Expert / 21 June, 2021 / Ellie Thompson

The Nitty Gritty Guide to Ovulation

I’ve lost count of the people that have asked me about ovulation, how it works, what happens and what’s normal when. There’s a lot of information out there so I’ve attempted to pull together answers to all the many questions we’ve had, but if there’s an area we haven’t addressed, do email in, and we’ll get one of our resident experts to answer your question. 

What is ovulation?

Ovulation is when one or more eggs are released from one of your ovaries. This happens toward the end of the time you’re fertile between periods. Each month, between 15 and 20 eggs mature inside your ovaries. The ripest egg is released and swept into one of your fallopian tubes. Your fallopian tubes connect your ovaries to your uterus (womb). Your ovaries do not necessarily take it in turns to release an egg. It happens quite randomly.

By Baby Centre

When does ovulation occur?

Many women today have no idea what a normal menstrual cycle is. Many have been on the Pill for 15 years or more so this is hardly surprising. Few women have a 28 day cycle. For some women their normal cycle is short (around 25 days) or long (around 35 days).

The fertility cycle starts on the first day of your period. Many women mistakenly believe that ovulation occurs ‘mid-cycle’.

Only if a woman’s cycle is a regular 28 days does she ovulate mid-cycle, around day 14. If her regular cycle is 25 days, then ovulation occurs around day 11 and a cycle of 35 days means ovulation occurs around day 21. Keep a diary while you’re trying to conceive.

Your diary should record the following:

  • First day of your period (Day 1 of your cycle)
  • Signs of cervical mucus – particularly noting the very fertile clear, wet, stretchy secretions
  • Lifestyle notes – evenings out, alcohol intake, stress at work, travel holidays, etc
  • Use of any medicines – such as painkillers for headaches, antibiotics etc
  • Occasions of full sexual intercourse
  • Libido
  • Physical feelings – abdominal cramps, headaches, energy levels, breast tenderness etc
  • Emotions – your moods. Are you happy, irritated etc?

It’s only after keeping a note of several cycles that any sort of pattern will begin to emerge and will provide you with a record of events which can be helpful in identifying problems such as irregular sexual intercourse, use of medication etc.

By Zita West
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What are the physical signs of ovulation?

Signs of ovulation

A physical sign is an increase in vaginal discharge, which changes from white, creamy or non-existent to clear, stretchy and slippery when you ovulate.

You may also notice other signs, such as:

  • breast tenderness
  • bloating
  • mild abdominal pain
  • slightly increased body temperature
  • increased sex drive
By NHS

Tell us about the exact changes in cervical mucus. What should we expect to see and when?

Cervical mucus is a fluid that is from the cervix. Estrogen helps produce cervical mucus during the first phase of a monthly cycle. Cervical fluid also helps sperm from the acidity of the vagina. Without fertile cervical mucus (or fluid) sperm would die within an hour or so decreasing the chance of getting pregnant.

Egg white cervical mucus (EWCM) is a type of cervical fluid that is produced right before ovulation, during a time when you are most fertile. The mucus is called EWCM because it strongly resembles raw egg white in that it is clear or streaked and is very stretchy and can be watery. By placing your clean fingers into your vagina and obtaining a sample you can check for the appearance of EWCM. When a sample of mucus is between your fingers, it may stretch for several inches and is comparable to egg whites.

Women in their twenties typically have more days of ECWM than women in their thirties. Although it is not always true, women in their twenties will have around 5 days of ECWM and a woman in their thirties may only have one or two days of ECWM. Being that this mucus is necessary for conception you should try to increase the amount you have present. This can be done by preventing dehydration and by using supplements like evening primrose oil.

By Babymed 

What should I be looking for in my cervical secretions?

During fertile times, oestrogen changes cervical secretions to allow sperm to live longer in the woman’s body, and enter the womb more easily. Typically fertile secretions are wetter, slippery and more stretchy. To maximise the chance of conception, sex should occur on days with optimal mucus quality, regardless of the exact timing relative to ovulation.

By Zita West

What is actually happening to my uterus during ovulation?

Ovulation is the name of the process that happens once in every menstrual cycle when hormone changes trigger an ovary to release an egg. This usually happens 12 to 16 days before your next period starts.

  • The eggs are contained in your ovaries. During the first part of each menstrual cycle, one of the eggs is being grown and matured.
  • As you approach ovulation, your body produces increasing amounts of a hormone called estrogen, which causes the lining of your uterus to thicken and helps create a sperm friendly environment.
  • These high estrogen levels trigger a sudden increase in another hormone called LH (luteinising hormone). The so-called LH surge causes the release of the mature egg from the ovary – this is ovulation.
  • Ovulation normally occurs 24 to 36 hours after the LH surge, which is why the LH surge is a good predictor for peak fertility.

The egg can only be fertilised for up to 24 hours after ovulation. If it isn’t fertilised the lining of the womb is shed (the egg is lost with it) and your period begins. This marks the start of the next menstrual cycle.

While an egg only survives for up to 24 hours, sperm can remain active for up to five days. It may therefore be surprising to learn that a couple can conceive through sexual intercourse four to five days before the egg is released.

The total ‘fertility window’, taking into account the lifetime of both the sperm and the egg, is about 6 days.

By ClearBlue

I’m experiencing cramps – just like period pains at what I think is ovulation time. Is this normal?

If you’re like 20 percent of women, your body will send you a memo when it’s ovulating, in the form of a twinge of pain or a series of cramps in your lower abdominal area (usually localized to one side ”” the side you’re ovulating from). Called mittelschmerz ”” German for “middle pain” ”” this monthly reminder of fertility is thought to be the result of the maturation or release of an egg from an ovary. Pay close attention, and you may be more likely to get the message.

By What to Expect 

How do shop LH kits work and exactly how reliable are they?

Ovulation tests work by detecting luteinizing hormone (LH). Just preceding ovulation, women experience an “LH surge” – a sudden, dramatic, and brief rise in the level of luteinizing hormone. Ovulation tests detect the LH surge, allowing you to accurately predict when you will ovulate. A positive result on an ovulation test means that the woman will most likely become fertile over the next three days – with peak fertility at 36 hours following the LH surge.

How do ovulation tests work? At the beginning of the menstrual cycle, the body begins to produce follicle stimulating hormone (FSH). FSH facilitates the formation of a follicle on one of the ovaries. The follicle contains and nurtures the egg. When a follicle has adequately matured, a surge of Luteinizing Hormone (LH) causes the follicle to burst and release the egg into the fallopian tube – the moment of ovulation.

Throughout the menstrual cycle, a small amount of LH is produced – but during the middle of the cycle LH briefly and dramatically increases. Elevated quantities of luteinizing hormone facilitate ovulation – and OPKs detect this LH surge through anti-LH antibodies contained in the sensitive testing membrane of the test.

The LH surge is, alas, very brief – and in order to detect the LH surge, a woman needs to test at the right time of the month – and the right time of day. As LH is produced by the body in the morning, mid-afternoon is considered the ideal time to test.

Once the LH surge has been detected, successful fertilization is most likely to take place one to three days following the LH surge – with peak fertility at 36 hours post-LH surge. Since this ovulation “window” only opens once per month (and the unfertilized egg has a short 24-hour life-span) predicting ovulation accurately is very helpful when trying to become pregnant. Below, you will find information on getting the most out of your ovulation tests (and visit our Ovulation Test FAQ for more testing tips).

How do I determine when to begin testing?

To determine when to start testing, you must first do a little calculating. Use the Cycle Chart below to figure out when to begin testing for your LH surge.

First, determine the average length of your menstrual cycle. The length of the menstrual cycle is the number of days from the first day of menstrual bleeding to the day before bleeding begins on the next period. Determine the usual length of the menstrual cycle over the last few months. Then, refer to the Cycle Chart to determine on which day of the menstrual cycle to begin testing.

Screen Shot 2015-07-07 at 15.51.18

By Ovulation-Calculator

The LH hormone is never being detected via the home kit.

I tested the day before I experienced ‘egg white’ like discharge, and the day itself. Should I be worried?

As the LH surge can be sudden and over in a flash, it is possible to receive a negative result and still ovulate. However, there are testing suggestions to help ensure the accuracy and reliability of tests. Most of these tips are covered in the bulleted points above. Most importantly, start testing when instructions indicate (based on your average cycle length); test at the same time every day; “hold your urine”; do not use a first morning urine sample (use later-day samples). If you have a very irregular cycle, you may consider using an ovulation microscope (which can be used for women with irregular cycles).

Ovulation Test Facts:

  • Ovulation tests detect luteinizing hormone, which suddenly, rapidly, and briefly increases in your system right before you ovulate.
  • A positive result on an ovulation test indicates peak fertility (best time to conceive a baby).
  • A positive result indicates that you will likely ovulate within the next twelve to thirty-six hours.
  • Lovemaking should take place the day you receive your first positive result, as well as the following 3 days after.
  • A positive result is indicated when the test line is as bold or bolder than the control line.
  • You’ll likely only see a positive lh test for just one day, perhaps two, and very rarely for three consecutive days. The duration of the lh surge is not long.
  • LH is produced by your body in the morning; therefore, you should use an afternoon or evening urine sample.
  • Hold your urine for about 4 hours or so before collecting a urine sample.
  • As the LH surge is sudden and passes quickly, some women elect to test twice daily.
  • Try to avoid flushing the body with liquids/frequent urination before ovulation testing.
  • Clomid can cause a “false positive result” if you test too early in your cycle.
  • Ideally, with ovulation tests, collect a urine sample at the same time each day and test daily (do not skip a day during the time you should be testing).
  • Follow instructions and make sure you begin daily testing when required. Women with different cycle lengths will start on different cycle days. For example if you have an “ideal” 28 day menstrual cycle, begin testing on cycle day 11.
By Ovulation Calculator 

Why does sex sometimes feel sore when I’m ovulating? It feels as though I’ve gotten smaller and my boyfriend has gotten bigger!

I would venture that if you only experience pain during sex in your mid-cycle, then your pain is most likely ovarian in nature. As the ovary is ready to ovulate it enlarges. When it enlarges it often moves down into the lower part of the pelvis. As the penis pushes the upper portions of the vagina and cervix it can make the ovary move thus causing pain.

By  Dr Gerard Honore, Healthtap.com

Are there any sex positions that can help us conceive?

Something to bear in mind is that saliva contains digestive enzymes that have a very damaging effect on sperm, so you might want to rethink your foreplay!

If he suddenly ‘read somewhere’ that his favourite position is the optimum one for making a baby, he’s pulling a fast one. Position doesn’t matter, assures Zita.

The most important thing is that you’re both relaxed and enjoying the passion, which gets the hormones surging.

By Zita West

Should I stay lying down after sex and for how long? Does raising your hips or ‘bicycling’ actually help sperm travel in the right direction?

Sitting upside down with your legs in the air isn’t necessary, but try to avoid your usual quick trip to the loo as soon as the deed’s done. ‘Lie flat on the bed for between 15 and 20 minutes to give the sperm time to travel and get to work,’ says Zita.

How many times a week should we be having sex?

The most important thing is regularity. ‘I’d say aim for around three times a week,’ says Zita.

‘The idea is that you’re keeping his sperm flowing and giving it an outlet, which is important for keeping it healthy.’

 By Zita West 
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