Determining Fertility
Q: I'm trying to get pregnant. Is there a way to figure out when I'm most likely to conceive?
Dr. Donnica: The most important way to enhance your fertility is to identify which days are your most fertile, and then to be certain to have intercourse on those days. A woman's most fertile time is the 24-hr period surrounding ovulation; when the ovary releases an egg. If we consider the day you start your period as "Day 1", most women ovulate around "Day 14". The released egg able to become fertilized for about 24 hours; this is your most fertile time. However, not all women ovulate on "Day 14". Some ovulate a little earlier and some later; some women ovulate irregularly. Some don't ovulate at all and don't know it. You can get your period even if you didn't ovulate. Even women who have their period the same days each month may not ovulate the same day each month, however.
Sperm can live inside a woman for about 48 hours. It is crucial for sperm to meet the egg in the fallopian tube in order to conceive. This is one reason we recommend that couples trying to conceive have intercourse every other day around the time of ovulation.
Some women can identify when they ovulate - some feel twinges in their lower abdomen and others may notice clear, stretchy vaginal discharge at that time. There are also four general techniques that have been shown to help women identify their most fertile days. Each of these methods is non-invasive, relatively easy to use, and relatively easy to practice. They vary in cost, convenience, and reliability. They are useful for couples who want to conceive sooner rather than later; for couples trying to achieve certain spacing between their children; and for couples who want to time a pregnancy to come at or around a certain season or around other work or family life events. THESE ARE METHODS TO ENHANCE PREGNANCY, NOT TO BE USED AS RELIABLE MEANS TO PREVENT PREGNANCY.
- Basal Body Temperature: The simple, inexpensive way of finding out the approximate time when you ovulate is to take your basal temperature first thing every morning, before even getting out of bed, and record it on a chart. A slight rise in temperature indicates ovulation, or the time you are most likely to conceive. You can buy a special Basal Body Thermometer at your drug store. Save all your charts so you can review them with your doctor. Three or four months of charting should be adequate.
- Ovulation Kits: There are several commercial home ovulation kits designed to identify when a woman is ovulating. By measuring the amount of luteinizing hormone (LH) in the urine, these kits can predict that ovulation will occur within 24-36 hours.
- Clear Plan Easy Fertility Monitor ™: More than the other two techniques, this product removes the guesswork about when your most fertile days are, thus reducing a significant amount of stress. It is a non-invasive, palm-sized electronic monitoring system designed to identify a woman's most fertile days by testing her urine for estrogen and luteinizing hormone (the two hormones that control fertility) approximately ten days per month. The monitor cues the patient when to test her urine and lets her know her days of low fertility, high fertility and peak fertility. This allows some advance planning. This product is not suitable for women whose monthly cycle is normally shorter than 21 days or longer than 42 days, however. This product costs under $200 to purchase from your local pharmacy without a prescription and additional urine testing dipsticks can be purchased separately if the initial 3-month supply is insufficient.
- The Cue™: This is the newest product to identify peak fertility days. Like the Clear Plan Easy Fertility Monitor, it is a palm-sized electronic monitoring system. Unlike the Clear Plan Monitor, it is based on measuring the electrolyte changes in saliva that accompany ovulation and peak fertility and is able to give up to 7 days advance notice of ovulation. Using an additional vaginal sensor (purchased separately), the Cue will also confirm ovulation on the day it occurs. The Cue costs $385 and the optional vaginal sensor costs an additional $85. The manufacturer, Zetek, will also rent these monitors for $45 per month. A more advanced model, OvaCue is able to store and retrieve data from month to month. This monitor costs $485, plus $85 for the vaginal sensor.
Created: 9/24/2000 - Donnica Moore, M.D.
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 A woman’s most fertile time is the 24-hr period surrounding ovulation; when the ovary releases an egg. 
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