One of the most critical steps in getting pregnant is learning whether you ovulate and when. Conception is much more likely during the ‘fertile window’ in a woman’s cycle, which includes the five days before ovulation and the day of ovulation. These six days reflect the lifespan of sperm (5 days) and that of the ovum (24 hours). However, the likelihood of conceiving is greatly improved in the 3 days leading up to and including ovulation.

When do I ovulate?

Getting to know your cycle and the physical changes that happen throughout will help to determine your most fertile window. The average length of a woman’s cycle is 28 days, but a ‘normal’ cycle length is anywhere between 21 and 35 days. The cycle is counted from the first day of one period to the first day of the next period. Start recording your cycle at least a few months before trying to conceive, so that you can learn more about your cycle and ovulation – I recommend an app, such as the Period Tracker.

You can also learn about your ovulation by paying close attention to the changes in your cervical mucus, measuring your basal body temperature throughout the cycle, as well as using ovulation predictor kits.

       Cervical mucus: Cervical mucus is released from the cervix to nourish and transport sperm and allow for fertilization to occur. A few days before ovulation the vaginal mucous changes and becomes clear, thin, and stretchy, similar to an egg white consistency. Ovulation is likely to occur on the last day you notice this type of discharge.

       Basal Body Temperature (BBT):  Every morning, as soon as you wake up, measure your under-arm temperature with a basal thermometer, while still laying in bed and before getting up. Ovulation corresponds to a rise of 0.5-1 degree Fahrenheit in your BBT. Progesterone is responsible for the increase in your body temperature, which should last until your next period.  

       Ovulation Predictor Kit (OPK): This can help to identify your fertile window. The OPK works by detecting a rise in luteinising hormone (LH) in your urine. LH spikes approximately 36 hours before ovulation, indicating a peak in fertility. I suggest having intercourse the day of the LH spike and 2 days after to optimize fertilization.

As part of the preconception screening, I also offer a variety of tests that can help determine the state of your fertility and how we can optimize your chances of conception.

The following tests should especially be considered if you have been trying to conceive without success:

  1.     Vitamin D – essential for optimal hormone status and overall health of parents and baby.
  2.     Anti-Mullerian Hormone (AMH) – an indicator of woman’s ovarian reserve, typically recommended for women over 30.
  3.     Food sensitivities – can cause a low level inflammation in the body, which can actually affect fertility. Especially important for PCOS patients who are already prone to inflammation. I recommend doing an IgG food sensitivity test.
  4.     Salivary Adrenal Panel – Stress is one of the most common causes of infertility. Unfortunately, most us can’t completely eliminate our sources of stress, but we can get a better understanding of how our adrenals are dealing with that stress by measuring how our cortisol (stress hormone) fluctuates throughout the day. It should be highest in the morning and at its lowest in the evening. Supporting adrenal function and regulating cortisol production will help to improve fertility.
  5.     Hormone testing – Getting pregnant is entirely dependant on your hormones and their fluctuations throughout the cycle. There are a number of tests that can provide us with more information about your hormonal status, including blood, saliva and urine tests.

o   Standard hormone tests (serum)- Estradiol, Progesterone, LH, FSH, DHEAS, Prolactin and Testosterone.

o   Complete Thyroid panel (TSH, free T3, free T4, antibodies; anti-TPO, anti-thyroglobulin) –  thyroid health is vital in getting pregnant and avoiding miscarriages. Screening for thyroid antibodies is part of the autoimmune infertility screening.

o   DUTCH (Dried Urine Test for Comprehensive Hormones) – this urine test assesses parent hormones (testosterone, progesterone, estrogen, cortisol) and its metabolites, which are vital in figuring out the underlying pathology. It also measures melatonin and oxidative stress.

  1.     Genetic testing – The two most common MTHFR mutations are C677T and A1298C. MTHFR genes play an important role in the methylation processes, one of which is the conversion of folic acid into its active form, 5-MTHFR. This active form is needed for DNA production in the fetus. MTHFR can also affect fertility and cause recurrent miscarriages.

The above tests are offered at Markham Integrative Medicine as part of naturopathic preconception screening. If you would like to optimize your fertility and your chances of having a healthy pregnancy and baby, request a consultation with Dr. Tatiana, ND

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