Disclaimer: We do not endorse any one method or brand. We will attempt to remain as impartial as possible and give you the many ways mamas to be can make sure they are ovulating.
- Symptoms: Straight-up symptoms such as breast tenderness, bloating, and one-sided abdominal cramping mid-cycle (a.k.a. Mittelschmerz) are some of the simplest ways to predict if ovulation is occurring. That feeling that you get before you get your period but after you ovulate is due to the progesterone! If you feel this, you are likely ovulating and making progesterone.
- Regular Menses: If your period is more on time than planes landing at O’Hare, you are almost for sure ovulating. The cadence and regularity of the menstrual cycle is set by ovulation—the signals sent from the brain to the ovaries ultimately make their way to the uterus. In response to these signals, the lining of the uterus is shed in a predictable pattern. By association, you can see that, if the ovaries are doing their job and ovulating, then your periods will be regular.
- Basal Body Temperature (BBT) Charting: Your temperature charting looks like a convicted felon’s polygraph test. If there are pretty predictable highs and lows, you are likely ovulating. Progesterone is a “hot” hormone. Therefore, after you ovulate, your temperature will rise. It will remain elevated as long as progesterone is on board. If pregnancy is not achieved, the corpus luteum will break down, and with it, a drop in progesterone and your temperature!
- Cervical mucus changes: Although most of us have not paid any attention to what our cervix is producing before we cared about progesterone and pregnancy, cervical mucus changes are a pretty good way to predict ovulation. The cervical mucus changes throughout the cycle ultimately become a more hospitable and welcoming place for sperm (after ovulation, it goes back to being uninviting once again). The changes are not only evident to the sperm but also evident to you (if you track it from the beginning to the middle to the end of your cycle), if you pay close attention.
- Ovulation Prediction Kits (OPK): It’s hard to walk into a drugstore without seeing an OPK. They seem to hang out next to the pregnancy tests—and as you can imagine, this can be sort of frustrating. Their popularity comes from their ability to predict ovulation and help couples time intercourse. By measuring the LH level in the urine (LH is the hormone that leads to ovulation), you can pretty reliably predict when or if you are going to ovulate. Although a small percentage of women (about 7%) will get a false positive—the test says you’re ovulating but you’re not—for most women, it is a pretty reliable way to predict ovulation.
- Ultrasound measurements: Serial ultrasounds done from pre- to post-ovulation are another way to confirm ovulation. The presence of a large follicle followed by the absence and then the presence of a corpus luteum lets you know ovulation has occurred.
- Progesterone level: The queen of ovulation confirmation is checking a serum (blood) progesterone level. Anything greater than 3 ng/mL (nanograms per milliliter for the science buffs!) in the mid-luteal phase is a positive. Note the boldfaced mid-luteal; timing is important when checking your progesterone. Day 21 is not day 21 for all of us! Make sure to mention how long your cycles are to your doctor before getting your blood drawn. And although we all obsess over what the level is and how high is too high and how low is too low, all we are looking for is a positive result to confirm ovulation.
So you see, there are really plenty of ways to know if your body is producing progesterone. Some are costlier than others, some are more labor intensive than others, and some are more accurate than others. But whatever you choose to check the ovulation box, it’s important that you do something to cross it off the list.
Confirming ovulation is an essential part of any fertility work-up. It may seem basic, but without an egg, there can be no embryo! Good news is that, when women have ovulatory issues, they usually have a ton of healthy eggs just hanging out waiting to be released, and we have lots of ways to persuade those eggs to come out! We just have to see why they are being so shy and what we can do to coax them out of their shell!