRACKING YOUR CYCLE
If you are a TTC veteran you are probably already familiar with the length of your cycle, when you ovulate, etc. If you haven't figured these things out yet, let's get you caught up. I like to keep it fairly simple, and these are the tools I recommend:
It's best to collect data on your cycle over several cycles so that you can identify patterns. Don't overanalyze a single cycle, but look for trends across cycles. Ideally, AF lasts 4-5 days (indicating healthy lining), ovulation occurs around CD 14 (giving lining time to build and egg time to mature properly), luteal phase lasts around 14 days (allowing egg to implant and trigger a shift in hormones that prevents the start of AF). Temperatures before ovulation should be consistently lower than a baseline temperature and temperatures after ovulation should be slightly higher than baseline and remain somewhat stead throughout the luteal phase. Deviations from these ideal patterns can indicate hormonal imbalances or other problems that could interfere with fertility. Jules Bogdanski has written an excellent series of articles describing how to interpret BBT patterns according to Traditional Chinese Medicine.
PLANTING THE SEEDS
if you've tracked our cycle and it's fairly consistent, you will have a pretty good idea of when you ovulate. The goal is to have sperm present and ready at the time the egg is released. Sperm can last up to several days and the egg must be fertilized within 12-24 hours. So intercourse or insemination should happen in the few days up to and including ovulation day. A lubricant like pre-seed can help the viability of sperm. The diva cup and The Stork are also sometimes used for getting sperm where they need to go without intercourse. And some women will use a diva cup after intercourse to help keep the sperm close to the cervix.
Follicular Phase
Part 1 - Menstrual Flow: The lining from the previous cycle is shed. Ideally this lasts 4-5 days.
Part 2 - Ovulation: a rise in LH triggers a release of an egg around CD14. Ideally this occurs around CD12-16.
Luteal Phase
Part 3 - Fertilization to Implantation: If the egg is fertilized, it takes a journey around 7 days long to the uterus and implants in the uterine lining.
Part 4 - If implantation has occurred, HCG rises, doubling every 48-72 hours. Sensitive home pregnancy tests may show a very faint positive at just 9 days post-ovulation (dpo), and most pregnancies will be clearly detectable by 14 dpo. If fertilization/implantation has not occurred the lining will shed signaling the start of the next cycle. Ideally the luteal phase lasts about 14 days.
TRACKING YOUR CYCLE
If you are a TTC veteran you are probably already familiar with the length of your cycle, when you ovulate, etc. If you haven't figured these things out yet, let's get you caught up. I like to keep it fairly simple, and these are the tools I recommend:
- fertility tracking account with Fertility Friend - the free version is sufficient. The mobile app is very user friendly and convenient. You can also print out BBT charts and fill them out by hand, but really the FF program is much more convenient.
- digital thermometer showing temp to the tenth of a degree - take your temperature upon first waking every morning and record it in fertility friend. You should see a temp rise the morning after ovulation and a temp drop just before or upon the start of the next menstrual flow. Don't get obsessive about the details here. We are looking for broad patterns to confirm when you ovulate. I've read that temps aren't accurate if you haven't had a consistent 4-hour stretch of uninterrupted sleep. However, even when very interrupted sleep, I still could see patterns that were meaningful in my temp charts. I strongly discourage setting an alarm clock to wake yourself up to take your temp at same time every morning. Getting natural sleep is more important. Just keep thermometer bedside and take it when you first wake up, before getting out of bed or eating/drinking.
- ovulation sticks by wondfo (on Amazon, cheap and accurate) - You should get a positive reading (both lines dark) 24-48 hours before you ovulate. Less than 50 cents each. Really, don't bother with the expensive ones at the store. Waste of money. You might use a lot of these. Start about 7 days after the start of your last menstrual cycle at first till you get a better sense of your cycle, use one per day....or two per day if you're not catching the positive reading. Some women have a very short LH surge, so testing multiple times per day can be helpful.
It's best to collect data on your cycle over several cycles so that you can identify patterns. Don't overanalyze a single cycle, but look for trends across cycles. Ideally, AF lasts 4-5 days (indicating healthy lining), ovulation occurs around CD 14 (giving lining time to build and egg time to mature properly), luteal phase lasts around 14 days (allowing egg to implant and trigger a shift in hormones that prevents the start of AF). Temperatures before ovulation should be consistently lower than a baseline temperature and temperatures after ovulation should be slightly higher than baseline and remain somewhat stead throughout the luteal phase. Deviations from these ideal patterns can indicate hormonal imbalances or other problems that could interfere with fertility. Jules Bogdanski has written an excellent series of articles describing how to interpret BBT patterns according to Traditional Chinese Medicine.
PLANTING THE SEEDS
if you've tracked our cycle and it's fairly consistent, you will have a pretty good idea of when you ovulate. The goal is to have sperm present and ready at the time the egg is released. Sperm can last up to several days and the egg must be fertilized within 12-24 hours. So intercourse or insemination should happen in the few days up to and including ovulation day. A lubricant like pre-seed can help the viability of sperm. The diva cup and The Stork are also sometimes used for getting sperm where they need to go without intercourse. And some women will use a diva cup after intercourse to help keep the sperm close to the cervix.
