How Do I Know if I’m Ovulating? What if I’m Not?
By Rachel Gurevich
If you’re not ovulating, you can’t get pregnant.
As always, go see your doctor if you’re worried about yourfertility. This way, if something is amiss, you can get the help you need faster.
In the meantime, here are a few ways you or your doctor can figure out whether you’re ovulating, listed in order from the least reliable sign to the most reliable sign.
At the end of the list, we’ll talk about what happens if you’re not ovulating… and what to do if you are ovulating, but you’re still not getting pregnant.
If you experience symptoms of ovulation each month, you might be ovulating. Or you might not.
The problem with only relying on symptoms is that they can occur (or not occur) for a variety of reasons.
Take for example increased vaginal discharge – more formally known as cervical mucus.
In most women, fertile cervical mucus does signal ovulation. But some women may not get noticeable cervical mucus due to medications they are taking or because of age.
Other women may get multiple days of fertile quality cervical mucus that never leads to ovulation. This is common in women with polycystic ovarian syndrome, a cause of infertility.
Tracking ovulation symptoms is a good way to time sex for conception. But when it comes to confirming whether or not you’re actually ovulating, it’s not so reliable.
3. Positive Results on an Ovulation Predictor Test? You Are Probably Ovulating.
Ovulation predictor tests look a lot like pregnancy tests. You pee on a stick (or into a cup, into which you dip a test strip), and it measures the level of the hormone LH in your urine.
LH peaks just before ovulation. So if you get a positive ovulation test result, you may be ovulating.
Or… you may not. (I know, it’s frustrating and confusing!)
In women with regular cycles, a positive ovulation test very, very likely signals that they are going to ovulate. It’s a good way to time sex for pregnancy.
However, in women with irregular cycles, a positive ovulation test may or may not signal ovulation.
Women with PCOS may have several LH peaks – so they will get a positive result multiple times throughout their cycle. One or none of those peaks may indicate actual ovulation.
They are more like misfires of the hormone LH. Your body is trying to kick start ovulation – it’s just not happening.
4 . Do You Have Regular Menstrual Cycles? You’re Very Likely Ovulating.
If you have regular periods, you are very likely ovulating. This is the number one indicator that you’re ovulating regularly.
Your menstrual cycles are all about the process of ovulation. So when your menstrual cycle is regular and falls within the normal range of days, that’s a very good sign that things are working well. (At least as far as ovulation goes…)
Your next question is probably – how do I know if my cycles are normal?
The quick answer is that if they are approximately the same number of days each month, and they fall within the range of 25 to 35 days, you’re probably having normal cycles.
Get a more detailed answer here:
What Is an Irregular Period?
One thing to note: some women assume that if they are having regular periods, that this means they can get pregnant.
Remember that ovulating just means the release of an egg – it doesn’t mean that egg is fertilization quality. It doesn’t mean the egg has a clear pathway to the uterus. And it doesn’t say anything at all about your partner’s fertility, and a number of other fertility factors.
Your body basal temperature is your body’s temperature at rest. If you take your temp in the morning, before you get out of bed or even go to the bathroom, you will get your body’s basal temperature.
Charting these temperatures over the course of a month can show you when and if you ovulate. This is called body basal temperature charting, or BBT charting.
After you ovulate, the hormone progesterone increases. This causes your body’s basal temperature to rise.
If you chart your temps, you will see this rise in temperature and know that you ovulated.
How to Chart Your Body Basal Temperature
Everything You Want to Know About BBT Charting
There is a small percentage of the population that ovulates but does not see a rise in temperature on an ovulation chart.
If charting isn’t giving you a clear answer, bring your charts to your doctor to discuss them and your fertility.
6. Are Your Progesterone Levels High During the Two Week Wait? You Are Ovulating.
If your doctor wants to verify whether or not you’re ovulating, he will order a blood test to measure the level of progesterone in your blood.
This is sometimes called a Day 21 Serum Progesterone.
The test is done on Day 21 of your cycle as they are assuming you ovulated on Day 14.
Progesterone levels peak one week after ovulation, and this is what they are looking for with the test.
If your progesterone levels are high on day 21, you are ovulating.
If your progesterone levels are non-existent or very low, you’re probably not ovulating.
Important note: the timing of this test is important!
If you know that you ovulate later (which you may know from body basal temperature charting), let your doctor know. She may be willing to do the test a few days later than Day 21.
However, ovulating much later in your cycle, or having menstrual cycles that are more than 35 days apart, is not a good fertility sign either. Late ovulation has been associated with an increased risk of miscarriage.
7. Did Ultrasound Confirm Ovulation? You Are Ovulating.
When it comes to fertility testing, using ultrasound to confirm ovulation is unusual. A progesterone blood test is less invasive and easier.
However, some doctors may use ultrasound to confirm ovulation. Usually, this is done during fertility treatment, so they can adjust fertility drug dosages, time an hCG trigger shot, or put the brakes on a cycle with too many follicles (potential eggs) developing, which could lead to twins, triplets, or more.
To check for ovulation, your doctor will order a transvaginal ultrasound.
Your doctor can see with this ultrasound the follicles developing and growing over a number of days. After ovulation, the follicles look like partially deflated balloons.
Ultrasound confirmation of ovulation takes place over a number of days.
8. What if I’m Not Ovulating?
If you suspect that you’re not ovulating, talk to your doctor. Don’t wait.
Bring with you a list of your worrisome symptoms, a list of your last menstrual cycle dates, and, if you’re charting your temperatures, your latest charts.
Anovulation is the diagnosis for a woman who is not ovulating.
Anovulation Symptoms and Treatment
If your doctor has already run tests and determined that you’re not ovulating regularly, you’re probably wondering what the next steps are.
Usually, but not always, your doctor will suggest treatment with Clomid. Clomid is a very successful medication, with few side effects, and has a good pregnancy success rate.
However, be sure your doctor checks your partner’s fertility and your fallopian tubes first.
That means a semen analysis for him, and an HSG (a special kind of x-ray) for you.
You may be eager to just move forward with Clomid. But if something else is also keeping you from getting pregnant – like blocked fallopian tubes, or male infertility – then you will have gone through those Clomid cycles for no reason.
No one wants that.
If your doctor won’t check your tubes and your partner’s fertility healthy before prescribing Clomid, go to someone else who will.
Your partner may need to see a urologist for the semen analysis. Then, after the test, you can return to your gynecologist to try Clomid.
It’s worth taking the time to get the basic tests done early.
9. What If I Am Ovulating But I’m Still Not Getting Pregnant?
Remember that ovulation isn’t the only key to conception. It’s just one part of the puzzle.
Also important is the health of the overall reproductive system in both partners.
If you’re struggling to conceive, and you’re pretty sure you’re ovulating, don’t assume this means everything is okay.
See your doctor and get checked out.
Even if you have clockwork cycles, if you’re 35 years or older, and you’ve been trying to get pregnant for six months without success, see your doctor.
Culled from https://www.verywell.com/how-do-i-know-if-im-ovulating-what-if-im-not-1960240