PREDICTING OVULATION   Predicting ovulation is key to successful conception. Methods of understanding your ovulation cycle and timing intercourse increases chances of pregnancy. If this is not the route you are taking, then conventional ovulation methods are also suitable. A woman's monthly cycle is measured from the first day of her menstrual period until the first day of her next period. The average woman’s cycle normally is between 28-32 days, but some women may have shorter cycles or longer ones. During ovulation and egg called the Ovum is expelled from the ovary.  When the hormone estrogen levels drop, this signals the hypothalamus to secrete Gonadotropin Releasing Hormone (GnRh). The pituitary gland is then signaled to release Follicle Stimulating Hormone (FSH), which causes about 10-20 follicles to grow inside the ovaries. Some women require injectable medications such as Menopur and Follistim to increase this hormone production. Other women may just require help stimulating the ovaries by using oral medications such as Clomid or Femara. Methods Calendar method Also referred to as the rhythm method. This method is based on the assumption that ovulation occurs 14 days or so prior to next menstruation. This method is only 91% effective with perfect use, however, this method is the least reliable. A woman would have to maintain a menstrual calendar for at least 6-8 months in order to identify the shortest and longest cycles; using the first day of menstruation as first cycle day (CD), calculate the fertile period by subtracting 18 days from length of the shortest cycle through length of  longest cycle, minus 11 days. BBT method This method is based on thermal shift during the menstrual cycle; temperature drops prior to ovulation, rises at a higher level until 2-4 days prior to next menses, then falls again if no fertilization happens.  This method is 97% effective with ideal use. Remember that this method can be affected by other factors that influence your body temperature such as illness, stress, fatigue, alcohol consumption, or sleeping on a heated pad. Example: Count the number of days between Day 1 of one period and Day 1 of the next period.

In this example, the shortest cycle was 26 days and the longest was 31 days. Subtract 18 from 26 to get the first unsafe day that is Day 8. Subtract 11 from 31 to get Day 20 as the last unsafe day. Therefore, Days 8-20 are the fertile time. Cervical mucus method Also known as ovulation or Billings method. A woman produces a certain type of mucus while she is fertile. This method is based upon cervical mucus changes that occur during the menstrual cycle. The effectiveness of this method is 97%, the same as the BBT method. This method entails assessing your cervical mucus daily for amount, color, consistency, and how thick it is. It is best to have intercourse or insemination for about for days while the mucus becomes more clear, elastic and slippery. Some refer to this mucus as egg whites" just before ovulation occurs and until ovulation is over. This method is only about 80% effective. The cervical mucus method is easy to use and costs nothing, however, be aware of circumstances that affect mucous such as vaginal infections, antihistamines, douches, and STD’s.



. Symptothermal method This method involves assessing multiple indications of ovulation, recording findings, then having intercourse during fertile period. The BBT and cervical mucus method should be used as primary indicators of ovulation. The secondary indicators of ovulation are increased libido, abdominal bloating, midcycle abdominal pain, also called Mittelschmerz, breast or pelvic tenderness. This method is only about 75% effective with typical use. These methods are only used for prediction of ovulation. Ovulation tests or ovulation predictor kits (OPK), are excellent tools for predicting ovulation during, a woman's most fertile time during her menstrual cycle. These tests look for LH surge detection in your urine to determine when successful fertilization will most likely to take place. References:Malpani, Dr. A., (2002). Malpani Infertility Clinic. Cervical Mucus and Fertility. Retrieved from (2009). Retrieved from: Hogan, M.A. (2007). Comprehensive Review For NCLEX-RN. Upper Saddle River, NJ. Pearson Prentice Hall


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