I know so many people who rely on OPKs to tell them when they’re ovulating…
But the truth is OPKs CAN’T confirm that ovulation actually happened (and neither can your period tracking app ). Luckily, using the tools in this post can identify if and when ovulation happened.
You might be thinking “but how does this help me if ovulation has already come and gone, haven’t I already missed my window of opportunity?!” I can tell you as a holistic fertility specialist, it helps me a ton to know if and when my patients are ovulating! It helps me to identify patterns in their cycles and where in the cycle they need the most support.
So let’s dive into the 4 ways we can confirm ovulation:
1. Basal Body Temperature Charting
In the follicular phase, basal body temps stay a bit lower. After ovulation, with the help of progesterone & thyroid hormones, temps shift upward and should stay up for the entire luteal phase. A temp rise of 0.2 degrees or more sustained for at least 3 days can usually confirm ovulation occurred. I personally prefer to continue taking temperatures for the remainder of the cycle to ensure they are staying up and to help identify underlying patterns we may want to support.
The chart in this photo gives a clear example of the sustained thermal shift, with ovulation having occurred the day before the rise in BBT.
Basal body temperatures are best taken first thing the morning with a basal temp thermometer that measures to the hundredth degree. Take your temp before you move around, drink any water, or take any meds. Don’t be alarmed that basal thermometers take FOREVVVVVER to take a reading…that’s just what they need to do to be accurate.
Not into waking up at the same time every morning for this? That’s ok, there are a few overnight wearables. My favorite is Temp Drop. Get 10% off Temp Drop HERE. Ovusense is a great option too, but some people don’t like that you have to insert it vaginally overnight.
2. Cervical Fluid (CM) Changes
The influence of estrogen in the follicular phase promotes changes in the fluid produced by the cervix. As one approaches ovulation, cervical fluid should be slippery and wet.
After ovulation, progesterone will cause a drying up of this fluid usually within 24 hours.
When you see a shift from wet to dry AND a temperature shift upward it’s usually an indication that ovulation occurred within the last 24 hours.
Peak day can be identified in retrospect as the day the cervical fluid was STILL wet before turning dry. It won’t necessarily be the day you noticed the MOST discharge. It typically takes 1-3 cycles to get the hang of CM observation, so don’t panic if this doesn’t click right away. Be sure to check out the post on ovulation prediction for a bit more on CM changes.
Tech is also catching up here. The Kegg is a device, that in just a few minutes of being placed vaginally can detect changes in the electrolytes that can tell you whether the CM is fertile. HOW FREAKING COOL IS THAT? It’s relatively new technology and I haven’t had many patients using it yet, but I’ll keep you posted!
3. Test Progesterone
Progesterone= Pro Gestation Hormone, aka you need it to get pregnant and stay pregnant.
We ONLY make progesterone AFTER ovulation. It’s role is to maintain the uterine lining so that a little embryo can implant and start to grow.
For the first 10 or so weeks of pregnancy, the corpus luteum in the ovary is responsible for making progesterone. After this point, the placenta should be able to take over progesterone production.
A blood test 7 days post ovulation can confirm whether ovulation occurred if progesterone is > 4 ng/mL. Ideally most functional fertility specialists want to see progesterone over 10 ng/mL. If progesterone was tested in the first phase (the follicular phase) of the cycle, we expect it to be low, because it is a hormone that is ONLY produced after ovulation and during pregnancy.
At home urine tests can also detect a progesterone metabolite called Pregnenadiol (PdG). These can be a great tool to give more information on the luteal phase and overall progesterone production.
4. Pelvic Ultrasound
After ovulation, a transient vital organ called the corpus luteum forms from the follicular tissue that once surrounded and nourished the egg (oocyte).
The corpus luteum is responsible for producing all that amazing progesterone.
A pelvic ultrasound can detect the presence of the corpus luteum in the ovary after ovulation has occurred.
This type of ultrasound is performed by inserting a wand vaginally and basically probing around to find the uterus and ovaries. This can be a shocker if you thought it would be like the type of ultrasound people get during pregnancy with the probe over the abdomen! If you’ve ever heard someone refer to “Wanda,” THIS is what they’re referring to. It’s uncomfortable, but not usually painful.
Most often these are performed as part of fertility treatment to check baseline follicle counts and leading up to ovulation as part of monitoring hormone supported cycles. It’s pretty unusual that I would order a luteal phase pelvic ultrasound since the temps, CM checking and blood test are less invasive and more cost effective.
Fun fact (but maybe also TMI ♀️): both of my kiddos were made from eggs that were released from my right side. Since I required early ultrasounds in both my pregnancies (bc PCOS with irregular cycles AND a history of ruptured ovarian cysts, long stories for another time)- I got to see the corpus luteum during both these pregnancies. The big hormone and physiology nerd in me loved this!
Are you ready to up your game when it comes to ovulation detection?
I’d love to work with you! If you’re trying to get pregnant, hoping to try in the next 1-2 years or are looking for a better understanding of your hormones and cycles, you’re in the right place.
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