We answer the most frequently asked questions from women trying to conceive. Fertility Nurse Specialist Jane Knight at the Zita West Clinic, has compiled the following questions:
Q. Can you ovulate twice in one menstrual cycle?
A. Yes, but this is not that common. This is what happens in the case of non-identical twins. If a second ovulation occurs, it is always within 24 hours of the first. You would not notice any difference in the timing of your fertile window.
Q. How long can the sperm survive?
A. Sperm can live for 2-3 days inside a woman’s body. However, during the optimum conditions in the few days leading up to ovulation, sperm can survive for up to a week.
Q. How long am I fertile for each month?
A. The vast majority of pregnancies occur due to intercourse in the five days before ovulation and the day of ovulation itself. This fertile window will generally occur earlier in shorter cycles and later in longer cycles.
Q. I have regular periods. Does this prove my ovulation is normal?
A. Regular periods are a good sign, but you will still get a period even if ovulation has not occurred, so they are not necessarily a sign you are ovulating.
Q. How can I be certain I have ovulated?
A. With great difficulty! Currently there are only three ways to confirm that ovulation is occurring: being pregnant; an ultrasound scan showing a collapsed follicle or a blood test showing a raised progesterone level.
Q. What is a progesterone test and should I have one?
A. A progesterone test can show ovulation has occurred, but needs to be taken ‘mid-luteal phase’ meaning about one week after your presumed ovulation, which equates to one week before your next period. This is about day 21 of a 28 day cycle. At this time a raised progesterone level will show that ovulation has occurred. Provided the test has been well-timed, a low progesterone implies no ovulation in that menstrual cycle.
Q. How accurate is temperature at indicating ovulation?
A. An accurately taken waking temperature can give some idea of the possible presence or absence of ovulation and any ovulatory problems, but temperature recordings are not conclusive and can be stressful so are not generally recommended.
Q. Should I use an ovulation predictor kit?
A. Some women find these kits useful, but they should be used alongside an understanding of how your cervical secretions change during your fertile time. An ovulation predictor kit tests for a surge in luteinising hormone. Ovulation normally follows within 36 hours of the LH surge, but a positive LH test does not always indicate that ovulation will follow.
Q. What should I be looking for in my cervical secretions?
A. During the fertile time, the hormone oestrogen from the growing egg follicles changes the quality of cervical secretions to encourage sperm to live longer in the woman’s body, and so enter the womb more easily. Typically fertile mucus secretions are clearer, 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.
Q. I’ve noticed as I get older I have less secretions – is this a problem?
A. Not necessarily. Plenty of water and good quality dietary fats (from nuts, seeds and oily fish) IS. can help. However, it is very important to ascertain whether secretions have diminished due to age, or to other factors such as hormonal imbalance.
Q. The time between ovulation and my period seems to have got shorter. Why is this?
A. As women age, ovulation becomes less frequent and the interval between ovulation and the next period (luteal phase) may be deficient or shortened. This may be a normal part of the ageing process or may have other causes. However, if there are less than 10 days from ovulation to the next period, there is not enough time for a fertilised egg to implant in the endometrium (womb lining).
Q. Which lifestyle factors most impact on ovulation?
A. Stress can have a large impact because it disrupts hormones associated with fertility. Weight fluctuations can also have an impact, and being underweight can be more detrimental to fertility than being slightly overweight. Other health issues such as anaemia and medications can have an impact. As can smoking, excess alcohol and poor diet.
Q. I think I might have a problem with my thyroid. Can that affect fertility?
A. The thyroid gland is like the body’s thermostat, releasing hormones to speed up your metabolism and burn more fuel, or slow down and conserve energy. Issues like stress and illness can affect the thyroid, disrupting its natural processes. And since your hormones are interrelated this can affect fertility.
Q. I’ve just come off the pill. How long will it take for my cycles to return?
A. This varies from person to person. The first month after you stop taking the pill is often a particularly fertile cycle. After this ovulation can be disrupted for a few months in some women. For others it may take longer for ovulation to return to a normal pattern, despite regular periods.
Q. I’m breastfeeding. What affect does this have on my fertility?
A. Breast-feeding suppresses ovulation and it may take a while after stopping breast-feeding for a normal ovulatory pattern to return, despite seemingly normal periods.
Q. Can I time intercourse to affect the sex of the baby?
A. No. When you have sex makes no difference to the gender of the baby.
Q. How often should we be having sex?
A. Three to four times a week is ideal. This will ensure a healthy amount of active sperm is always present to fertilise the egg. Sex should also happen in enough time prior to ovulation for the sperm to ready themselves in the cervix or fallopian tubes.
For more information on ovulation, timing sex to conceive, investigations into ovulation problems or unusual patterns of cervical secretions, you may like to arrange a fertility awareness consultation with Jane Knight, fertility nurse specialist. www.zitawest.com